Allow me to vent

I finished all of the requirements for insurance on or around 3/3. On 3/4 my insurance company received the paperwork from my doctor's office. On 3/10 my insurance company mailed out a letter to me saying they did not receive the 'coding' for the surgery, and that information from my doctor's office. I had already called my doctor's office and spoke with the claims specialist there because I had called the insurance company prior to receiving the letter in the mail (Hey, I'm impatient and have a busy summer, I really thought I'd have this surgery in March after what the doctor said, after my first consultation with the doctor). The claims specialist was adamant that the correct coding was on page 3 of what she sent them (and after reading a few things here, I definitely believe her because, hey, it's what she does for a living, right?).

So on Thursday, I received the letter dated 3/10, and I went ahead and called the insurance company again to check (thinking that surely by now this was all figured out, because I mean, if she sent it in on page 3, how could they not see it?!). The Customer Service person I got apparently looked though all of the pages sent in by my doctor's office and claimed that there were NO codes... OK. Fine.

I called the claims girl back at my doctor's office and left a message... on Thursday. And Friday. And have called again today.

I have BCBS of TX, and my doctor is Dr. Ronnie Keith out of Norman, OK. He is highly regarded, and came to me from a very good source - good friend is a bariatric nurse at Norman Hospital, so I know she has good authority on the best in our area. However, I really am beginning to think his office staff is overworked and unorganized!

I'M TIRED OF WAITING! Please tell me that this too shall pass, and that any day now I will get the phone call telling me all is good, you are approved, and let's get started on that Pre Op Diet!

Has anyone ever been denied after receiving an initial OK from the insurance company?

I don't have any experience with your situation, but I feel for you. I'm sure it will get worked out. Soon all this will be just a blip on the journey to your new life!

pam

I have gone through all requirements and the Doctor has changed his status with my insurance. He is now out of coverage. So he a week before surgery I'm left trying to find an in coverage Doctor that will take me. Very frustrating!!!!!

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Oh No! That's awful!! I hope you're able to find someone quickly that'll take everything you've done and go with it.

From what my insurance told me, the approval is based on the procedure only. Not the doctor that sends in all of the required paperwork, so you should be able to walk into another doctor's office, and at least be almost done with their requirements - I think most docs work off of what your insurance wants...

Keep us updated

I have gone through all requirements and the Doctor has changed his status with my insurance. He is now out of coverage. So he a week before surgery I'm left trying to find an in coverage Doctor that will take me. Very frustrating!!!!!


Sent from my iPhone using the BariatricPal App