Been Denied And Lied To.

[rmb2300 26]

On November 1st my surgeons office tried for approval with BCBS but on submitted the date of surgery and nothing else they blamed it on new changes the insurance comoanies submittal process. Then they had it voided and on November 14th resubmitted this time they did not submit any supporting documents from my PCP or regarding my comorbalites whhich I have several. When I spoke yo my surgeons office about my denial letter and that it stated they were informed by my Dr office that I was only requesting the surgery due to my weight she said she was not aware of the reason but that this was the only reason correct I advised her not it was not that I have Type 2 diabetes, sleep apnea, PCOS, and high cholesterol. She said if that is true than she doesn't understand why they denied me as she had not spoken to the insurance company. So I called the insurance company and was informed that the very person I had been speaking to at my surgeons office was who had informed them of the weight being my only issue and tgat they never received anything regarding my ither issues. I am so angry that I was lied to by her I called and spoke to the office manager and she acted like this wasn't an issue. What should I do? My surgeon is the best in my area I dont want to have to change doctors but I can't believe thid ud happening in January I eill have been dealing with this gor an entire year.

[Ms.AntiBand 2,984]

Talk to your surgeon. It's a 99% chance he has no clue what the office/nurse submits. Push it and make them do it right

[rmb2300 26]

I thought about that too I think I have to make an appointment to speak to him not sure but good idea. Your right he probably has no idea about whatss is going in my friend is gaving similar issues toobwith same office staff

[Jerzygurl 372]

Some of them are incompetent. I ran into a similar problem but became a pest until they got it corrected.

You are your own best advocate. So advocate.

[rmb2300 26]

I spoke to a case manager at my insurance I only have about 25 days left to appeal she tried to call tge surgeons office with me on the line and got the run around too so I will be going there tomorrow per her and my friends advice and push the isdue.

[devonn 12]

If they are an office that only does bariatric surgery them they should be very well versed in the insurance dealings. Bariatric surgery is a medical area that has very specific insurance requirements how does their office not know what they are? I would be furious that their incompetence is holding up your progress when that is their business.

[rmb2300 26]

They do deal strictly in bariatrics and are a center of excellence. I agree it is ridiculous that they have no clue on what they are doing they keep telling me that they deal with insurance daily and know what they are doing but, I surely can't tell by their actions that they know anything at all, they even tried to use my EKG for surgery clearance instead of the letter from my PCP. Hopefully today I will get some kind of resolution. My insurance did file a complaint on my behalf on the office staff members that created the issue.