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BCBSM vs. OSU Medical center



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I am so frustrated.....I need to vent so here it goes....

I started this process in July. Being that my BMI is greater than 50, the 6mo weight loss program was waived. I submitted all of my information at the end of July to my surgeons office- OSU. I went to an informational seminar on August 5th. First appointment with the center on August 31st along with the psych evaluation on August 30th. On September 30th I had an EGD. On October 9th my information was submitted to BCBSM for pre approval for the sleeve surgery. October 9th and 16th I had my dietiatian classes for life after surgery. On Ocotber 29th and three times before that I had contacted BCBSM to verify they had all of my information they needed to preapprove me. Finally on the 29th I was told that I was pre approved for the inpt hospital stay and the procedure itself. Being so exicted I called my surgeons office to notify my insurance case worker. He stated that he hadn't recieved anything and he would contact them. After playing phone tag between him and BCBSM for over 5 hours he finally got ahold of a real person at BCBSM who notified him that I had not been pre approved for the procedure, that they never had a precertification form or paper work for the surgery itself, just the inpatient hospital stay. The lady at BCBSM told him he sent the info to the wrong fax number and gave him another to refax everything to. She then informed him that it would take up to another 30 business days for approval - this all occured on 10/29-10/30. So my information was resubmitted on the 29th of October. I have been in contact with BCBSM several times since and they will not give me any information, other than the fact that it is not them (BCBSM) that requires preapproval for the surgery- it is the physicans office. BCBSM only requires preapproval for the hospital stay. They keep telling me that the providers office will have to contact the provider inquiry line for that information. My insurance worker, who I'm sure is sick of me, will rarely answer my phone calls and rarely return them. I have left multiple messages. It has been well over 30 business days since my information was submitted. I believe if I don't hear from him by tommorow I will be in contact with his office manager....If they don't help me I will be finding a new surgeon. I have invested so much into OSU's program I really don't want to go somewhere else. I feel as though I have been very patient, I have had all my requirements met since the end of september. I love the office and physicans but I have had nothing but a horrible experience with the insurance cordinator.....BCBSM has not very helpful in the communication department either.....I feel as though I have slipped through the cracks. Anyone else have this similar issue and if so what did you do to resolve it?

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