Waiting for Approval

[Chrisann 0]

Be Positive, stay positive and work the phones tomorrow.

[4jin 0]

thanks ChrisAnn,

how are your incisions doing?

[tweety63 0]

thanks ChrisAnn,

how are your incisions doing?

4jin did you here anything yet????

[4jin 0]

I called...and after 35 minutes calling..and calling...i finally spoke to the same rep is spoke to on 1/8/07. She said she called the psych office and left a message, but did not receive a call back. She said she got the letter I sent with the license number but she can't do anything with that it has to either come from the psych doctor or from my surgeon's office.

I have been calling both this morning to no avail. Left messages.

Called again to the psych office-left message for her to call me back....left message to the medical coordinator at my doc's office as well.

I am going to wait until 11:30for a call back. I will then start aggressively calling both offices. But my surgeon's office can't do anything as I am sure they received the same report I did-without the license. I looked at mine last night and it was missing the lic #.

(taking deep breaths) to calm my anger down....

[4jin 0]

ok its not working I am going to have a mad-evil breakdown...and I am starting to take it on my co-workers....sorry..

I got anger issues to begin with-with BC/BS....now I am just seeing steam come out of me.:eek::mad::mad:

[StLouisGal 1]

Have you tried the benefits coordinator at your work. It's usually in the HR department. Maybe a call from them would light a fire under some of these folks.

[4jin 0]

Have you tried the benefits coordinator at your work. It's usually in the HR department. Maybe a call from them would light a fire under some of these folks.

Not sure...I work for a huge corporation I don't know if our benefits coordinator is even here in this same state or not.

but I will give it a try...

I just got off the phone with the psych office. she is paging the psch to check his voicemail ASAP and sent my tel#. She said he just has to go in and edit the report and add his lic # and can only be done by him.

I explained to her that is the hold up with my approval.

She understood and said I should be called back and handled today ASAP.

You bet I am going to follow up with them at noon if I don't hear back.

Going to go ask about our benefits coordinator now...

thanks guys

[4jin 0]

Ok just as I suspected...all we have is an 1-877 number for our benefits center. There is no person here that can help....I am on my own.

[StLouisGal 1]

It's still worth a shot to call the 1-877 number and see if you can get a live person on the phone. Sometimes the larger the corporation, the more pull they have. (and the better their reps are)

[Chrisann 0]

Incisions are still red and itchy, but almost no pain. So things are getting better.

I am the BA here and I deal with 300 employees who get medical benefits. I can't believe that you don't have a person in your company, no matter how large it is, to discuss this.

I would also report the psych doctor to your insurance company as being non responsive. There has to also be someone you can complain to in your state, like to the Board of Health or whatever agency sanctions doctors. It is unbelieveably rude that this doctor is ignoring you.

[4jin 0]

well guys the doctor called me himself personally.

He can't believe they are holding me back for that. He apologized for the number not being on there. He still couldn't believe as he says he does lots of reports for many insurances especially BC/BS.

I said just another bump in the road that needs demolished to move on....he took the insurance rep's/nurse reviewer info and said will fax himself today. He said to call him on Monday before noon if they claim did not receive or if I need anything from him and gave me his personal cell#.

Now it is back to waiting until Monday to call the insurance company to check they received it.

In the meantime I am going to contact my HR benefits coordinator with an attempt to receive help to get this thru..

we'll post update..

[4jin 0]

Ok guys I called my HR's benefits help center line. Spoke with a benefits specialist who connected me with a benefits coordinator...who wasted my time and his time. He said they have no weight on the decision made by the insurance company for the prior approvals.

Made me so mad....waste of time...

I said reminds me we have a new chief in town and not the old employer we all loved because people are sure acting like it.....

I said..oh...thanks for wasting our times....I will be proceeding with an appeals attorney when I receive a denial letter once they are done playing the stalling game-as by law they are required to give me their decision within 30 days..and that will be soon.

and then I hung up...

....uuuuuuuugggggggghhhhh!!!!!!!!!!

Leave it to me to have the tough journey.....why?...why?....

[4jin 0]

i am so depressed and upset right now....

TOM must be around the corner because I normally am not this emotional....

[StLouisGal 1]

I am so sorry they are treating your this way. I would call the insurance company back later this afternoon (I know it is a Friday and they may not answer) For you to go through another weekend not knowing will be terrible.

[AmyMT 0]

4jin,

I am sorry to hear about the struggles you are having with the insurance. I really understand what you are going through as I was exactly where you are just last Friday. I have confidence that you will hear good news after all this torment and I will keep you in my prayers.

~Amy