Insurance Help Please

[melmo 0]

Hi I am new here! I am so frustrated with my insurance/dr's office I could cry. I have jumped through all the hoops(psych appt, egd,etc). About a month ago my case was submitted to the insurance or was it? My insurance is saying they have never received anything in relation to my surgery. My case manager at the Dr office says she has submitted it three times. My insurance company says that my case manager should have a pending authorization number but when I ask her for it she doesn't have it. Has this happened to anyone? What else can I do? Thanks and nice to meet you all

Melissa

[Pookeyism 1,143]

Ask your case manger how she is submitting it - if she says fax or snail mail tell her no, scan it and send it to an emai (get one from your insurance company) - and have her cc your email address in the email. Tell her to do it within 24 hours.

Is this your PCP or Bariatric doc? Either way maybe you should switch. AND LET US KNOW WHO IT IS, lol....we get alot of this here, but no one says which offices are doing it.

[melmo 0]

Thanks I would have never thought about that. She says she has faxed it everytime. I will def. call the insurance and get an e-mail address. The office is KC Bariatric. This is the only doc in Kansas City that my insurance is in network with. *sigh* Thanks again!

Melissa

[SpecialK1960 252]

With my insurance (United) they gave my Dr's office the pending authorization number. The doctor's office sent it to me so I could follow-it online with the insurance company. It also allowed me to push a bit and get a quick approval, which I needed for work scheduling. When I sent in e-mails stressing the need for a quick decision, I simply refered to my case number.

All medical records and systems are now required to be electronic, if there was a pending claim, the doctor's office would have a claim number. My guess is that they never submitted. It is your health - be a little pushy. If you have any reason to doubt what they are telling you, ask to see a copy of the submission to the insurance company. Tell them to send a copy to you directly.