Is It My Insurance Company Or Surgeon's Office That Is Incompetent?

[RobinGirl 34]

I am not sure if its my surgeon's office or my insurance company that can't get it right. My application has supposedly been submitted to Anthem 3 times. The office said they submitted my first application to Anthem CA on January 17, 2012. During this time my company downsized and I opted for COBRA coverage. Unfortunately that caused a hang up and my policy was canceled on Feb 1, but reinstated by Feb 3. Of course during that time Anthem denied my application as I was not insured. Needless to say I was not happy! The office resubmitted my application on Feb 6 for the second time. I have been calling the office once or twice a week to check on the status. All they tell me is that they haven't received word yet from Anthem. Then a week ago she says that they are receiving info back on other patients and I should be approved soon. Well another few days go by and nothing. By this time I am beyond myself and I am beginning to believe that I am getting the shaft for some reason. So I call the office again (I feel like a stalker) and she says that she did call Anthem and guess what- they said to resubmit the application again. This is the THIRD time. I don't know who to believe. Is the insurance company or the Surgeon's office incompetent? By the way my surgeon's office is a Bariatric Center of Excellence so this should not be an issue. I have called my insurance and I can't get through to anyone who can help me. I have been given quite the run around and I am really at my whits end. Has anyone else had this happen? Could it be because I have COBRA coverage? Does Anthem think I will just give up and go away? Any advice would be very helpfull.

[Dukes Mom 0]

I have Anthem also and was approved within a week and also received a letter from the Ins Co stating they are covering it. I also received a letter from nurse/case mgr from Anthem letting me know she is available if I needed to talk. I was banded on 2/8. Good luck

[Ladybug28 73]

The squeeky wheel gets the grease...keep calling the insurance co until you get some kind of explanation. Ask for the person in charge. Everyday if thats what it takes to get some info. I'd be very upset too.....hang in there and KEEP calling! Deb

[RobinGirl 34]

Thank you for your info. I am just so disgruntled. I am tempted to make an appointment with the surgeon just so I can ask her about her incompetent front office staff.

[NWgirl 574]

Call 1-800-824-0581 and follow the prompts. It is the number for Anthem transplant and bariatrics number. You will need to leave a message for Angela if you do not have a case manager containing your insurance #, full name, and DOB. Someone should call you back and at least be able to speak with you.

[RobinGirl 34]

Call 1-800-824-0581 and follow the prompts. It is the number for Anthem transplant and bariatrics number. You will need to leave a message for Angela if you do not have a case manager containing your insurance #, full name, and DOB. Someone should call you back and at least be able to speak with you.

Thank you thank you thank you!!!!

[NWgirl 574]

No problem. I had to call to verify when I was switched to Anthem this year, and they don't really seem to have the number advertised anywhere. I only got it because a customer service person gave it to me. Hope you get things figured out!

[RobinGirl 34]

Stephyanders- Thank you so much for your help, unfortunately that devision of Anthem does not support mine - Elements Preferred. I was able to get through to the correct devision this morning but of course they do not have any information on my case. They suggested that my doctor's office could be sending the info to the wrong department or the like. Argh! I called their office but of course the person I am working with was on the other line and would need to call me back. I am not holding my breath. Is there any other option for me? Should I ask to speak directly with the Doctor (doubt I could get through to her) or call the medical board or the insurance board? I would go to another surgeon but there isn't another BCOE in my area. Should I just go to Mexico and get this over with?

[honk 780]

I am not sure if its my surgeon's office or my insurance company that can't get it right. My application has supposedly been submitted to Anthem 3 times. The office said they submitted my first application to Anthem CA on January 17' date=' 2012. During this time my company downsized and I opted for COBRA coverage. Unfortunately that caused a hang up and my policy was canceled on Feb 1, but reinstated by Feb 3. Of course during that time Anthem denied my application as I was not insured. Needless to say I was not happy! The office resubmitted my application on Feb 6 for the second time. I have been calling the office once or twice a week to check on the status. All they tell me is that they haven't received word yet from Anthem. Then a week ago she says that they are receiving info back on other patients and I should be approved soon. Well another few days go by and nothing. By this time I am beyond myself and I am beginning to believe that I am getting the shaft for some reason. So I call the office again (I feel like a stalker) and she says that she did call Anthem and guess what- they said to resubmit the application again. This is the THIRD time. I don't know who to believe. Is the insurance company or the Surgeon's office incompetent? By the way my surgeon's office is a Bariatric Center of Excellence so this should not be an issue. I have called my insurance and I can't get through to anyone who can help me. I have been given quite the run around and I am really at my whits end. Has anyone else had this happen? Could it be because I have COBRA coverage? Does Anthem think I will just give up and go away? Any advice would be very helpfull.[/quote']

Had surgery with Anthem NY while on Cobra. Approved within a week.