mscathyl 0 Posted December 21, 2007 My last visit to the Dr. was 10/17 . I was told then that they were going to submit everything to BCBC and it would take two months for insurance approval. I called them before Thanksgiving and asked if they heard from the insurance co. yet . They told me they didn't and they would call me as soon as they did. Well, I just got off the phone with the DR.s office and they told me they didn't even submit the paperwork yet that they were waiting for me to get my 5 year weight history from my primary DR. before they could submit any paperwork to BCBS.WHAT!!! I've been waiting for approval for over two months and they were never in touch with me to tell me that they needed my weight history? I told the woman at the Dr.s office that this was the first time I heard of the 5 year history thing. She insisted that I was told all about it . I felt like she was calling me a liar . As a matter of fact that was exactly what she was doing .Bitch!!!! I've been working on getting this surgery since Jan. I did EVERYTHING they told me to do when they told me to do it so why would I intentionally leave out an important piece of the plan? At least admit they made a mistake .And why didn't they call me two months ago and ask about it . I'm sitting here crying I feel like they wasted a year of my life.Can I still trust them ? Share this post Link to post Share on other sites
reif78 0 Posted December 21, 2007 i know exactly how you felt i went throught the same thing. i was referred to my surgeon from my pcp so i went to my surgeon for my 6 month of weight checks. then when everything was submitted my insurance company said they needed weight checks from my pcp and then a letter of recommendation from my doctor and i was like but i did the weight checks at my surgeons office. i was irritated by then thinking all this work and then to do another 6 months with my pcp for weight checks. thank god they just accepted from the surgeons and i faxed them a letter of recommendation. i started my journey in january by the time the insurance co approved me and was able to get a surgery date it was december 12,2007 even though i shoulda had it sooner it was well worth the weight. Share this post Link to post Share on other sites
Teresajo 0 Posted December 21, 2007 When I started my weight loss journey in August I figured out right away that my hospitals staff were not the brightest bulbs on the Christmas tree. In September to the dietitian which was the last person I needed to see for approval, says "every thing looks fine I'll send all the paper work in tomorrow". So I go Off to Las Vegas for two weeks naively thinking that when I get back I'll be setting up a date for surgery. She calls me on the last day of my trip and say she just needs to get my weight because she wrote it down wrong during our visit. After being completely dumb founded for a few seconds I asked why she was just now calling me and her answer was of course " I've been busy." Even now she doesn't return calls. Which Is why I love this site. There's always someone who can give an answer to even the silliest sounding question. Share this post Link to post Share on other sites
Forestcat5 1 Posted December 21, 2007 I had a similar situation: After the surgeon's office sent in my info I got a denial letter from my insurance co saying I hadn't met all the requirements. I was crushed, and had a second or two where I considered giving up. But I really thought I HAD done everything I was supposed to. I called the surgeon's office and they said I didn't send them everything that was required (which made me wonder then WHY they sent anything??) But I contacted my family Dr (who was very supportive) and she called my ins co, then faxed over the info they wanted - and I got an acceptance letter the next week! So I would say don't give up, take a deep breath and send the surgeon's office what they want, OR maybe see if your pcp can step in and contact your ins co directly. These things happen - the people at the surgeon's office have many, many people to handle, and tons of paperwork. I know it doesn't make the waiting any easier though!!! Good Luck!!!!! Share this post Link to post Share on other sites
Marimaru 7 Posted December 21, 2007 Is there another doctor in your area? If so, walk into your surgeons office and tell them you want copies of everything in your file. Once you get the copies, tell them that if they want to keep patients, maybe they ought to you with the respect of doing their jobs properly. Share this post Link to post Share on other sites
kagoscuba 0 Posted December 21, 2007 5 year weight history is what BCBS used to deny me. I said F that, went ahead as a self-pay, then submitted anyway and have been paid for everything except the hospital stay. So out of a $23k bill, I've ended up paying about $13k. Don't lose hope!! Share this post Link to post Share on other sites
mscathyl 0 Posted December 21, 2007 If I knew for sure I wouldn't have to go through the whole process all over again I would go to a different Dr. We have at less three or four in the surounding area . This one was suppose to be the best . It wouldn't be so bad if they would admit that they made a mistake instead of blaming me for their mistakes . Just say we're sorry we thought we told you that we needed your weight history .and then why wait over two months to call me to get . After they put the package together and saw it was missing call and ask for it don't wait two months and tell me that I called in Nov.they didn't tell me that it was submitted and they were waiting approval. I know what they told me . Share this post Link to post Share on other sites
mscathyl 0 Posted January 12, 2008 I got my weight history and mailed it to the Dr. office they said they received it and submitted everything to the insurance co. on the 1/9. Now my two month waiting period starts all over again. I hope it goes by fast . Share this post Link to post Share on other sites
Artsy 0 Posted January 12, 2008 Does the doctor know what happened to you? I would certainly make sure he/she does. They need to know how front office is treating their customers. Share this post Link to post Share on other sites
mscathyl 0 Posted January 12, 2008 When I mailed them my paperwork I also inclosed a letter to the Dr. about what happened and how I felt about it . I haven't heard anything from him . When I called the Dr.s office to see if they received my history they didn't say anything about it and when I started to say something I was told that it was in the past and we have to move forward now . No apology , She just brushed it aside like it never happened. Like I said before if I didn't have to start all over again I would go to another Dr. Share this post Link to post Share on other sites
Artsy 0 Posted January 12, 2008 I strongly suspect the doctor never saw that letter. You're back on track now, though! Good luck. Share this post Link to post Share on other sites
mscathyl 0 Posted January 12, 2008 Thanks I need all the good luck I can get and I think you're right about the Dr. not seeing the letter. Share this post Link to post Share on other sites
mytrybe 0 Posted January 13, 2008 I have BCBS and they covered me 100%, but I had to submit a 5 yr history and get the surgeon to write the reccomendation to BCBS. I called my insurance company myself before even seeing a dr about it though. I just called and asked if it were covered and what the exceptions were....sorry you are having bad luck with yours. I hear BCBS of Texas is the WORST ! Share this post Link to post Share on other sites
mscathyl 0 Posted February 17, 2008 Approved at last ! I got a letter from BCBS yesterday that said I was approved. I call the Dr's and they didn't hear anything yet so they are going to call BCBS to confirm it on Tuesday then call me to set the date for surgery. I'm so excited! Share this post Link to post Share on other sites
*susan* 1,709 Posted February 17, 2008 Congratulations on finally getting through all the red tape. Let us know your date. Share this post Link to post Share on other sites