ColleenErin1974 195 Posted April 27, 2017 I've been done with my pre-evaluation appointments and testing since 2/23/17. I have been calling the office about 2 times a week to see what is going on.It took most of March to just get my surgeon to look at everything and medically clear me. Once that was done, I was told that now all this is to go to my insurance company for approval (that was 4/4/17).I was not contacted about this, and after a week I called the office, spoke to the manager, and was told that everything is at my insurance and I just have to wait.Ok, after another week I called and was told my case is pending. Again, I wait.I do this 2-3 more times and keep getting told its pending.Today, 4/27/17, I call again with no response. Now, I call my insurance to see what I should do. I talk to insurance company. She says that there is nothing about prior approval in my case and we start investigating!According to my insurance, I do NOT need approval for WLS with my policy. OMG! SMH.Now, I ask them what is my Doctor waiting for? She asks for my surgeons number and who I've been in contact with there. I give her the info, she puts me on hold, and she contacts them.About 25 minutes later, she comes back to me and says that the manager has given my info to the surgeon for him to get me a surgical date. WHAT????My insurance lady than asks why have they been lying to me saying I'm not approved for surgery yet, when I did not require approval in the first place! The manager tells her that someone else messed this up, not her and she would make sure it is taken care of.So, now I know this office has been just placating me with a bunch of BS! I put a call into the manager myself and as of now, no call back yet! I'm beyond pissed off here. I've done everything I have had to do since 11/16 and I've been ignored for what reason?Tomorrow, bright and early I will call the manager again and if no response, I drive for an hour to the surgeon and don't leave until she talks to me.OMG! Has anyone else had anything like this happen???Ugh!Any info would be appreciated! 1 TaRena reacted to this Share this post Link to post Share on other sites
TaRena 32 Posted April 28, 2017 I've been done with my pre-evaluation appointments and testing since 2/23/17. I have been calling the office about 2 times a week to see what is going on.It took most of March to just get my surgeon to look at everything and medically clear me. Once that was done, I was told that now all this is to go to my insurance company for approval (that was 4/4/17).I was not contacted about this, and after a week I called the office, spoke to the manager, and was told that everything is at my insurance and I just have to wait.Ok, after another week I called and was told my case is pending. Again, I wait.I do this 2-3 more times and keep getting told its pending.Today, 4/27/17, I call again with no response. Now, I call my insurance to see what I should do. I talk to insurance company. She says that there is nothing about prior approval in my case and we start investigating!According to my insurance, I do NOT need approval for WLS with my policy. OMG! SMH.Now, I ask them what is my Doctor waiting for? She asks for my surgeons number and who I've been in contact with there. I give her the info, she puts me on hold, and she contacts them.About 25 minutes later, she comes back to me and says that the manager has given my info to the surgeon for him to get me a surgical date. WHAT????My insurance lady than asks why have they been lying to me saying I'm not approved for surgery yet, when I did not require approval in the first place! The manager tells her that someone else messed this up, not her and she would make sure it is taken care of.So, now I know this office has been just placating me with a bunch of BS! I put a call into the manager myself and as of now, no call back yet! I'm beyond pissed off here. I've done everything I have had to do since 11/16 and I've been ignored for what reason?Tomorrow, bright and early I will call the manager again and if no response, I drive for an hour to the surgeon and don't leave until she talks to me.OMG! Has anyone else had anything like this happen???Ugh!Any info would be appreciated!I'm certainly interested in seeing what you find out tomorrow morning. Or what song and dance you'll get. So sorry you're dealing with this. Like you need the extra stress!! Good luck in the morning. I hope you get some justification. Ta Rena Share this post Link to post Share on other sites
ColleenErin1974 195 Posted April 28, 2017 I'm certainly interested in seeing what you find out tomorrow morning. Or what song and dance you'll get. So sorry you're dealing with this. Like you need the extra stress!! Good luck in the morning. I hope you get some justification. Ta RenaI can't wait for the excuse. My insurance lady caught them red handed lying. I will definitely keep ya posted! This will be eye opening I'm sure! Thanks! 1 TaRena reacted to this Share this post Link to post Share on other sites
RJrocks 69 Posted April 28, 2017 I have never heard of an insurance company that does not require approval. Whom are you with? Share this post Link to post Share on other sites
ColleenErin1974 195 Posted April 28, 2017 I'm with UHC care improvement plus Medicare Advantage. All I needed for insurance approval was do a 3 month supervised diet. The insurance lady said with this insurance because I have to pay my full deductible there is no prior approval needed. Granted my deductible is $6,700, but I have that all saved, so all I need is a surgery date. 1 TaRena reacted to this Share this post Link to post Share on other sites
Redmaxx 740 Posted April 28, 2017 Sorry to hear about this. I received a collection letter (from a collection company) stating that I owed money to the hospital. I was never billed by the hospital. I called the billing department and they looked up my account and somebody had coded it with a do not contact or send a bill so they referred it to the collection agency. They "fixed" the coding issue and recalled it from the collection agency. I have to have a security clearance for work and something being sent to a collection agency is a great way for me to lose the clearance. Good luck to you and I can't wait to hear what the manager has to say. 1 TaRena reacted to this Share this post Link to post Share on other sites
pattycaketoo 133 Posted April 28, 2017 Have you found anything out today? Share this post Link to post Share on other sites
ColleenErin1974 195 Posted April 28, 2017 Well, sorry for the delay in my response. It has been a LONG day!I called the office manager at 10:30am today. I left a voicemail to please get back to me. By 2:30pm I still had no response and called her again leaving another message. At 3:15pm I finally got a call back, but not from the manager. The financial lady called me to let me know that I do not require authorization for the WLS, but only for the hospital stay. I asked her why has it taken so long to get back to me if I did not require approval? I know this lady spoke directly to my insurance lady yesterday about this situation. She was not sure why the manager lied to me for almost 4 weeks.So, she then sent me over to my surgeons secretary. I then asked her why I've been waiting for a surgery date for more than 4 weeks?Here's the response:She said she got the info about me being medically cleared about 3 weeks ago. I knew this much. Then she tells me that the surgeon misplaced my chart! SMH! She then tells me she was given a surgery date by him for me, but couldn't give it to me because of the misplaced chart! She says she told him after he found it that I have now been waiting for the date for 3 weeks. She says she now hasn't heard from him so as to contact me and get the surgery done. Now, she said she isn't sure if the date that had been picked is still good! She said she will email and text him for a response and she will then call me with the info.Of course he is not at the office and it's Friday! So I have to now wait through the weekend again! This is a giant FUBAR! I am just astonished with this situation! At this point I am still being dodged by the manager. I'm sure I won't hear from her again because she will have to tell me WHY? was I lied to and strung along about this.So, as usual, I have to sit and wait!I cannot wait until all this is in the past and I can just work on a healthier me!Sorry for such a rant, but I needed to vent! Share this post Link to post Share on other sites
Sweet as peaches 759 Posted April 28, 2017 35 minutes ago, ColleenErin1974 said: Well, sorry for the delay in my response. It has been a LONG day! I called the office manager at 10:30am today. I left a voicemail to please get back to me. By 2:30pm I still had no response and called her again leaving another message. At 3:15pm I finally got a call back, but not from the manager. The financial lady called me to let me know that I do not require authorization for the WLS, but only for the hospital stay. I asked her why has it taken so long to get back to me if I did not require approval? I know this lady spoke directly to my insurance lady yesterday about this situation. She was not sure why the manager lied to me for almost 4 weeks. So, she then sent me over to my surgeons secretary. I then asked her why I've been waiting for a surgery date for more than 4 weeks? Here's the response: She said she got the info about me being medically cleared about 3 weeks ago. I knew this much. Then she tells me that the surgeon misplaced my chart! SMH! She then tells me she was given a surgery date by him for me, but couldn't give it to me because of the misplaced chart! She says she told him after he found it that I have now been waiting for the date for 3 weeks. She says she now hasn't heard from him so as to contact me and get the surgery done. Now, she said she isn't sure if the date that had been picked is still good! She said she will email and text him for a response and she will then call me with the info. Of course he is not at the office and it's Friday! So I have to now wait through the weekend again! This is a giant FUBAR! I am just astonished with this situation! At this point I am still being dodged by the manager. I'm sure I won't hear from her again because she will have to tell me WHY? was I lied to and strung along about this. So, as usual, I have to sit and wait! I cannot wait until all this is in the past and I can just work on a healthier me! Sorry for such a rant, but I needed to vent! @ColleenErin1974 that situation sucks big time all of them should be ashamed of themselves. That stress enough alone makes you not want to deal with them. My prayers are with you. 2 BgR72 and TaRena reacted to this Share this post Link to post Share on other sites
ColleenErin1974 195 Posted April 28, 2017 17 minutes ago, Sweet as peaches said: @ColleenErin1974 that situation sucks big time all of them should be ashamed of themselves. That stress enough alone makes you not want to deal with them. My prayers are with you. Thank you for the prayers. I suffer with PTSD and severe anxiety with panic attacks and this situation has been hard due to this. Having to wait over the weekend now is going to be fun. I want to go out and walk because that helps me feel better, but it is 90 degrees and 200% humidity where I am and I'm stuck inside. Share this post Link to post Share on other sites
Sweet as peaches 759 Posted April 28, 2017 4 minutes ago, ColleenErin1974 said: Thank you for the prayers. I suffer with PTSD and severe anxiety with panic attacks and this situation has been hard due to this. Having to wait over the weekend now is going to be fun. I want to go out and walk because that helps me feel better, but it is 90 degrees and 200% humidity where I am and I'm stuck inside. Sharing your feelings and getting it off your chest is beneficial to those who may have the same problems. I know about severe anxiety and it takes over your life. So let it out I applaud you for letting us share in your pain. Monday will be here before you know it. 2 TaRena and ColleenErin1974 reacted to this Share this post Link to post Share on other sites
ColleenErin1974 195 Posted April 28, 2017 20 minutes ago, Sweet as peaches said: Sharing your feelings and getting it off your chest is beneficial to those who may have the same problems. I know about severe anxiety and it takes over your life. So let it out I applaud you for letting us share in your pain. Monday will be here before you know it. Thank you for the kind words. This surgery is a huge deal for me. It's good to know I am able to talk here and someone is actually listening and understanding what I'm feeling. I appreciate everyone here! 2 Sweet as peaches and TaRena reacted to this Share this post Link to post Share on other sites
Sweet as peaches 759 Posted April 29, 2017 29 minutes ago, ColleenErin1974 said: Thank you for the kind words. This surgery is a huge deal for me. It's good to know I am able to talk here and someone is actually listening and understanding what I'm feeling. I appreciate everyone here! You're so welcome. Anytime! We are all have one thing definitely in common to be healthy and live for our family most important ourselves. God bless you so much.😎 1 TaRena reacted to this Share this post Link to post Share on other sites
Ms. Brightside 121 Posted April 29, 2017 I've been done with my pre-evaluation appointments and testing since 2/23/17. I have been calling the office about 2 times a week to see what is going on.It took most of March to just get my surgeon to look at everything and medically clear me. Once that was done, I was told that now all this is to go to my insurance company for approval (that was 4/4/17).I was not contacted about this, and after a week I called the office, spoke to the manager, and was told that everything is at my insurance and I just have to wait.Ok, after another week I called and was told my case is pending. Again, I wait.I do this 2-3 more times and keep getting told its pending.Today, 4/27/17, I call again with no response. Now, I call my insurance to see what I should do. I talk to insurance company. She says that there is nothing about prior approval in my case and we start investigating!According to my insurance, I do NOT need approval for WLS with my policy. OMG! SMH.Now, I ask them what is my Doctor waiting for? She asks for my surgeons number and who I've been in contact with there. I give her the info, she puts me on hold, and she contacts them.About 25 minutes later, she comes back to me and says that the manager has given my info to the surgeon for him to get me a surgical date. WHAT????My insurance lady than asks why have they been lying to me saying I'm not approved for surgery yet, when I did not require approval in the first place! The manager tells her that someone else messed this up, not her and she would make sure it is taken care of.So, now I know this office has been just placating me with a bunch of BS! I put a call into the manager myself and as of now, no call back yet! I'm beyond pissed off here. I've done everything I have had to do since 11/16 and I've been ignored for what reason?Tomorrow, bright and early I will call the manager again and if no response, I drive for an hour to the surgeon and don't leave until she talks to me.OMG! Has anyone else had anything like this happen???Ugh!Any info would be appreciated!Ugh. So sorry they are treating you this way! If at all possible, I'd seriously consider changing to a different surgeon. If they are treating you this way NOW, I cannot imagine how they will treat you post-op. [emoji19] Sent from my SM-G930P using BariatricPal mobile app 2 GBLady41 and TaRena reacted to this Share this post Link to post Share on other sites
TaRena 32 Posted April 30, 2017 I'm just getting to read about what happened on Friday. I'm frustrated FOR you. Not only are you being lied to but the surgeon has lost your chart! Really?! Makes you feel confident in your team. It almost sounds like everyone is just passing the buck. Your only alternative is to change teams but that would mean starting all over from square one. SMH! I do hope you get resolution to this and fast. I'm rooting for you and pray you do get the satisfaction you deserve. Share this post Link to post Share on other sites