Re: iT'S ME AGAIN

[Guest guest]

Cathy,

Make sure they understand that you are calling regarding pre-approval

(sometimes called pre-authorization) NOT pre-certification. Sounds

like from what they told you that they think you mean pre-cert

(that's what the insurance industry calls it when you have to let

them know you have been hospitalized--just certifying the hospital

stay--it has nothing to do with prior approval). It's kinda

confusing, I know. Of course, if your surgery isn't approved, neither

will your hospital stay be covered.

If you get the run around, don't let them put you off. Ask for a

supervisor. Be prepared for the customer service rep to try to talk

you out of it; they probably get written up for it. I used to be a

CSR in a call center for a health insurance company and we

were " strongly advised " not to transfer an insured member to a

supervisor. You may also be told they will have the supervisor call

you back; if you don't get a call back within 24 hours, call again.

But many times a CSRs hands are tied and they CAN'T tell you

anything. A supervisor, however, can get things done (if he or she is

at all customer oriented).

Good Luck!

XXXOOO

(also in NC--not far from you!)

> Hi,

> Well, I called United Healthcare, but I'm still lost. The person

I talked

> to wanted to know what my surgery date was, I told them it hadn't

been set

> yet as I was waiting for approval. He said that there was no

approval showing

> up in the computer, but he said that Dr. R or his office would have

to call

> them as that is the way they approve is by phone call from my

Doctor or I

> guess the office to them. Now what do I do? Do I email Debbie and

tell her

> this? Will they make the call do you think?

>

> Cathy in Lenoir, NC

> Wanting to be on the other side

> BMI 42

> Patient info emailed 5/2/00

> A journey of a thousand miles begins with a single step