What Exactly Do These Coordinators Do?

[change4life2012 50]

You owe it to your surgeon to tell them how their staff has handled or mishandled your file. Remember' date=' this is how the MD gets paid & in turn, pays THEIR salaries. If they are sitting on files or don't understand your benefits, they are costing HIM money!

Now for the other disclaimer: it is the policy-holder's responsibility to know what benefits your policy allows. Become the subject matter expert before you go down this road. I printed the policy (you can ask customer service to mail or email you it) and handed it to the staff. I met ALL the requirements before I saw the surgeon & knew that my carrier had up to 30 days to make a pre-determination (same as most carriers). I was approved in 2 days & scheduled for surgery 2 weeks later.[/quote']

I know what me benefits are and have a max of 20,000 for bariatric surgery. I had all of my requirements completed the same day as my consult. It did take a few days for all of the tests to get to my coordinator. So i was very prepared at my consult. Would you recommend calling the hospital billing for this information possibly since my coordinator just states price is between myself and insurance. I just feel comfortable signing and not having a clue if i will owe or not.

[Heyher 581]

Oh I was subject matter expert before my consult. And I told her in detail what was required. I only have my nut appointment and pulminary exam left then she can submit. She started getting back to me right away when I copied my surgeon on emails. My surgeon givs all his patients his direct number, cell phone, and direct email. So if she keeps slacking I will let him know. I don't expect an answer in 5 minutes. But within the same week is preferred. :-)

But I figure once I am approved I get to start working with the medical team. So that is what's keeping my hopes and drive going.

[Need-a-Sleeve 211]

You can call the hospital & ask for an "estimate". They can't give you an exact price of what it is going to cost. The reason is each patient is unique--you may have complications (heaven-forbid) & it costs more.

The best advice I can give you is to take a notepad & write down EVERYTHING they give you when you are awake. After discharge ask for an itemized bill. Compare your notes to theirs, for example, if they say they put an abdominal binder on you, but you brought yours from home, you can dispute it.

[change4life2012 50]

You can call the hospital & ask for an "estimate". They can't give you an exact price of what it is going to cost. The reason is each patient is unique--you may have complications (heaven-forbid) & it costs more.

The best advice I can give you is to take a notepad & write down EVERYTHING they give you when you are awake. After discharge ask for an itemized bill. Compare your notes to theirs' date=' for example, if they say they put an abdominal binder on you, but you brought yours from home, you can dispute it.[/quote']

I am calling the hospital Monday morning. Thanks for the suggestion of the itemized bill.

[isajck 229]

I know what me benefits are and have a max of 20,000 for bariatric surgery. I had all of my requirements completed the same day as my consult. It did take a few days for all of the tests to get to my coordinator. So i was very prepared at my consult. Would you recommend calling the hospital billing for this information possibly since my coordinator just states price is between myself and insurance. I just feel comfortable signing and not having a clue if i will owe or not.

Asking for estimates from the doctor and hospital can be helpful but do not stress over the figures received. What is billed is usually very different from what is paid if these are contracted providers with your insurance company.

For example, my facility bill was just over $30k and the pay amount $22K while my surgeon billed almost $15K and was paid only close to $4k. Also do not forget there will be other ancillary charges associated with an inpatient stay as well.

[Sleeve tattoo 17]

WOW!! There is sooooo much to this whole process. Anyone who says that this surgery is taking the easy way out wieght loss should be slapped AND HARD TOO. It takes a lot of work to have to deal with the medical insurance and the medical staff. This is all before we deal with the surgery itself. I'm glad HeyHer asked the question because I found out some good info from the answers.

[NDN_RN 527]

My surgeons coordinator was very nice, but would take a couple of days to respond. i did all my legwork. The surgeon's nurse gave me the names of the gastroenterologist for my EGD, Gave me a sample letter for my PCP, which Typed up myself, putting in my information, leaving room for letter head. I gave it to my pcp who signed it, put it on letterhead and sent it right in, had my EKG and blood work, scheduled and paid for all three nutrition visits my self. When the last letter came in, she sent it that day to insurance. i bit my tongue for the following 3 business days, then called the insurance directly, to find out they wanted information that was clearly in their possession or not required. I demanded to speak to an insurance nurse. I explained nurse to nurse the problem, and although it was on another nurses to do list, she approved it on the spot! I called my coordinator who said to me she wished all her patients were like me. Yeah, I made it easy!

[FDclerical 318]

Its odd because in the beginning my coordinator was extremely helpful and returned all my phone e calls the same day "!! Now that I'm done it came down to me stalking them for 2weeks before submission "!!! Please read my one and only blog. Its like they know how anxious we are and its not hard to hit FAX and then send!!!

Sent from my SCH-R720 using VST

[tuturunner 29]

I have very little confidence in my coordinator. I knew I had three months of diet supervision so when I never got an email reply or phone call regarding a question I did cut her some slack. But month two is finishing up soon, does that mean at some point soon I'll be able to get a response? Its the worst customer service experience ever. So I try to talk to other people at the office instead if necessary. Hoping I don't have to be a pest.

[Ready4success 380]

I knew that my out of pocket maximum for the year was 1k, and doctor's visits prior to that were chopping away at amount. It happens I had to have surgery for an unrelated problem, and had to pay bills for that, and that also chipped away at the out of pocket maximum. By the time it was all said and done, I had met my out of pocket maximum. I called my insurance and found out that my co-pay for inpatient hospitalization was $100, so that's what I planned for. If you know what your out of pocket maximum is, see how close you've come to meeting it, then you know it won't be more than that, unless you have to do something that is not covered by insurance at all. For anything not covered, I used my flexible spending account.