Pissed at my office insurance person

[Jersrose43 837]

She submitted the paperwork to the insurance two weeks ago. I had no idea she had done this I had not even spoken to her once about it. I just finished going through all the visits and preps and stuff.

So surprise I get a letter from Cigna saying they need more information last Thursday

They need the notes on the 3 months visit with nutritionist and pcp letter. I picked up pcp letter Monday and scanned and sent it over to her. That was the 21st.

Mind you 3 months of NUT visits were conducted in her office. She didn't send with original request

She says she would send over letter from pcp on Monday. Ok. On track now.

So yesterday I open the mail and there is the rejection dated the 25th.

Not medically necessary because why?

No NUT notes!!!!!!!!

No letter from PCP!!!!!!!!

Nothing indicating comorbidities - which is in the pcp letter and if she was doing her job reading her own office notes. she would've seen I have high blood pressure and asthma.

Can you say friggin pissed at stupidity!

So needless to say I will be on her ass on Monday morning.

[Get.Waisted 45]

I would be pissed also. It's always strange when I hear stories like this about dropping the ball when submitting yo the insurance. They should be able to this stuff with their eyes closed I'm sure it's not their first time. That really shows a lack of professionalism, sorry you're having to deal with this mess but hopefully everything is resolved quickly.

[gourmetone 394]

Hang in there, stay the course you will reach your desired goal just another bump in the road

[vogue 310]

It may not be her fault. Firstly these things are either submitted via fax or email or via some electronic program. Maybe all of the pages didn't go thru.

I know I've faxed things to my insurance company several times and they claimed they never received it. I re- fax and I know all pages went and they claim they still haven't received it.

Have some patience and send whatever they ask via a system that gives a receipt confirmation

[Jersrose43 837]

It may not be her fault. Firstly these things are either submitted via fax or email or via some electronic program. Maybe all of the pages didn't go thru. I know I've faxed things to my insurance company several times and they claimed they never received it. I re- fax and I know all pages went and they claim they still haven't received it. Have some patience and send whatever they ask via a system that gives a receipt confirmation

I work for my insurance carrier

[Susysleever 265]

Why don't people do their jobs? How about update the patient of the status of nut, psych, etc?

[Jersrose43 837]

Am going to call the appeal number tmmw and pull the files they sent over. I am so disappointed.

I know that trying an appeal makes it harder. She should just have sent everything in the first time correctly.

[Janette0911 0]

• I am going through the exact same thing with Cigna. However, on my 3 month nut, I was told FOUR different times that all I needed was the receipt from online weight watchers. I also had 2 months of dietician through Cigna's on wellness group for 2 months last summer. I have to do WW online because we are so far out in the country, there is no class. ( those are from Cigna rep & insurance clerk)
• After denial it goes to -"reconsideration" -My pcp letter was sent again on Thursday and now suddenly at 3 pm on Friday, my surgery is cancelled.
• They are having a peer to peer on Monday a.m. to try and resolve it. But Cigna is obviously just trying to screw people over. When I spoke to Cigna Thursday all they needed then was the PCP clearance.

But, by the insurance dept not having all my paperwork the first time, they denied it- not medically necessary. Then they denied it again Thursday night/ Friday morning because of this "missing paperwork"

So, all this has caused a denial on original, a denial on reconsideration and probably a denial on appeal.

Just make sure to continue doing their job for them. Otherwise, Cigna will screw you.

[Jersrose43 837]

Update. My blood pressure Is WAY WAY UP!

I called doc office. I spoke to her April 10 she had sent it on April 7. She says.

So ok. I called insurance.

I have been calling insurance every day since April 14 for status. Don't have don't have

They confirm it takes 7 days business for recon

I email the insurance person on April 15 - I just talked to them they don't have it.

Today I called office again. Can you confirm you sent it? Insurance person on PTO

Office manager says I will call you back

5 minutes she has the fax and confirmations shows it sent on ..... Wait for it. April 15. Hey my email was when?

So I called insurance again

Nice woman called the auth team direct. Nope don't have it. Says it takes 7 days etc but they should have it if they sent it. I have confirmation it went through. Read her the fax #.

She faced to the wrong number.

[Susysleever 265]

Hate ins. companies. Sorry about yours

[sleeve30 33]

Update. My blood pressure Is WAY WAY UP! I called doc office. I spoke to her April 10 she had sent it on April 7. She says. So ok. I called insurance. I have been calling insurance every day since April 14 for status. Don't have don't have They confirm it takes 7 days business for recon I email the insurance person on April 15 - I just talked to them they don't have it. Today I called office again. Can you confirm you sent it? Insurance person on PTO Office manager says I will call you back 5 minutes she has the fax and confirmations shows it sent on ..... Wait for it. April 15. Hey my email was when? So I called insurance again Nice woman called the auth team direct. Nope don't have it. Says it takes 7 days etc but they should have it if they sent it. I have confirmation it went through. Read her the fax #. She faced to the wrong number.

WOW!!!!!

[Jersrose43 837]

Hate ins. companies. Sorry about yours

It wasn't my insurance it was stupid dope at the doc!

[Susysleever 265]

O. I am sorry about the dr. office.

[Mary Cade 23]

Sorry to hear about this ,so unfair. I am so scared the same will happen to me. Good luck on getting your approval

[cherrytree15 78]

That's sucks. Sorry to hear that. People don't realize that when they halo ass do their jobs, they are playing with your life, future and health. I hope the surgeon is a good one, because how the hell do you screw that up? Isn't this what they do all day everyday. Surely you no better than to submit a half ass file. My surgeon's office wouldn't even schedule time with the coordinator to discuss submission until I had all documents completed. I hope things work out.