Question:
Am I in charge of my insurance or is the nurse at the doctors office?

I AM SOOO FRUSTRATED RIGHT NOW....I CALLED THE DOCTORS OFFICE TO SEE IF THEY HAD TURNED IN MY PAPERWORK TO MY INSURANCE COMPANY AND THE NURSE RUDELY SAID, " WE DISTINCTLY TOLD YOU THAT WE WILL TAKE CARE OF THIS AND IT WILL TAKE 6 WEEKS....IF YOU CALL YOUR INSURANCE CUSTOMER CARE LINE THEY WONT KNOW DIDLEY ABOUT ANYTHING, WE SEND THE PAPERWORK TO A SPECIAL DIVISION OF YOUR INSURANCE COMPANY..." THEN I ASKED IF I COULD HAVE A FAX # OR SOMETHING TO CONTACT THEM AND JUST ASK IF THEY HAVE RECIEVED THE PAPERWORK AND SHE SAID NO! GRRRRRRRRRRRR.....IVE HEARD SO SO MANY STORIES ABOUT PAPERWORK DISAPPEARING INTO OUTER SPACE......WHAT SHOULD I DO?? BE PATIENT AND WAIT SIX WEEKS AND HOPE EVERYTHING WAS DONE PROPERLY OR TAKE CHARGE OF THE INSURANCE (THAT I PAY FOR)?    — Karen W. (posted on October 8, 2002)


October 8, 2002
You have every right to call the insurance company to check on the status of your paper work, do not let a rude clerical worker make you feel like you are not allowed to contact your insurance that you pay for. If she continues to be rude I would ask nicely and then demand to speak to your surgeon about her behaviours.
   — Melody M.

October 8, 2002
You are. By the way, one of the reasons I changed my original surgeon was becasue of his inept and non-compassionate office staff. There is no excuse for rudeness. Especially not when the surgeon is going to make a mint off of you.
   — PaulaM

October 8, 2002
I found out who the person was at my insurance agency (SuperMed Plus of Ohio) who was going to be making the decisions on my case. I got on a first name basis with her actually, and when the decision came through that the insurance company was going to pay for it, she called me personally at home to explain what would happen next. I encourage you to contact your insurance company and get someone who will talk to you like a human being, not a disembodied voice at the other end of a phone line. And do think about looking for other surgeons--mine was great, and his staff was too.
   — Carla C.

October 8, 2002
Most physicians offices take care of the paperwork because they will have to submit it anyway. Some patients call their insurance to find out what is needed for approval but bottom line is it always goes back to the doctor's office needing to submit the paperwork with the medical profile, tests, etc. I also had a surgeon's office staff like yours, they acted like they were doing me a favor. I finally asked for the phone number they had called at my insurance company, then called myself, to be told they had no record of a request on my behalf. I ended up getting my PCP and Orthopedist to submit records on my behalf, then calling my surgeon's office at least a dozen times (they never called back and one person told me "If you don't like the way we do things here, you can go somewhere else.") I finally wrote a "Personal and Confidential" letter to the surgeon; things moved more quickly after that. In the end, I switched surgeons because I was still going to have to deal with these people after the surgery and didn't feel it was worth it. Good luck to you.
   — Arlene S.

October 8, 2002
You, you , you are in charge of anything to do with your surgery.If that lady gives you any more lip, ask to speak to her supervisor. If that doesn't help, ask to have the surgeon call you ASAP. And if they don't like it, I would find another doctor quickly. I had a bad experience with a surgeon's office too and have changed surgeons. I am very pleased with the response I have received from Dr. Martin's bariatric assistant Anne. Good luck!
   — LM O.

October 8, 2002
Again Karen, they are giving you the bull! I would ask to speak to the supervisor and if I didn't get satisfaction I would ask to speak with that persons supervisor and go to the top until I got satisfaction. Everyone answers to someone. You need to get tough and TELL her that YOU have every right to know exactly what is going on with your precertification. My surgery was approved in 2 days, but it took too long for them to get the paper work there. I called daily until it went in. Then I called the ins company to make sure it was received. Also when I had plastic surgery, called and found the contact person at the insurance company. I have a "special division" also being on a Cobra plan. There is still someone that can answer your questions. It's YOUR insurance and your life, not hers, she sounds controling and I personally wouldn't put up with it. Get tough!
   — ZZ S.

October 9, 2002
Last I checked, I payed for my insurance, not the surgeon's office or his staff. They could be a little more compassionate considering your insurance money is paying her salary.
   — J. W.

October 9, 2002
I would be livid if I recieved that haughty of a response from someone I was trusting with the paperwork. I called my insurance company and made sure they got the paperwork. I called a week later to check on the review progress, and they told me it had been approved. The approval letter was in the mail. I say call your insurance yourself, and find out if they have your file. Calling your insurance won't push any more buttons in the Doctors' office, and maybe you will know before them when you are approved. Also, You need people that are working for you, because sometime it takes another letter to get a good result.
   — Tricia J.

October 9, 2002
You not only pay for your insurance but you also pay highly for your surgeon and his staff. You have the right to call your insurer and your physicians office whenever you care too! Physicians and insurance companies are wealthy due to customers and patients. They can be rude as hell but it's still YOUR insurance, YOUR money and YOUR time! I called my insurer every day until I got an answer. It may be annoying to them but we are paying for these services! She was in the wrong by telling you that you could not have the fax or phone number--no excuse for rude, disrespectful behavior!
   — jenn2002




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