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Surgeon office delays?

I have now completed every requirement needed to put in the insurance authorization request. My surgeon's office confirmed to me that they had everything they needed from me one week ago. Needless to say, I'm excited! In addition, many on this forum with the same insurance have stated that they have been approved as quickly as 1 day. In my initial call to my insurance company (6 months ago), they stated usually 5 days... but admitted that sometimes it's quicker than that.

I called my insurance company again today to double check my coverage and status. To my surprise (and dismay) I was told that they had not yet received any authorization request from my surgeon's office. In addition, the individual I spoke to checked with another office to see if it was received but not yet entered into the system. They said no.

So, I called my surgeon's office and spoke to my insurance coordinator. I asked her if there was anything else she was waiting on from me. Instead of answering my direct question, she seemed to be a bit coy and annoyed that I asked. She simply said.... “I told the dietician to let you know what was needed”. I explained to her that the dietician told me that they had everything needed to put in the insurance authorization.

So, I asked her again if she had everything she needed to file the insurance authorization. She said..... "yes, but don't expect to hear back from me for 2 weeks". I asked her if she had yet filed the authorization with the insurance company, but again she simply stated that it would take 2 weeks. I tried to be as professional as possible. I told her I understood, but just needed to know whether the paperwork was sent in. After my 3rd attempt at getting an answer, she said "yes", but did not tell me when. Needless to say, she was a bit impatient with me.

So... it's either lost, still in transit, or I'm not being told the truth. Since I don't own a crystal ball, I've learned to give folks the benefit of the doubt. Still, am I being unreasonable for asking questions like these?

UGH!

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  • Well, I ended up "escalating" this do someone higher up in the office this past Monday. She called me back and told me that the IC had faxed the auth request to UHC the previous Friday. I just con

  • SweetnCurvy
    SweetnCurvy

    Omg! That is my EXACT insurance! Yeah they were REALLY swift in giving me an auth number. Idk whats up with ur surgeon's office but the way they are acting is not right. I think u should stay on that

  • I received similar response/attitude from the referral coordinator at my PCP's office. She always acted like I was annoying the hell out of her just because I had questions and would call to follow up

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I have now completed every requirement needed to put in the insurance authorization request. My surgeon's office confirmed to me that they had everything they needed from me one week ago. Needless to say' date=' I'm excited! In addition, many on this forum with the same insurance have stated that they have been approved as quickly as 1 day. In my initial call to my insurance company (6 months ago), they stated usually 5 days... but admitted that sometimes it's quicker than that.

I called my insurance company again today to double check my coverage and status. To my surprise (and dismay) I was told that they had not yet received any authorization request from my surgeon's office. In addition, the individual I spoke to checked with another office to see if it was received but not yet entered into the system. They said no.

So, I called my surgeon's office and spoke to my insurance coordinator. I asked her if there was anything else she was waiting on from me. Instead of answering my direct question, she seemed to be a bit coy and annoyed that I asked. She simply said.... “I told the dietician to let you know what was needed”. I explained to her that the dietician told me that they had everything needed to put in the insurance authorization.

So, I asked her again if she had everything she needed to file the insurance authorization. She said..... "yes, but don't expect to hear back from me for 2 weeks". I asked her if she had yet filed the authorization with the insurance company, but again she simply stated that it would take 2 weeks. I tried to be as professional as possible. I told her I understood, but just needed to know whether the paperwork was sent in. After my 3rd attempt at getting an answer, she said "yes", but did not tell me when. Needless to say, she was a bit impatient with me.

So... it's either lost, still in transit, or I'm not being told the truth. Since I don't own a crystal ball, I've learned to give folks the benefit of the doubt. Still, am I being unreasonable for asking questions like these?

UGH![/quote']

Omg what a nightmare! The ins coordinator sounds like a piece of work. By any chance is ur insurance UHC?

  • Author

Indeed. UHC Choice Plus.

Indeed. UHC Choice Plus.

Omg! That is my EXACT insurance! Yeah they were REALLY swift in giving me an auth number. Idk whats up with ur surgeon's office but the way they are acting is not right. I think u should stay on that coordinator and if u live relatively close to the surgeon's office, go down there so.they can see how serious u are about improving ur life. They should have submitted by now and u should be approved by now...so sorry this is happening

  • Author

Well, I ended up "escalating" this do someone higher up in the office this past Monday. She called me back and told me that the IC had faxed the auth request to UHC the previous Friday.

I just confirmed with my insurance that they indeed have the auth request, but they didn't received it until Monday. Either way, mission accomplished. Wish me luck!

Thats great!! Like I've said before "WE NEED TO BE OUR OWN ADVOCATE WHEN IT COMES TO OUR HEALTH".. I have one of those insurance coordinator's in my surgeon's office but it took me telling the surgeon that I was going to change surgeon's for her to move her butt and then call me 10 minutes after leaving the office to tell me she would be submitting my paper work.. So I'm so happy that you were able to get things moving along to start a new life, a healthier life..

So glad to hear the request was received!:)

Omg! That is my EXACT insurance! Yeah they were REALLY swift in giving me an auth number. Idk whats up with ur surgeon's office but the way they are acting is not right. I think u should stay on that coordinator and if u live relatively close to the surgeon's office' date=' go down there so.they can see how serious u are about improving ur life. They should have submitted by now and u should be approved by now...so sorry this is happening[/quote']

How long did it take for your approval. I also have UHC

How long did it take for your approval. I also have UHC

I was approved in one day, they submitted in the morning and by afternoon I was approved.

I received similar response/attitude from the referral coordinator at my PCP's office. She always acted like I was annoying the hell out of her just because I had questions and would call to follow up on things being sent to insurance. It's their job-they shouldn't act like that! However, I just try and remind myself that getting insurance approval and surgery is not as important to anyone as it is for me! Do whatever you have to do to get your goal accomplished! Good luck! :)

  • Author

Today I get a voicemail from UHC "Treatment Decision Support". Here's what I learned from them:

With Treatment Decision Support, you have access to nurses who can provide information about conditions like back pain that can be treated in more than one way. The nurses can help you understand your treatment options, and connect you with quality physicians. Treatment Decision Support nurses can also explain what you can expect during your treatment.

I was a bit leery about sharing info because... well... I wasn't sure who they were. My guess is that they are hired by UHC (or my employer in conjunction with UHC) to have me consider alternatives. The synical side of me thinks it was a money saving call... but who knows for sure.

Of course, the non-synical side of me is willing to hear other possible reasons, especially from those who have spoken to this group before :-)

Something similar happened to me! I understand what you are going through! I will now pray for both of us that this all works out! Lol

This must be a requirement, because I am going through the same thing also. The coordinator was wonderful until I called and asked about my paper work? What's up with that? She actually got PO'd that I called the insurance company to see if she turned in the paper work. She had the nerve to ask me why I called them. I had to inform her this was my insurance and I was the one who was having surgery. Go figure.

  • Author

I called UHC today. Evidently my request was entered incorrectly. It was marked as out-patient instead of in-patient, causing a delay. Hopefully I can get an approval in the next couple of days.

  • Author

Got approved today. I'm told that the next step is for the nurse to take a look at my chart, review it and sign off on it. Once that's done, they'll pass it over to the scheduler to set up a surgery date.

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