Denied after being approved and devastated

[GrungeGrownUp 10]

On 9/4/2019 at 4:27 PM, Panda333 said:

Hello, I'm the original poster - Latest update. Well last week I raised such cane with my dr's office and the insurance company. I decided to take control rather than let them rule my life. Today I get a call from the insurance company. They received my appeal and did research. it turns out there were some errors in the plan docs which caused confusion. They said "Congratulations!" I am covered and it DOES not have to be an IOQ, although they prefer it. Whoo hoo. But then they told me I had to get with my dr's office to tell them to resubmit with the clinical information showing I went through all of the steps. So I happily sent an e-mail to the business office and told them what to do. I blind copied in my surgeon because I just don't trust them.....(They were so quick to give up on me) I told them to kindly re-submit and gave them the person's name (RN) to reference. I basically hand delivered their job.....happy, I went on with my day....

then......... 5 minutes later........

The insurance lady I just spoke to called me back...and said...Oh I meant to tell you..... I did mention your surgeon and hospital doesn't have to be an IOQ but if an IOQ is available in your geographic area you have to use them. I went to my handy google maps. IOQ is 6 miles from my house but the surgeon I selected and have already paid $4200 is 28 miles. So.....I guess there is a chance insurance could deny again.. The funny thing is when I was first searching for doctors, I checked out Orlando Health (the IOQ) and they never called me back.....

arghhhhh...the confusion and agony of waiting. Meantime the hurricane was coming and i have been stress eating here in Florida.

Thanks for listening...

Orlando health? I have aetna a d an trying to user Dr. Smith at Advent Health in Celebration. How did this work out for you? A friend used Orlando Health and she hated the office staff and told me not to use them if I didn't have to.