Insurance said YES, now they say NO???!

[Guest guest]

Hi everyone,

So get this...I was scheduled and confirmed/approved for 4 parts of

this surg. 8/9 and also an overnt stay. The parts were upper AND

lower reconstruction, oral surgical services and lastly genioplasty.

Oh and I have Vytra, pos.

So, when I got the apprvl letter recently and was talking to a rep, I

asked what the codes were and she told me. I was like REALLY!?

Approved for Genio too? YES was the answer.

I recall the the os said they may consider that " unnecessary " and

cosmetic, so I may have to cover that-a near $4000 mind you. So I

asked the rep--are you sure???? YES. (good!)

I was also told that if I had to pay this, I needed to do it PRIOR to

the surg --in short, no $, no genio surg. (mind you-told to me more

nicely than I write now)

So I called the OS-ins person...Check this out...I don't have to pay

you, they are, I said. She doubts me and says, REALLY?? That doesn't

sound right...I will call them and check.

Ok.

Got a letter again, approval for the same as I did last time, upper-

lower-genio-os serv. 2 letters...same stuff--good!

waiting...she still hadn't heard at their office.

that was weeks ago. waiting, waiting.........another letter,

approving 2 nts if necessary.

then she calls me last thurs to say, they went ahead and did approve

2 nts if nec (I was down as an out pat and they NEVER said that in

prev talks-always 2-4 nts?! so she called and changed it----whatever-

maybe that's why this happened...ha, that would be something)

last nt, after a really difficult 2 days-just in life in general, I

get my mail--BIG LETTER from Vytra. After " re-review " -NOPE...changed

their minds and they ARE NOT COVERING IT-the genio-AT ALL.

Pardon, but what the BLEEEEEEP!?!!!??

I feel so shafted. I get all these yes letters and reps on the phone,

then the os office checks and NOPE.

What's your take? Are they trying to get more $ from me than the ins

co? Can the ins co give then take-ith it away?? With no new info or

files of my case...how do you make 2 diff assestments on the same

info????

I could cry.

scream.

I'm just so frustrated. it's 2.5 wks until and what a curve ball.

What do I do? bec, I want to discuss this with someone...

HELP! please....jo

(sorry if this is a repeat, I posted on both sites bec I really need

some good ideas and info here...thanks!)