How can they get away with this!

[spiritstalker 29]

Well I am 13 days away from my surgery, and I got the most devistating call from my doctor that the insurance is now saying I am NOT approved! They have already sent letters to myself and to my doctor that I WAS approved and faxed them an approval number for the surgery, and even told them how much my co-pay was going to be... NOW they say sorry someone screwed up and now I am not approved!!! I am so frustrated I have already started my liquid diet... My doctor did say they were going to figure out if there was anything they could do legally since the insurance had already approved it twice now.... Hope no one else has to go through the same hell I have been going through HealthSmart insurance is a joke.

[LipstickLady 25,682]

Ack! So glad your surgeon is fighting for you!

[inarakatra 51]

I hope that your Doctor can resolve your issues.

[No Day But Today 5]

If you have a healthcare ombudsman in your state, you may want to give them a call.

[ppasjm 37]

I would call your state's insurance commissioner. Here's a link for MO--

http://insurance.mo.gov/help/contact.php You'll probably have to copy and paste it. It even has a place to file a complaint on the right hand side of the page.

Consumer Affairs Division

Matt Barton, Director

Insurance Consumer Hotline: 800-726-7390

Fax: 573-526-4898

Email: consumeraffairs@insurance.mo.gov

(Consumer complaints, inquiries, brochures)

[NtvTxn 1,262]

Well I am 13 days away from my surgery, and I got the most devistating call from my doctor that the insurance is now saying I am NOT approved! They have already sent letters to myself and to my doctor that I WAS approved and faxed them an approval number for the surgery, and even told them how much my co-pay was going to be... NOW they say sorry someone screwed up and now I am not approved!!! I am so frustrated I have already started my liquid diet... My doctor did say they were going to figure out if there was anything they could do legally since the insurance had already approved it twice now.... Hope no one else has to go through the same hell I have been going through HealthSmart insurance is a joke.

How disappointing for you. Hopefully it will be resolved soon. I'm sorry.

[PhoenixTheDiva 112]

Something similar happen to me with a different procedure I was having done. The code for the procedure was entered wrong for payment . Example procedure is 234.5 well some idiot enter 23.45 therefore it gets kicked out as unapproved. Look over your paperwork and see if this is the glitch. Good luck hope you get it straightened out

[Ms.AntiBand 2,984]

Wow.. That's awful and this is the second poster today with this happening to. Did it state why you're not approve vs when they did approve you? Omg.. I would be soooooo pissed! Fight for the approval and don't back down. They want you to back down... They can't make money if they approve ever surgery that is submitted even if you're entitled to it. They depend on people not fighting

[memk 42]

Well I am 13 days away from my surgery' date=' and I got the most devistating call from my doctor that the insurance is now saying I am NOT approved! They have already sent letters to myself and to my doctor that I WAS approved and faxed them an approval number for the surgery, and even told them how much my co-pay was going to be... NOW they say sorry someone screwed up and now I am not approved!!! I am so frustrated I have already started my liquid diet... My doctor did say they were going to figure out if there was anything they could do legally since the insurance had already approved it twice now.... Hope no one else has to go through the same hell I have been going through HealthSmart insurance is a joke.[/quote']

I fight with ins comp for a living.. As long as you have that approval letter... There's nothing they can do to bad that someone made a mistake they approved it and you have proof.. I work in Oncology we have lots of patients that have to have approvals for chemo some of these drugs can be up to 20 grand a dose... So once approved its to bad for them and they have to pay your surgeon.... Good luck!!

[spiritstalker 29]

Thanks for all the great advice and info everyone... Happy news I got them to pay and I am back on for surgery... They did give away my June 24th appointment, but I am rescheduled for July 1st... I will take it! I will just be glad when it is all over with. Thanks again!

[inarakatra 51]

That is awesome news!!! BIG CONGRATS!!!