Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Surgeon office delays?



Recommended Posts

I have now completed every requirement needed to put in the insurance authorization request. My surgeon's office confirmed to me that they had everything they needed from me one week ago. Needless to say, I'm excited! In addition, many on this forum with the same insurance have stated that they have been approved as quickly as 1 day. In my initial call to my insurance company (6 months ago), they stated usually 5 days... but admitted that sometimes it's quicker than that.

I called my insurance company again today to double check my coverage and status. To my surprise (and dismay) I was told that they had not yet received any authorization request from my surgeon's office. In addition, the individual I spoke to checked with another office to see if it was received but not yet entered into the system. They said no.

So, I called my surgeon's office and spoke to my insurance coordinator. I asked her if there was anything else she was waiting on from me. Instead of answering my direct question, she seemed to be a bit coy and annoyed that I asked. She simply said.... “I told the dietician to let you know what was needed”. I explained to her that the dietician told me that they had everything needed to put in the insurance authorization.

So, I asked her again if she had everything she needed to file the insurance authorization. She said..... "yes, but don't expect to hear back from me for 2 weeks". I asked her if she had yet filed the authorization with the insurance company, but again she simply stated that it would take 2 weeks. I tried to be as professional as possible. I told her I understood, but just needed to know whether the paperwork was sent in. After my 3rd attempt at getting an answer, she said "yes", but did not tell me when. Needless to say, she was a bit impatient with me.

So... it's either lost, still in transit, or I'm not being told the truth. Since I don't own a crystal ball, I've learned to give folks the benefit of the doubt. Still, am I being unreasonable for asking questions like these?

UGH!

Share this post


Link to post
Share on other sites

I have now completed every requirement needed to put in the insurance authorization request. My surgeon's office confirmed to me that they had everything they needed from me one week ago. Needless to say' date=' I'm excited! In addition, many on this forum with the same insurance have stated that they have been approved as quickly as 1 day. In my initial call to my insurance company (6 months ago), they stated usually 5 days... but admitted that sometimes it's quicker than that.

I called my insurance company again today to double check my coverage and status. To my surprise (and dismay) I was told that they had not yet received any authorization request from my surgeon's office. In addition, the individual I spoke to checked with another office to see if it was received but not yet entered into the system. They said no.

So, I called my surgeon's office and spoke to my insurance coordinator. I asked her if there was anything else she was waiting on from me. Instead of answering my direct question, she seemed to be a bit coy and annoyed that I asked. She simply said.... “I told the dietician to let you know what was needed”. I explained to her that the dietician told me that they had everything needed to put in the insurance authorization.

So, I asked her again if she had everything she needed to file the insurance authorization. She said..... "yes, but don't expect to hear back from me for 2 weeks". I asked her if she had yet filed the authorization with the insurance company, but again she simply stated that it would take 2 weeks. I tried to be as professional as possible. I told her I understood, but just needed to know whether the paperwork was sent in. After my 3rd attempt at getting an answer, she said "yes", but did not tell me when. Needless to say, she was a bit impatient with me.

So... it's either lost, still in transit, or I'm not being told the truth. Since I don't own a crystal ball, I've learned to give folks the benefit of the doubt. Still, am I being unreasonable for asking questions like these?

UGH![/quote']

Omg what a nightmare! The ins coordinator sounds like a piece of work. By any chance is ur insurance UHC?

Share this post


Link to post
Share on other sites

Indeed. UHC Choice Plus.

Share this post


Link to post
Share on other sites

Indeed. UHC Choice Plus.

Omg! That is my EXACT insurance! Yeah they were REALLY swift in giving me an auth number. Idk whats up with ur surgeon's office but the way they are acting is not right. I think u should stay on that coordinator and if u live relatively close to the surgeon's office, go down there so.they can see how serious u are about improving ur life. They should have submitted by now and u should be approved by now...so sorry this is happening

Share this post


Link to post
Share on other sites

Well, I ended up "escalating" this do someone higher up in the office this past Monday. She called me back and told me that the IC had faxed the auth request to UHC the previous Friday.

I just confirmed with my insurance that they indeed have the auth request, but they didn't received it until Monday. Either way, mission accomplished. Wish me luck!

Share this post


Link to post
Share on other sites

Thats great!! Like I've said before "WE NEED TO BE OUR OWN ADVOCATE WHEN IT COMES TO OUR HEALTH".. I have one of those insurance coordinator's in my surgeon's office but it took me telling the surgeon that I was going to change surgeon's for her to move her butt and then call me 10 minutes after leaving the office to tell me she would be submitting my paper work.. So I'm so happy that you were able to get things moving along to start a new life, a healthier life..

Share this post


Link to post
Share on other sites

So glad to hear the request was received!:)

Share this post


Link to post
Share on other sites

Omg! That is my EXACT insurance! Yeah they were REALLY swift in giving me an auth number. Idk whats up with ur surgeon's office but the way they are acting is not right. I think u should stay on that coordinator and if u live relatively close to the surgeon's office' date=' go down there so.they can see how serious u are about improving ur life. They should have submitted by now and u should be approved by now...so sorry this is happening[/quote']

How long did it take for your approval. I also have UHC

Share this post


Link to post
Share on other sites

How long did it take for your approval. I also have UHC

I was approved in one day, they submitted in the morning and by afternoon I was approved.

Share this post


Link to post
Share on other sites

I received similar response/attitude from the referral coordinator at my PCP's office. She always acted like I was annoying the hell out of her just because I had questions and would call to follow up on things being sent to insurance. It's their job-they shouldn't act like that! However, I just try and remind myself that getting insurance approval and surgery is not as important to anyone as it is for me! Do whatever you have to do to get your goal accomplished! Good luck! :)

Share this post


Link to post
Share on other sites

Today I get a voicemail from UHC "Treatment Decision Support". Here's what I learned from them:

With Treatment Decision Support, you have access to nurses who can provide information about conditions like back pain that can be treated in more than one way. The nurses can help you understand your treatment options, and connect you with quality physicians. Treatment Decision Support nurses can also explain what you can expect during your treatment.

I was a bit leery about sharing info because... well... I wasn't sure who they were. My guess is that they are hired by UHC (or my employer in conjunction with UHC) to have me consider alternatives. The synical side of me thinks it was a money saving call... but who knows for sure.

Of course, the non-synical side of me is willing to hear other possible reasons, especially from those who have spoken to this group before :-)

Share this post


Link to post
Share on other sites

Something similar happened to me! I understand what you are going through! I will now pray for both of us that this all works out! Lol

Share this post


Link to post
Share on other sites

This must be a requirement, because I am going through the same thing also. The coordinator was wonderful until I called and asked about my paper work? What's up with that? She actually got PO'd that I called the insurance company to see if she turned in the paper work. She had the nerve to ask me why I called them. I had to inform her this was my insurance and I was the one who was having surgery. Go figure.

Share this post


Link to post
Share on other sites

I called UHC today. Evidently my request was entered incorrectly. It was marked as out-patient instead of in-patient, causing a delay. Hopefully I can get an approval in the next couple of days.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 1 reply
      1. stevieoriole

        Am feeling this right now. My surgery date is 4/1. Sign the consent tomorrow. I feel like I overloaded myself with too much info, too many opinions. Got to the point where I was wondering if I should do this. Then I thought of my reasons for taking this step and that settled my nerves. Still get moments of doubt but am striving forward. Am just going to follow my book from the surgeon. Joined this because I was told by my dietician that I should do this for support

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×