Why do they wait until the last minute!

[MelJ113074 0]

Hey Guys,

It's Melissa. I'm freaking out about how my surgery is scheduled for 1 week, 2 days away and I have yet to even hear if my insurance is approved. My insurance company said they just received the info on last Friday. Plus my Pre-admin testing (EKG) yielded some heart abnormalities and now I have to meet with a cardiologist on Wednesday.... 1 week before I'm susposed to have surgery.

I think I just have this feeling in the pit of my stomach that I'm going to be denied. I only started this process less than 2 months ago. I'm not sure, but I think my insurance said something about a 3 month physician supervised diet. If I find out I have to wait another 3 months I'm going to lose it!

Just wish me luck with my insurance and my cardiologist appt. May 5th will be here in no time.

Oh yeah! I have Aetna in NJ. If anyone has any experiance with that let me know.

Take care,

Mel

[Manda87 3]

I honestly don't understand why your DOCTOR doesn't wait until you are approved to schedule the surgery. Many doctors do this and I believe it's because they care more about your money than the actual patient. That just drives me crazy. I'm glad my doctor's office had a enough sense to wait until they heard from the insurance company.

You need to talk to your doctor and ask him why they aren't waiting to schedule the surgery until they hear from the insurance. PLUS, you should have gone to the cardiologist BEFORE your paper work was submitted.

I wish you good luck. I'm sorry that you have to deal with such insanity!

[Laura Lane 0]

patience, patience, i am sure you'll do fine!!! keep us posted and goodluck!!!:thumbup:

[monkeymama 0]

Melissa- I can empathize with what you are going through...

My surgery was also delayed due to cardiac issues. I had an abnormal stress test so I had to get a nuclear stress test (which thankfully was fine)... the delay was about two weeks. In hindsight (my surgery is tomorrow) I kind of appreciate the two weeks extra I had to prepare.

As far as having a surgery date- when the surgeon submits the paperwork he/she sometimes puts a date on there but it really is a "dummy" date- just to get things along. I think that's weird they set a real date before approval. Are you doing a preop diet? Which surgeon are you using? (Im in Jersey too)

Hey Guys,

It's Melissa. I'm freaking out about how my surgery is scheduled for 1 week, 2 days away and I have yet to even hear if my insurance is approved. My insurance company said they just received the info on last Friday. Plus my Pre-admin testing (EKG) yielded some heart abnormalities and now I have to meet with a cardiologist on Wednesday.... 1 week before I'm susposed to have surgery.

I think I just have this feeling in the pit of my stomach that I'm going to be denied. I only started this process less than 2 months ago. I'm not sure, but I think my insurance said something about a 3 month physician supervised diet. If I find out I have to wait another 3 months I'm going to lose it!

Just wish me luck with my insurance and my cardiologist appt. May 5th will be here in no time.

Oh yeah! I have Aetna in NJ. If anyone has any experiance with that let me know.

Take care,

Mel

[MelJ113074 0]

I'm in South Jersey close to Philly, so I'm having the procedure done at U Penn. My surgeon is Dr. Korus. I'm really all prepared, so I hope there's no delay. I already told my employer I needed those 2 weeks off.

Oh well I'll just hope for the best,

Thanks guys

Melissa

Melissa- I can empathize with what you are going through...

My surgery was also delayed due to cardiac issues. I had an abnormal stress test so I had to get a nuclear stress test (which thankfully was fine)... the delay was about two weeks. In hindsight (my surgery is tomorrow) I kind of appreciate the two weeks extra I had to prepare.

As far as having a surgery date- when the surgeon submits the paperwork he/she sometimes puts a date on there but it really is a "dummy" date- just to get things along. I think that's weird they set a real date before approval. Are you doing a preop diet? Which surgeon are you using? (Im in Jersey too)

[BetsyB 9]

How frustrating! I hope, by now, you've gotten good news.

My surgeon won't schedule surgery until clearance is given---otherwise, it would be a scheduling nightmare!

I'm always surprised when doctors' offices do schedule in advance of approval. Talk about unnecessarily increasing patient anxiety!

[AnneGG 0]

My surgery has been scheduled before insurance approval, too, but I've completed all my pre-op requirements except for one nutrition class I will be going to this afternoon, I have excellent insurance, and they have given it a month- May 26.

It does sound rushed in your case. Good luck!

Edited April 29, 2010 by AnneGG

[Rsilversea 2]

My doctor has also scheduled my surgery in advance of approval. He's never had problems with anyone with my insurance getting approval but they are dragging their feet in my case. My doctor is thinking he will have to reschedule my surgery and if, by some bad stroke of luck, my insurance denies me he's going to appeal.

[MelJ113074 0]

OK here the latest and greatest"ish".

I had the appt with the cardiologist and I'm a OK. Actually they told me I was pretty boring and sent me on my way.

Then later in the day I spoke with my insurance and the let me know the only thing they're waiting on to make a decision is a 2 year weight history. What am I susposed to give them for that? I didn't go to the drs that often, so I don't have very many weights by him in the last year. I'll talk to the surgeons office tomorrow. My surgery is less than 1 week away and I'm still waiting for approval. Hopefully by Friday I'll know.

Take care,

Melissa

[jdonnajay 0]

Hey Guys,

It's Melissa. I'm freaking out about how my surgery is scheduled for 1 week, 2 days away and I have yet to even hear if my insurance is approved. My insurance company said they just received the info on last Friday. Plus my Pre-admin testing (EKG) yielded some heart abnormalities and now I have to meet with a cardiologist on Wednesday.... 1 week before I'm susposed to have surgery.

I think I just have this feeling in the pit of my stomach that I'm going to be denied. I only started this process less than 2 months ago. I'm not sure, but I think my insurance said something about a 3 month physician supervised diet. If I find out I have to wait another 3 months I'm going to lose it!

Just wish me luck with my insurance and my cardiologist appt. May 5th will be here in no time.

Oh yeah! I have Aetna in NJ. If anyone has any experiance with that let me know.

Take care,

Mel

i have blue cross/blue shield of nj-direct access...your lucky if you only had to do a 3 month documention diet..i had to do a 6 month plus, i had to send in all the doctors notes for the past year..insur didnt want to see a letter, the actual doc's notes is what they wanted..good luck

[jdonnajay 0]

OK here the latest and greatest"ish".

I had the appt with the cardiologist and I'm a OK. Actually they told me I was pretty boring and sent me on my way.

Then later in the day I spoke with my insurance and the let me know the only thing they're waiting on to make a decision is a 2 year weight history. What am I susposed to give them for that? I didn't go to the drs that often, so I don't have very many weights by him in the last year. I'll talk to the surgeons office tomorrow. My surgery is less than 1 week away and I'm still waiting for approval. Hopefully by Friday I'll know.

Take care,

Melissa

i had to go to my doctors every month for 6 months...(i went over a year). everytime i went, i asked for a copy of my notes each time..my surgeon's office summited the actual notes, that stated wt, blood press., what my diet was, and what kind of exercise i was doing. my insur., want no less then that. i was appoved last week, tentative date may 18. good luck

[MelJ113074 0]

I'm just so confused!!!!:thumbup: So yesterday I talk to the insurance company and they tell me the ONLY thing the need to make a decision is my weight for the last 2 years. At first I freaked becasue then my BMI was about 37 and rising, but I have a co-morbidity (sleep apnea), so it only has to be > 35. OK So I should be in the clear right??? Wrong. When I got home I had a letter from Aetna telling me they needed other crap I didn't have (3 month diet, a 6 month something else). Now if they know I don't have those things wouldn't they just deny me then and there instead of waiting for the 2 year history. I mean that would be the humaine thing to do. I don't know why they're waiting until Monday (48 hrs before the surgery) to tell me I'm denied for something they already know I don't have and didn't ask me for when I talked to them on the phone!

Oh well I'm done for now. Hopefully I'll be back on Monday GLOWING!!!!

Take care,

Melissa

[monkeymama 0]

Melissa- I would go by what they told you on the phone yesterday. If you got the letter yesterday as well that means it was mailed out latest the day before so what they told you on the phone is the most current. Good Luck!

[MelJ113074 0]

UGH!!!! I'm ~36 hrs away from surgery and I STILL don't have an answer from the insurance company...

This isn't looking good.

[MelJ113074 0]

FINALLY!!!!! Today at 11:30am I got the call saying I was approved. Nothing like taking it down to the wire!!!

Take care all. I'll be banded in the AM!!! YEAH

Melissa