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Advice Please!

Am in need of major support/ advice! My insurance company called me today and told me I was approved for surgery.........but NOT at the hospital I have chosen! They then gave me names of 2 hospitals I would be fully covered at. I called my ins company 3 months ago and gave them the name address and phone number of the hospital I was going to and they said yes it was covered, and when I told the lady that today she said .....sorry you were mis informed;(

So I called one of the hospitals and they said I would have to start from the beginning and they would not except any of my previous testing! And there was no way I'd get in by the end of the year! I have already met my deductables so if I got it this year it would cost $0!!!!

I feel like I've been lied to and cheated out of what I have worked so hard for! What should I do?

Is this a sign I should not do it?

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you should still get it....you said you called one of the hospital, try the other one. the testing they might be talking about is the blood work, ecg, and the pre op testing that the hospital does right before your surgery. I would go down to the hospitals in person with all of your paperwork that you have. this is important, and people are more willing to help you when you are right there in their face vs over the phone. dont take no for an answer!

It's not a sign you shouldn't do it. It is an unfortunate event. Hang in there and start over with the new surgeon. It is tough and I don't blame you for feeling cheated, but you can do it. How much is your deductible, if you don't mind telling us? Please keep us informed. We care.

Have you actually talked to the surgeon? My surgeon decided what testing I needed, not the hospital. Maybe he/she will be willing to work with you. Sassygirl is right; there is nothing like a face to face discussion.

  • Author
you should still get it....you said you called one of the hospital' date=' try the other one. the testing they might be talking about is the blood work, ecg, and the pre op testing that the hospital does right before your surgery. I would go down to the hospitals in person with all of your paperwork that you have. this is important, and people are more willing to help you when you are right there in their face vs over the phone. dont take no for an answer![/quote']

The other hospital is an hour and a half away! But is well worth it! I may just go next week in person that's a great idea!

It's just gonna be a long commute for the after care;(. Very sad.....I actually cried...lol...guess that means I know I'm ready for it!

  • Author
It's not a sign you shouldn't do it. It is an unfortunate event. Hang in there and start over with the new surgeon. It is tough and I don't blame you for feeling cheated' date=' but you can do it. How much is your deductible, if you don't mind telling us? Please keep us informed. We care.

Have you actually talked to the surgeon? My surgeon decided what testing I needed, not the hospital. Maybe he/she will be willing to work with you. Sassygirl is right; there is nothing like a face to face discussion.[/quote']

My deductables is $1500 that is why I'm anxious to do it this year...lol

It's hard to keep a positive attitude when this happens. I really have no one to talk about this to, so talking it out isn't happening! Lol

I agree with sassygirl too. Every hospital will accept test results (labs, x-rays, etc.) from other hospitals as long as you sign a consent form to release the records and you can even bring them with you in person. I work in a hospital and I have done this myself so I know it can be done. I would schedule a consultation with the new surgeon and bring everything with you to the consultation. I know it must be frustrating right now, but I have a feeling that once you are able to meet with the doctors, they will be willing to work with you to get this accomplished as fast and as hassle free as you want too.

Good luck to you.

Can you ask the insurance company to treat your preferred hospital as in-network? It seems ridiculous to have to drive 1.5 miles for your aftercare. I would definitely try to work it out with the insurance company. Perhaps you can enlist the help of your employer's HR department/insurance administrator?

They can make exceptions sometimes.

You have us to talk to about it!

The other hospital is an hour and a half away! But is well worth it! I may just go next week in person that's a great idea!

It's just gonna be a long commute for the after care;(. Very sad.....I actually cried...lol...guess that means I know I'm ready for it!

my hospital and doctor was 2.5 hours away...I wanted the surgery, that is where my insurance said I would be covered...that is where I went, nuff said :)

you want it honey, then travel :D

  • Author

Update.....I am still in...yay!

I will be going to the hospital 1 1/2 hrs away but sooo worth it! They are gonna except all preop testing, but they will have to resubmit to insurance after

I meet the dr. Which is on sept 27, then they want me to take 2 of there nut visits then surgery time!

I am just so happy it's still this year! Even though I would have had it in oct at least it's still gonna happen!

Thank you all for your support!

Update.....I am still in...yay!

I will be going to the hospital 1 1/2 hrs away but sooo worth it! They are gonna except all preop testing' date=' but they will have to resubmit to insurance after

I meet the dr. Which is on sept 27, then they want me to take 2 of there nut visits then surgery time!

I am just so happy it's still this year! Even though I would have had it in oct at least it's still gonna happen!

Thank you all for your support![/quote']

Yayyyy!!!!! I'm so excited for u!!! Well they r submitting to insurance on Monday for me. The nurse a d schedule coordinator didn't relay the same info to me. Basically Sept 17th will be a follow up not pre open appointment. I'm staying positive. I can wait. Hopefully I get approved super fast. Soooooo happy for u that u don't have to start allover again!!

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