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Authorized but no response from doc



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First I got a denial letter from insurance. A few days later I got a second letter saying the denial had been reversed and surgery was authorized. I waited 7 weeks to hear from my doc who is 4 hours away. I finally called to say what the hell this is taking too long. They said they only had the denial, they did not receive the authorization. The admin assistant also said, oh yeah your paperwork has been on my desk I just didn't know what to do because I hadn't heard from our insurance specialist either. I had to scan and send her my authorization from Cigna. None of this sounds normal and it feels like they're giving me the run around for some reason. I would love some advice how to deal with this because my instinct is to run as far away from this doc as possible and even start over with someone else if I have to.

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Welcome.

How do yo feel about your Doc?

Office staff can be frustrating. Somehow, it seems our paperwork and approval is not as important to them as it is us.

My Docs staff was generally, well, frustrating. I got all my requirements documented and submitted to the Office Insurance Coordinator. She said she would get it to the insurance in a day or two, great. In three or four days, I called the insurance company to 'help' if they had any questions or concerns. No file. I called the office person, oh it's sitting right in front of her, she's putting it together and will get it to the insurance in a day or two. In three or four days, I called the insurance company, and guess what? No file. Grrrr. I called the office again, and oh, they moved the office over the weekend, and the fax machine has not been hooked up. The file is right in front of her, and tomorrow when the fax is working, they'll get it out. A week later, I skipped calling the insurance and called the office. No, they hadn't faxed it yet. But they'll get right on it. If insurance has an issue, they kick it back pretty quick. Two days later, the office called me! I was approved.

Moral of the story is don't take incompetence personally. If you like the doc, stick it out.

Good luck,

Tek

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I don't think the people that work in the offices realize that once we have made a decision to go this route we want it TODAY! When I got approved and we were discussing dates I picked mid September and her response was "Oh, he is on vacation until Oct 9." How dare him! He is out having fun while I'm stressing about waiting 2 more weeks for surgery! So I took Oct 9. I figured he would be well rested and ready to get back to work! All worked out fine! Keep on top of them...you really have to be your own advocate!

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20 hours ago, biskit76 said:

First I got a denial letter from insurance. A few days later I got a second letter saying the denial had been reversed and surgery was authorized. I waited 7 weeks to hear from my doc who is 4 hours away. I finally called to say what the hell this is taking too long. They said they only had the denial, they did not receive the authorization. The admin assistant also said, oh yeah your paperwork has been on my desk I just didn't know what to do because I hadn't heard from our insurance specialist either. I had to scan and send her my authorization from Cigna. None of this sounds normal and it feels like they're giving me the run around for some reason. I would love some advice how to deal with this because my instinct is to run as far away from this doc as possible and even start over with someone else if I have to.

Please try to be a *little* patient with Docs and staff right now, so much backlog is slowing processes down. Especially since you were originally denied, the really might have just put your file to the side and moved on to more straight forward cases. But do stay in constant communication with them now so they know you're serious.

BTW, You must have super patience already since you waited 7 weeks to contact them. I would have contacted them the same day my decision was overturned, picked my surgery date and started my pre-op diet 😆

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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