Empire Blue Cross Blue Shield PPO

[kaninag 35]

You know these ppl at EmpireBlue are a lot ruder than regular BCBS ppl....I called today and I hit the wrong extension but I told the lady what I needed and she said she would connect me. Then she picked up and said that she showed that my information was sent to a case manager just yesterday and she was like it will take 30 days for a decision and I said well I still want to talk to someone in that department...and she put me on hold and came back again and said that she sees that I have been calling everyday and that if I am calling to see about a decision its not going to be ready because it takes 30 days.....I just hung up!!! I am soooo fed up with these ppl telling me that IT WILL take 30 days...not it coud take up to 30 days......they're really pissing me off and once I get my approval I am gonna send a nastygram!!!!

[pippinje 0]

You know these ppl at EmpireBlue are a lot ruder than regular BCBS ppl....I called today and I hit the wrong extension but I told the lady what I needed and she said she would connect me. Then she picked up and said that she showed that my information was sent to a case manager just yesterday and she was like it will take 30 days for a decision and I said well I still want to talk to someone in that department...and she put me on hold and came back again and said that she sees that I have been calling everyday and that if I am calling to see about a decision its not going to be ready because it takes 30 days.....I just hung up!!! I am soooo fed up with these ppl telling me that IT WILL take 30 days...not it coud take up to 30 days......they're really pissing me off and once I get my approval I am gonna send a nastygram!!!!

See when she told me that she see's I have been calling everyday, I would have been like, "Yup! And I am going to continue to do so until I get my approval, so you can either connect me to the correct department or get me your supervisor."

I work in cc so I don't put up with much crap.

[kaninag 35]

I'll remember that next time.

[kaninag 35]

AAAAAAAAHHHHHHHH...I knew it my doctor received a letter today stating that insurance wanted a psych eval!!! I KNEW IT KNEW IT!!! GREAT...So I asked does that mean I am approved if I have this done...they couldnt say because my records werent complete...great so here I go gonna spend $325 more on this whole process!!!! And still am not garanteed an approval!!!

[pippinje 0]

AAAAAAAAHHHHHHHH...I knew it my doctor received a letter today stating that insurance wanted a psych eval!!! I KNEW IT KNEW IT!!! GREAT...So I asked does that mean I am approved if I have this done...they couldnt say because my records werent complete...great so here I go gonna spend $325 more on this whole process!!!! And still am not garanteed an approval!!!

Sorry about that. Your doctor should have called Empire before ever starting the process and confirming what they required to cover the surgery. Hope you get it done quickly.

[kaninag 35]

Yeah the girl at the front desk says that he knows its required but that sometimes he tries to waive it....but she said they always end up having to have it....well why didnt she tell me that 2mo ago???!!!!

[CynthiaMcC 0]

That's crazy, the insurance process is hard enough, why on Earth would he think that he could skip a step? I'm sorry to hear that. If it helps, my psych eval was covered by insurance and also happened pretty quickly.

[pippinje 0]

If the girl at the front desk knows he can't waive it, why on earth does he think he is all-mighty and can do so. Sheesh. Medical school go to his brain much? LOL. Hang in there. I am rooting for you. Hopefully I will get my psych report back today so I can have my PCP turn in. I hate this waiting game and I know it was a big letdown to think you were almost there adn then have to do something else. Keep your chin up and keep coming back here for support. :smile:

[pippinje 0]

OK. I am about to pull my hair out, so thought I would come here to vent. Why is it so hard to get people to do their job? I had my psych eval on the 8th and had to wait until the 16th to get my report(which was later than they promised when I did it). I get it and realize they have my DOB and DOE wrong on the report. So I call back and even though its their error they say they can't get me a corrected one until the next day. So I have already let me pcp know that I have the report on the 16th and they tell me that all they have to do now is send my chart to the surgeon and their letter and everything will be good to go. So I call the surgeon this morning and let them know the corrected eval was faxed and they say they have it. but they are still waiting on my chart. OK WHAT THE HEY. Didn't my PCP tell me yesterday they were sending that. WHY aren't people following through. I shouldn't have to follow them around and make them do their job. Maybe I am being a little pushy. I AM JUST READY TO GET THIS SUBMITTED TO INSURANCE. So I left a message for my PCP to call me because the chart is needed. Still no call.

:tt1::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad:

Ok. I feel better. Just had to vent.

[kaninag 35]

OUCH PIPPIN that sux. I am sorry that you are having such a tough time. But, unfortunately the staff at dr's offices dont understand and dont care bc its not their life. You have to really stay on top of these ppl. It seems like we're all learning this the hard way.

On a brighter note my psych eval was prob the easiet thing I have had to do. I saw him today and my surgeon ALREADY has my evaluation!!! I couldnt believe it I was like wow now why cant everything else in this process be this easy!!! SO, hopefully they will fax everything tomorrow and I can finally get my approval...I HOPE I AM SOOO SCARED THAT I AM GONNA BE DENIED esp after seeing all the denials come thru lately.....

GOOD LUCK TO YA PIPPINJE STAY ON 'EM!!!!!!

[pippinje 0]

Way to go kaninag. Good to hear atleast the people you see are on the ball. Good luck on getting that approval!

[kaninag 35]

OH YEAH Another note CALL PCP today!!!! If he/she is anything like the doctor I work for they will take forever to call you back! Be PUSHY!!! Who cares if you get on their nerves....its their job to help you!!!! When I call my doctors office I'm I am so sorry to bother you but.... (so then they feel guilty for being annoyed)!!!!

[kaninag 35]

!!!!!!!!!!!!!!!!I just couldnt stand it...I said I wasnt going to call the insurance company today but I just called and GUESS WHAT THEY ALREADY HAVE MY EVAL!!!! THEY ACTUALLY ALREADY HAVE IT!!!! I COULDNT BELEIVE IT...and for once the girl I talked to was REALLY NICE and she said it is in your file for the case manager to review...she said everything looks good and GOOD LUCK TO YOU!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I'm so excited that I am jumping up and down and all jittery!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I cant almost TASTE MY APPROVAL!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[jelbel 0]

Good luck!

I know that the people in the Drs. offices , both at the family Dr. and the bariatric office are so slow and mixed up. I will have to go through this again ,because my husband wants to get banded next year. I will start taking his paper work months before.

[pippinje 0]

Good luck K! I called Empire late Friday and of coarse, they still don't have anything from my surgeon. Getting pretty close to getting copies of all my paperwork and going to someone else.........