Might be a stupid question....

[baileyj908 37]

I have been playing phone tag with the office manager at my Dr office. I am waiting appoval from my insurance. I called my insurance and they said they are not showing anything in their system yet. I was told she submitted my info (Nov 3) to the "pre certification department" and they send info based on surgery dates. My question is - who do they think the pre cert department is with? Do you think the precert department is with my insurance? Or another part of the process at my Dr office (and once they approve they send it to my insurance?)? It confused me when she said they approve and send info based on surgery dates. So I don't know who has my application/paperwork - my doctors office still or my insurance.

Edited November 15, 2015 by baileyj908

[BLERDgirl 6,417]

Sounds like you aren't getting straight answers. I would try this:

Clarify with the office manager she sent the request in to your insurance co. Ask her if it was sent by fax or electronically and confirm the date she sent it.

Then call the insurance company and inform them that the office manager at _____ hospital says she sent the info via ___ on Nov 3 or whatever dates she give you. Follow that up with asking what the typical turn around time for a pre cert of this sort usually is.

[baileyj908 37]

Thanks I will try that.

[baileyj908 37]

So tried to reach the officer manager and got clarification. On November 3 she submitted my paperwork to the precert department of the GI surgery at the hospital. They have to approve the surgery and then they send to my insurance. Glad I got an answer but still frustrated because they haven't made any decisions so my paperwork has not been sent to my insurance yet. My surgery date is in 1 mnth and 2 days. Really hope they start the process of getting approved quickly.

Edited November 16, 2015 by baileyj908

[Tssiemer1 549]

I have been playing phone tag with the office manager for weeks. Apparently I'm missing 2 things that I have already done. So now I'm scrambling around trying to get this info again. Uuuugh. It's frustrating.

[BLERDgirl 6,417]

So tried to reach the officer manager and got clarification. On November 3 she submitted my paperwork to the precert department of the GI surgery at the hospital. They have to approve the surgery and then they send to my insurance. Glad I got an answer but still frustrated because they haven't made any decisions so my paperwork has not been sent to my insurance yet. My surgery date is in 1 mnth and 2 days. Really hope they start the process of getting approved quickly.

I suspected that it was something like this. The good news is turn around time once it actually goes to the insurance company is typically only 3 - 5 days. If you are concerned I would call the office manager back and remind her of your tentative surgery date and ask if she could follow up with the hospital's pre- cert dept.

[baileyj908 37]

Got the message today that I am approved

[Amy Wolfe 49]

Congratulations that's the best feeling!