Can I just blow some steam about insurance?

[3loves 0]

:hurt

My insurance rec'vd my L of PreD on 2/14/06. They told me 7-14 days for a decision. Last week I called, as I have every week since then, and apparently they have been short-handed and should have a decision this week.

Today the lady from the PreD called me after I had LMOR (left message on recorder) for her. She told me to call back on Friday and they should have a decision b/c they are now making progress. I thanked her and told her I didn't want to be a pest, but I was anxious. She kindly said I wasn't coming across as such and just call on Fri.

This is DRIVING me CRAZY!

I understand being short-handed and even have a bit of sympathy for them. Some of you may think that's insane to feel that way about an insurance company, but they are always so nice a professional. They even call me back! :clap2:

The Lord is teaching me patience and I haven't waited near the amount of time some of you have. I just know that my surgeon is scheduling 2-3 mos out and I want to get a date.

Thanks for letting me rant. I feel better getting this off my chest. I told my DH and he smiled and said he would be O.K. :tired

Can't wait to post my surgery date or heaven forbid, my denial letter!

[Angels 0]

United Health Care (MDIPA) has a 48 hour processing time for review and determination, which they met. However, just getting the customer service reps to provide complete and accurate information is a big problem. I have written to the CEO, Mr. Thomas Barbera regarding the fact that his employees need training and need to be fully aware of all covered benefits along with the entire process from start to finish. So that when speaking to the reps you get consistent accurate information. As a result of the misinformation it almost caused me to lose out on getting all the required documentation in within the 45 days. Because once you submit any correspondence it starts the clock ticking. Praise GOD with lots of hardwork, support of my PCP I got all required documentation in 3 days prior to March 6, 2006, expiration date and got APPROVED!! My surgery date is 4/4/06. I hope you get everything resolved and get a date but be persistent like I was because this is your destiny and those customer service reps have no compassion at all!!

[sarahv 0]

Look at it this way - you could have some other insurance company who scoffs when you asked them about coverage of this kind!!

I get your frustration - I really do - but consider how much worse it could be and thank God that you are fortunate enough to have the right insurer!

I pray for patience(for us both= ))

Good Luck with your approval and banding!!!

[3loves 0]

~Angelu~ Sorry you had such a hard time. :cry From what I've read, it's not unusual to experience problems with insurance "communication". I had 2 reps tell me that turn around time was 30 days....according to the PreD dept, it's only 7-14 days. Training sure would benefit all parties!!

~sarahv~ You are so right! I need to be thankful instead of complaining. I'm not too proud to ask for guidance and hear the truth. It's easy to feel sorry for myself when in reality, I am very fortunate.....so far anyway. Thank you for your prayers and I will do the same for you. :clap2: Where are you in this process?

[sarahv 0]

I am just starting out. I found out yesterday after a bit of wishy-washieness on the part of the insurance company that it is not covered and there is a written exclusion in the policy.

So, I'm bummed by that and I apologize, as my feelings of that whole thing may have prompted me to respond to your thread with a bit of attitude.

I didn't mean to minimize your frustrations - I really do understand - maybe I'm feeling a little sorry for myself as well = ))

I was just sitting here thinking about what I could auction off on Ebay to come up with the funds to pay for my surgery.

We have been digging outselves out of debt and are almost there - my husband shared with me last night that he would not want to get a loan for the surgery and feels that with our tax refund would be able to swing it without a loan if we can put it off for a few months.

That is discouraging as well - I feel like now that I've found my WLS - I want to get it over with and get on with my life!!! I don't want to live like this anymore.

I did get an offer from Dr. Ortiz - because of the hurricanes near Cancun they aren't doing any procedures there but they are offering Dr. Ortiz's expertise in Tijuana for $8500 for anyone scheduling in March or April.

Now that I got to vent = )))

Let me know if you have a good fund raiser for Ebay!!!

[3loves 0]

Please don't apologize, there is no need. I didn't feel like you were minimizing me feelings at ALL. I can tell you totally can relate to the frustration I'm going through. Anyone that is preband can and those postband have been there. It's all part of the process I guess...finding our own way to the band. :phanvan

For me, it's like deciding to start Weight Watchers, but I'm not going to start for another 3 or 4 mos. Imagine how that would feel. I do, however feel there are reasons this process takes so long. It is a huge commitment and shouldn't be takenly lightly. I think this entire process does weed out some of those who should not get the band. Does that make sense?

There is no way I could ever do a self pay, so I admire your determination. I am a SAHM and I sell stuff on E-Bay just to buy the kids clothes and shoes each season. E-Bay has been a lifesaver for us at times.

The biggest success I've had on E-Bay has been with my Longaberger baskets. I don't know if you have any of those, but they have brought me some big bucks in the past. I'm starting to see a change in the demand though b/c everyone is getting so tight these days. I've also seen some on my Gymboree stuff go for much more than expected.

The Ortiz deal sounds pretty good. I'm sure you can make that happen. :biggrin1: ~Keep us informed of your progress~ :hat:

[swprdr 0]

Being self employed I was hoping someone could provide me with info on any insurace company that may approve the Lap procedure with the least resistance. If I am going to get new insurance might as well try to cut out some headaches I live in Southern California

[Kat1215 0]

I just wanted to add 2 things. I have United Healthcare and they dropped a bomb on me 2 days before surgery. The WLS is covered on my policy but my Dr. wanted a letter to verify before surgery. I had just about given up and had decided to have it done over the summer (I'm a teacher and needed to have surgery during spring break) when it was approved. The catch was that they had decided they would only pay the surgeons a max of $1000.00 in network. Of course my surgeon was insulted and pulled out of the network. The short story is that my surgery should have been paid in full by my insurance but since they changed the amount to the surgeon 2 days before my surgery we had to come up with $3600.00. My point is to be careful with United Healthcare and make sure you know exactly what they will pay. The second thing is that I read in Newsweek a while back that if you have the right Unicare policy it will cover WLS. As a private policy it might be expensive but it might be worth looking into. Good luck to everybody with your insurance compainies.

[sproutwife 0]

Does anyone here have United Healthcare through Compass Bank? I keep getting different info from each UH rep that I speak with. I met with the doc on 01/31/2006 and for some reason they did not send my predetermination to UH until March 1. Now it seems to be stuck in some limbo.

[shackdog 1]

I know what you mean, being agrivated about insurance but how would you like to have to pay for it yourself. My insurance will not cover my surgery so I have to pay for it myself, that blows...................

[3loves 0]

shackdog ~ You are right....we need to be thankful for what we do have and be more patient. It's just hard sometimes and it helps to put it in writing and talk to others.