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Waiting on the darn letter....

Ok...I am probably going to come across here as very impatient...but I need to voice this.

I was approved last Thursday (January 31st) and I haven't received the approval letter from the insurance yet. They claim it was mailed on Friday from Dallas, Tx. I live in Houston.

The problem is that my surgery is scheduled for 2-13-08 (one week from today) and I have no idea about my pre-op requirements...clear-liquid diet, blood work, pre-registering with the hospital...

The doctor's office is telling me that they cannot proceed without that letter in hand. They won't even talk to me about pre-op. They have already called the insurance company and confirmed that I was approved. Can anyone explain this? Why is this letter so important?

I asked the care coordinator if they could fax the letter to me so I don't miss my surgery date. She told me they could not fax it, but that the doctor's office only needed to call and confirm that I was approved and they should be able to move ahead. EXACTLY! Why do they need a letter to back this up?

GGRRRRRR!!

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I am waiting on the same damn thing. I was approved on January 29th, letter mailed that day, still nothing. My Dr.s office says they have to have the hard copy. So I called my Insurance and they can't fax it, they said the online approval should be fine. UGH! Every day I stalk the mailman waiting to see if it is there and nothing. I feel for you I am in Houston too - and let me tell you, if I knew where my Insurance company was, my happy butt would be in there demanding a hard copy myself. This is insane. Keep me informed, I am not allowed (according to my husband) to call either the Dr.s or the insurance until the letter comes in. Apparently, he believes that since I have all of the arguments already played out in my head that I may just cause a wee problem and tick the wrong person off. So I am not so patiently waiting.

  • Author

Hi minpinmom-

Wow....we are dealing with the same doctor's office!!

I am:

-Racing home to check the mail DAILY at lunchtime.

-Calling the office just to see if by chance they received the letter before

me? :eek:. (ok...only once so far)

-Driving husband (who is having this surgery too) crazy because I won't shut

up about it...lol.

If they can go online and see that it is approved...then print the darn thing and lets get moving!!

The same thing happend to me. The only difference is I didn't and still dont have a surgery date, but they would'nt allow me to come to the surgery orientation to get my date until they had letter in had. It only took a few days for me to get it, but for whatever reason the surgeons office took forever to get it. Same thing as far as them not doing anything, even when the insurance coordinator said that's all they had to do. I emailed my nurse at the surgeons office a copy of my letter, then she scheduled my orientation date. The bad thing about this is the fact that they only offer orientation once a month, so by the time she got my copy of the letter, January was booked up. I had to wait till February 20th...which is coming up. She then said they are booking surgeries four weeks from when I come in because the doctor only does surgery on Wednesdays. :eek:

Believe it or not, it makes me feel better knowing that it is not such an uncommon thing. I was approved on Jan 29, I guess we can watch each other and see how long it takes. Really and truthfully, I thought I would have been banded next week, but this really blows. At least we are approved, we are going to be banded! Hopefully soon.

  • Author

Oh, you guys...this really does suck!!!!!!!

I AM aggrivated. But...looking at the big picture, we are the lucky ones. We have actually been approved already.

I am vowing to be a little more patient. (Ummm....yeah...)

Like I have said before, this shouldn't be this hard for us. It is horrendous. I am surprised half of us don't lose it before this is over. Congrats to you guys for getting your approvals. You are almost there. Hang in there, all of us are crossing our fingers that your mail holds good news today. Good luck.

Wow, I feel really lucky. I was approved on Feb 5 (I had checked on-line), called the surgeon's office, they checked on-line and they made my appointment for Feb 6. I went to my appointment and am scheduled for surgery on March 19.

I have Tricare insurance and am not sure how long it will take for me to get the approval letter in the mail, but I am very glad that the surgeon's office did not make me wait for it.

Good luck to all of you who are waiting.

Lisa in OK

  • Author

Woo-Hoo!! I got my letter today. I am so excited!!

Just so you know, this is how the letter looked:

Dear blah blah:

We have completed your review..........yada, yada...you are covered....yada, yada.....please feel free to call if you have questions or concerns....

Sincerely,

blah blah

All of the hoopla for this????????? LOL

Good luck to you guys still waiting...I will be watching for your reply!

This cracks me up! So, my hubby has vertigo and is in bed, so I sneak in here and get on the phone with Tricare (if you haven't followed my story, he has banned me from calling them again), but when the Cats away . . .

So, I call Tricare and say, gosh, I still haven't received my auth in the mail, since you can't fax it to my Dr. could you fax it to me? She says, oh honey, it was faxed to your Surgeon and your PCM on 1/30 and then again on 2/1 per your request. Stunned, I say, oh wow, thanks, I thought yall couldn't fax on my behalf, she says, it depends on who you talk to yada, yada, yada, anyway, she gives me the fax number and it is to the Houston office and my coordinator is not at that office, the lady takes the fax number to the other office (mind you, she didn't burst into flames when she did it either). Says it will be re faxed tonight to the other office. She also says if I know my PCM very well, I can call them and have them fax their copy.

So, I call the surgeons Houston office, sure enough, the fax machine must have eaten the damn paper - uhm, twice. Whatever. So, I call my PCM, they are going to track down the paper and fax it over. :-)

Hopefully it will get done by one of them tonight and I can schedule tomorrow. ROTFLMAO, because I have thought this EVERYDAY since my approval came through.

Oh, congrats on getting your letter, and people say miracles don't happen!

  • Author

Minpinmom!

Sneaking on the phone?? LOL :regular_smile:. Way to take the bull by the horns!

If the fax machine at the surgeons office in Houston is eating paperwork....oh crap! I've got to give them a call. I just faxed over my "hard copy". They may not have gotten it!!!

Congrats on your news too!

  • 3 weeks later...

I don't know about you guys but I am loosing my entire mind over this waiting crap. I can't do anything or call anyone I am just waiting, and waiting. I waited patiently for 1 week now this is week 2 and I am going a little crazy with anticipation.

OK, time for some fun. I have had my surgery - but still haven't received the letter in the mail! Too funny. I had my insurance company fax and fax and fax until finally the Dr.s office got it. They finally got the approval (via fax), and I was scheduled for preop the next day and surgery 5 days later! Keep calling and BECOME the biggest pain in the butt your insurance company has ever had. (Mine has to log each time I call) waahaaahaaa (Wendy's evil laugh)

Lana24-I feel your pain. It was three weeks for me Tuesday. Just hang in there.

Wendy-I enjoyed your post so much. I had quit calling my ins. company, but you have inspired me to start calling again! Glad all went well with you.

The waiting game is worse than the 6 month diet that many of us had to go through. Personally I don't recommend calling customer service at your insurance company. Let me share with you what mine told me:

I had been waiting 4 weeks for approval. I had called the insurance company on 2/8 but they had a high volume of calls and they would only take my name and number and reason for call. I gave them my name and number and that I was checking the status of the request for pre-authorization. I am still waiting for that callback. Never happened. I tried again this past Monday and got a rep to talk to. Well, he told me that I would likely be denied because I had used an out of network provider for my psych eval (I used the one on the bariatric team doing my lapband). He said I might even have to do the 6 month diet again because I used and out of network dietician (since I needed the diet, I used the dietician on the bariatric team). I nearly went ballistic over the diet (which I had finished in mid January). I said Weight Watchers, Jenny Craig and the like aren't "in network" so what difference does it make that I used a dietician in or out of network. All he would say was stay in network. AND he said that my surgeon did it backwards, that I needed a surgery date BEFORE the request for pre-auth because if approved it is made out for that date. Needless to say I had a complete meltdown. This fool was telling me that the last 8 months of my life were just wasted. At 63 I didn't want to start over. I called the surgeon's office, tried holding, but ultimately had to leave a message for the person who gets pre-auths. After a bit of telephone tag, she caught up with me (I had already written a letter to the surgeon's office with 2 pages of complaints--hadn't mailed it yet). She was calling to tell me I was approved!!!! I am going to a Center of Excellence, so I kind of thought they had done this at least a few times before me. She told me they give an estimated date, then change it when they give me a real date. I also thought that if I wanted to go out of network and pay out of pocket that it shouldn't concern my insurance; one less claim to pay for them (I have Carefirst Blue Choice--Maryland). Obviously it didn't. Beside my weight (currently 236) and my BMI (~37/38) I have just about every co-morbidity except diabetes. I couldn't imagine them turning me down. But according to Blue Choice customer service, that was exactly what was going to happen.

Sorry to ramble on. My point is: call the surgeon's office and speak to the person responsible for sending your paperwork for approval. She will know what is going on more than the insurance company. And I never mailed my letter.

In every experience I have had - dealt with me waiting on the INSURANCE company - as was my Dr.s office. If I hadn't called my ass off every day - I would still be waiting!

I agree - if your Dr.s office is crap and not keeping you updated - call them - but everyone that I have talked to - we are all waiting on the Insurance Company and Lord knows they aren't going to keep you or your Dr.s office updated!

Congratulations on getting your approval - sounds like you have waited a long time for it!

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