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The Insurance Decision

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Jessica Lyndsey

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August 19, 2010

 

I mailed back the paperwork I got at the seminar a few days later. The response was almost immediate. The surgeon's receptionist called and told me that AETNA had denied my appeal. I tried to get approval on my own at first but had held out hope that the medical staff had some secret language or handshake that would unfreeze the cold-dead hearts of my insurance benfits reps. Apparently not.

 

She told me I could consider doing it as a self-pay patient. The hospital has a financing plan that approves everyone (with 30% down) and gives you five years repayment time with prime plus 6% or no interest if paid in 1 year. She encouraged me to consider it and told me the next step would be a psych consult if I decided to proceed. I told her it was a lot to process and I'd let her know.

 

I thought it over for a week or so and vaccillated like a mad woman. My mother and friends convinced me to see the therapist, talk about it some more and not make my mind up just yet. Since my insurance covered the psych visit, I figured what the hell... :thumbup:

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Another thing to do is to keep all of your receipts and turn them into the insurance company after the surgery. Have the hospital try to get your pre-admittance approved prior to the surgery (even if it is denied..save the denial). Turn in all of this after the surgery. Appeal the denials...you never know...I was self pay as well. I sent in my receipts and did just what I explained...there were 3 bills...one for the surgeon, one for the anes, and one for the hosp...I got 50% of the surgeon and the anes bill reimbursed and 100% of the hosp bill reimbursed!

If you really want something don't give up...fight, fight, fight! Not all insurance companies work the same way. I fought for pre approval for 2 years prior to having the surgery..then went self pay..then for 10 months fought for the reimbursment. If they would only see how much healthier we can be they would approve it in the beginning!

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