Insurance finally happened to me

[Guest guest]

Dear Gang,

After all the posts about insurance denials or insurance

companies just not paying at all, I have finally come up against the

same hurdle to jump. Even though I sent my patient information the

first time (its been almost two months ago now) it never went through

to Dr. R's computer. I sent it again about 2 weeks ago and yesterday

Barbara got the information so she could call my insurance company.

(Thank you Barbara!) They told her that my approval for the MGB was

to go before a review board and it would take 10 days to 6 weeks to

determine my eligibility. This is a big shock to me since I didn't

even proceed to make a PCP appointment or go through ANY testing

without 'pre-authorizing' this with my insurance. They gave me the

green flag and I was off and running like gangbusters, searching for

a PCP, having labs taken, going through many tests such as

echocardiogram and stress testing. I sent my packet in and even

called the insurance company one more time for good measure. " Yes,

Mrs. Tedeschi! You can have this surgery all we need is your doctors

one sentence line that says this surgery is 'medically necessary'.

I called the insurance company after Barbara so diligently

called them for me, and told me what they told her. I spoke to a

lady there who said, " Oh, I don't know who told you your surgery

would be a go. Everytime we have a case like this that is an

elective proceedure it has to go before a review board. " ....Then, " I

don't know WHO would tell you that because we NEVER say that to

anyone. " I then proceeded to tell her that not only ONE person told

me that I could have surgery but TWO people said I could have

surgery. I also said now I know what all my friends from MGB were

talking about. Insurance companies DO jerk you around. She got a

little bit angry and defensive at this comment and her only

consolation was, " I am sorry mam " . (Boy if I had a dollar for

everytime she said that.....) Then she told me the only thing I could

do is keep calling and see if the letter came in from my PCP that was

her recommendation for surgery. (Which by the way was the same

letter she sent to Dr. Rutledge, and not just one sentence.) They

would not accept Fax, they said it took too long for them to retrieve

and that it would be faster and least likely to get lost if my PCP's

letter were mailed.

I am sorry that all of this is so long. I just needed to vent.

I am a very patient person and accept that people are not on the same

time table as I am. I feel like my cocoon has been dropped in the

mud. Just when my shell was beginning to crack open so I could unfurl

one beautiful wing. Alas, spring is not here YET...I will wait a

little more before I take flight. The journey is long. For all the

people who have had trouble with insurance I now know your

frustrations. To my dear friend, , who finally gave up the

battle with insurance because they wouldn't pay, I salute your

courage. To Dr. R, I am still coming one day to see you. I will be

packing my Hibiclens, Gatorade, and Citrucel....LOL. For everyone

else who has had the surgery or has a date, my prayers are with you

for a sucessful journey into your new awakening.

Love,

Love is very patient and kind.

(from 1st Corinthians)