Confused

[j_war06 0]

Yeah I know this should go under insurance, but its kinda talk too right?

I was wandering how long an insurance company has to make up its mind about approving the surgery? They told me the other day that it would take 30 days, I have always heard that they only had 15 business days to overturn a denial?? I am so confused? School starts on August 15, looks like another stay at home year thanks to my great orthopedic surgeon and UnitedHealthcare. I have been thinking a lot about just getting the surgery done and forwarding them the bills and if they pay they pay, if they dont then they dont. I dont know I feel so bad about my parents paying for this, its soooooo expensive, but so is my life and I know that it will kill me pretty quickly with all my comorbities. How do I go about getting them to pay after I have the surgery, I have heard of it being done before, I just am really scared. But atleast it would be done in the right amount of time, and if they approve it then they can pay and pick up payments and if they deny it then we were going to pay for it anyway. Hmmm HELP??? ANYONE???

[FRECKLES3 1]

I Work For An Insurance Company...the 15 Day Rule Is For General Referrals And Preauths For Surgery. When Something Has To Be Reviewed By A Medical Director They Are Allowed 30 Days ..let Me Stress This Part...if All The Information Is Turned In!!!! Have You Called And Made Sure They Have Everything They Need To Review Your Case??? If It Gets Denied Over Stuff Not Being Turned In Then You Have To Start The Process All Over Again. If It Gets Denied Because You Dont Meet Criteria Then You Have To Go Through An Appeal Which Again Can Take 15-30 Days For That And You Need To Submit Additional Information, Etc. If It Gets Denied Again Then Your Only Option Is To Appeal It Through The Department Of Insurance. As Far As Going Ahead With The Surgery Before Insurance Pays For It...i Would Have To Say That Is Not Wise With United Healthcare..it May Give Them More Leverage To Deny You. Generally There Is Coverage After The Acceptance..not Before. If Your Parents Are Paying No Matter What....well..thats Definitely Your Choice. My Suggestion Would Be To Call The Insurance Company Every Day And Bug Them. It Will Get Them Moving...believe Me On That!!!! Have Your Doctors Office Call And Check Too!!!!! If You Arent Getting The Answers You Want Ask To Speak To A Supervisor!!!! Good Luck And Let Us Know How It Turns Out!!!

[Dragonwillow 0]

My doctors office says that United Health Care is one of the quicker responders. I would call and make sure they have everything they need. And then get on your dr. office and make sure they sent everything in on time. If you just called and they said it would take 30 days....well they aren't stupid...they are going to give you the longest amount of time it takes them, not necessarily how long it actually takes. You are just a file to them, you want to talk to people there and make sure that you get someone who will see you as a person, you will more than likely get better anwsers and responses then.

Melissa

[j_war06 0]

My doctor keeps saying he will call, and will not (talking about my orthopedic surgeon). This surgery is not for me to look great in a mini skirt, it is so that I can walk again. We have called the insurance company every other day since they recieved the Appeal letter on July 11. August 11 might be too late, I cant go to school like this. I cant stand my orthopedic surgeon and hope that he has the same problems as me someday, but then ofcourse he would be able to pay for it right?

[j_war06 0]

Plus, mom refuses to call and she has to be the one to make the call because I am a minor and the insurance is under her company, I just dont know what to do, I am hurting so bad, I barely got out of bed today.