More Insurance Seething, and a Bit of Hope
I’m still pretty ticked off at my clinic. The last woman I talked to (“C” of the Latest Installment of the Insurance Debacle) was very sweet. However, each time I have called her back, she has seemed momentarily surprised to hear from me. She looks into the computer and promises to get on it “first thing tomorrow morning”. Uh, isn’t that what you told me last time?
The kicker is, when I talked to C last Wednesday , she looked in my file and let it slip that IT DIDN’T LOOK AS IF ANYONE HAD ACTUALLY SEND MY INSURANCE THE PAPERWORK! This was the paperwork that had to be sent after the expected first rejection. The paperwork I called and followed up on and was assured was sent. She grilled me on whom I had talked to (I usually write it down, but because there are only 3 of them, I hadn’t). After a second, she started to backtrack and say “I’ll get right on this”… you know what’s coming next… “first thing tomorrow morning”.
At least she called me two days later to say the paperwork had been sent off. NO WONDER I was rejected on the basis of “insufficient documentation”. There was NO documentation. I’m still seething. A little.
Today I called my insurance company and talked to the sweetest lady (yes, I got her name and call reference numbers). She pulled everything up, noting that the FIRST information they had received was not until AUGUST 2ND. Seethe. Seethe. She did the magic electronic paperwork thing and said “I’m sending this off to corporate right now. Let’s get this paid for you – this is a lot of money!” I was swooning at this point. I got reference numbers, AND a time frame: 15-21 days.
I’m ticked off at my clinic – I knew I’d be rejected the first time, but the second one gave me a panicky shock. I knew we did all the paperwork right, but it’s still at the whim of the insurance company whether they’ll approve me. I feel like I went through a week of panic and not sleeping based on erroneous information and incompetence – of course the insurance denied the appeal – they had NO INFORMATION!! They now have 60 pages (!) of information. I hope that will be enough.
I should’ve called my insurance company a month ago, but I was assured by my clinic that everything was being taken care of. I know, I know, I learned my lesson!
Thankfully, I have hope now that my claim may be approved. Now that they have actual information and all.



6 comments:
Leah that is unbelievable!!!! I'm shocked that they didn't send the information for you! BAH! Can you make a complain? But for the other side now i have a lot of hope that they will pay now and that explain why they didn't want to pay before!
My insurance was just submitted nearly a month after I turned in all the required paperwork. It is very upsetting and shouldnt take an entire month to get the cover letter done. But...how much can you complain....you dont want to tick off the office staff at your lapband docs office!
Sigh.
I always say if you don't do it yourself it won't get done. I would have been FUMING at the clinic. They would have had to put me on their "do not answer the phone if this lady calls" list!
Sounds like things are looking up!
I feel your pain. My surgeon's office was not the best to deal with, and I am so sorry that you do not feel like you are having the kind of success you want.
I'm thinking of you, and can't wait to to hear when this is all settled and victory is yours!
Keeping my fingers crossed for you honey!
Good luck Leah! Be relentless!!! Insurance companies count on wearing you down!
Dagny
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