What do you think... my hopes are up...

[Poodles 0]

Have been calling my insurance company all week, as they have been telling me that my file is in "medical review". I finally asked today what that means. The lady said that once it gets thru the first person it goes to a nurse, once it gets past the nurse it goes to a doctor. The doctor then puts the final yes or no on it. It has reached the doctor at this point. My sweet hubby says that it sounds like it has rec'd two yeses at this point and waiting for the final ok from the doctor.

My hopes are WAY up. I hope they don't burst my bubble... what do you think?

[PhotoNut 7]

Sounds very positive to me. Always hope for the best, you might get disappointed but at least you spent that time in a positive happy way, rather than wasting time being worried about things which you can't control. Right?

Oh, and if you end up in need of bubbles, talk to Kim_8. Apparently she is producing them in the back of her throat! LOL

[3loves 0]

I'm right there with you. :wave: I was told to call Fri for a decision. I can't believe it's almost Fri. :bounce: I hope we both get the answer looking for.

[Poodles 0]

OH 3loves, I hope you get it. I just got off the phone with my insurance company again and the lady said that it is still in review. She said that it has made it through to this point, just needs the "final" ok. Hope! hope! hope!

Let me know what you find out today 3loves! Will keep my fingers crossed for you!

[karenj 0]

3 loves..... it is friday, what did you find out? fingers and toes are crossed!

[3loves 0]

Still there with you Poodles. Let's have a toast to sanity b/c I'm losing mine. It's nice to company!!

Are you ready for this? Talked to Patty in PreD dept and she said they STILL haven't gotten to my file and try back next week. :blabla: WHAT??? This is the third time I've been told to call back for an answer. I have been giving them the benefit of the doubt and now I'm confused. Are they really that busy or are they brushing me off? I was so excited when I called that I was shaking a little bit. I just don't understand. I called me DH at work and asked him to speak to HR to see if they would be able to assist in anyway (as long as they think it would not be inappropriate). I don't want to tick them off, but their 7-10 day turn around has turned into 32 days. :think

[karenj 0]

3 Loves, I believe (in texas anyway) that the insurance company has 30 days from the date of the initial request to either APPROVE OR deny your predetermination. You might want to check with your states insurance codes. You should easily be able to find it online! Hang in there, you are very close!

kj

[DonnaB 3]

I say, don't push 'em. If they get annoyed it would be really easy to just write "DENIED" to get it off their desk. Give them some time to check it out. Call back once a week - I'd say mid-week - and just be patient. Just my opinion.

[3loves 0]

Good advice. I am at their mercy and can't afford the risk of ticking them off. Like you said, they could easily stamp a big fat "Denied" on my file. I will hold off till Wed. In the meantime, I will check the state codes. I'll hold unto that info and see what develops next week.

~Poodles~ What day next week are you going to call?

Good golly....I want to be banded! :phanvan

[Poodles 0]

Figure I will call late Monday, or Tuesday. I am calling once a day. Being very polite and saying thank you. Have not pushed any buttons. I always ask if I can call back the next day. I know Mondays are hectic so it may be Tuesday before I can get to it... Just don't think I could make it to Wednesday without checking in. Waiting is the hardest part. Especially when someone else holds your life in their hands...

[Mvpo8961 1]

Can I join this little party. My surgeons office manager sent my first packet into insurance on the 13th of February. On the 21st of February I called and they said it had been received on the 20th and was being processed. Well I called the next day just to verify my information was correct and lo and behold no packet. Called daily for three weeks and it mysteriously never showed up in the computer again. After the insurance co asked me to request a refax on info for the third time I figured something was up. So I called the surgeon's office and they refaxed everything. Received on 3/6 by the insurance co and forwarded 3/9 to the predetermination office. So I am IMPATIENTLY waiting for an answer. I am calling every other day and asking if there has been any action yet. I want to cry everytime I see where someone has been approved. But I'm hanging in there like ya'll are. M:peep:

[3loves 0]

Poodles ~ I don't know if I can wait till Wed, but maybe I'll call Tues and just talk to the regular reps instead of being transferred to the PreD dept. That way, they can check the notes on my file and I'll call back on Wed if they still don't have an answer. Your right, waiting is the hardest part. :cry Keep in touch.

Mvpo8961 ~ I'm glad you posted. Seems like you been through some rough weeks lately. You can't help but wonder if they just tossed your file to the side, if it was lost, or if they actually did't get it. Insurance is so mysterious and my instincts are to question things like this. It is hard to read about someone being approved, yet you are also excited for them. I do believe it will happen for each of us when it's time. I have personally learned so much during this entire process and know that I am a stronger person b/c of it. NOW ~ GIVE ME MY BAND!! Keep in touch and let us know how things are going. It helps to blow some steam here. Thank the Lord for LBT.....it has been a lifesaver for me!! If you need a shoulder to cry on, PM me and we'll cry together. :think

This is all we can do for now. :ranger: :)

[Mvpo8961 1]

Thanks for the shoulder. Everytime I get teary I just look at the Before and After pictures to remind myself why I am persisting. Then I REALLY get teary!!!!!!!!!!!! M:think

[Mvpo8961 1]

Well I just talked to my ins co. My LofPD has been in review for two weeks. They will NOT take incoming phone calls into the PreDetermination office. I wanted to make SURE everything they needed was in my file. They told me if they needed anything THEY would contact the submitting doctor. So I called my doctor's office to see if they had been contacted about needing additional info. They have not been contacted and so believe ins co has everything they need. So I am just waiting now.

Twidding my thumbs, reading on LBT and a wishing time would hurry! M :scared: :typing: :Cry: :pout: :rose: :confused:

[Shelby 0]

Hang in there! Keep in contact with your surgerons office and feel confident that you have done everything you can do. What's meant for you - won't go by you!