So Frustrating

[Feralpeg]

I went to see a surgeon a few months ago. I need to have a problem corrected. The surgeon wrote up the various options and submitted them to my insurance company. The surgeon told me it would be about 8 weeks before I'd hear anything.

After 8 weeks, I called the surgeon only to be told that I'd have to contact the insurance company directly to find out my options. So, I contacted the insurance company. They still need to review my records and the various options. However, once they do, they will not tell me what my options are because that would be like advising me on a medical procedure. They only thing they will tell me, after the review, is which CPT codes they will cover. Now, I have to call the surgeon back and get a list of CPT codes that he sent in as possibilities.

This is so very frustrating. I'd really like to get this taken care of, but I feel like I'm running in circles. I told the surgeon my preference, but he really didn't pay much attention to my wishes. I really have no idea what he wrote up. He did not give me a copy. When I do find out what the insurance company will cover, I am not planning on using this surgeon. I'd just really like to know my possibilities before I see anyone else.

It's times like this I really wish I was rich enough to do what I need to have done without worrying about insurance.

 

[Uncle Remus]

Man, I hope your medical condition isn't life threatening.

 

[mrFDNY]

I went to see a surgeon a few months ago. I need to have a problem corrected. The surgeon wrote up the various options and submitted them to my insurance company. The surgeon told me it would be about 8 weeks before I'd hear anything.

After 8 weeks, I called the surgeon only to be told that I'd have to contact the insurance company directly to find out my options. So, I contacted the insurance company. They still need to review my records and the various options. However, once they do, they will not tell me what my options are because that would be like advising me on a medical procedure. They only thing they will tell me, after the review, is which CPT codes they will cover. Now, I have to call the surgeon back and get a list of CPT codes that he sent in as possibilities.

This is so very frustrating. I'd really like to get this taken care of, but I feel like I'm running in circles. I told the surgeon my preference, but he really didn't pay much attention to my wishes. I really have no idea what he wrote up. He did not give me a copy. When I do find out what the insurance company will cover, I am not planning on using this surgeon. I'd just really like to know my possibilities before I see anyone else.

It's times like this I really wish I was rich enough to do what I need to have done without worrying about insurance.

It's amazing how the insurance companys have set standards that hospitals and doctors have to adhere too.Instead of treating every patient differently,they treat you like a insurance code,its very disgustion!!Hope you'll get what you need and feel better quick!

 

[Feralpeg]

Man, I hope your medical condition isn't life threatening.

No, it isn't life threatening, but it isn't something I should let go for a long time and it is somewhat painfull.

 

[Feralpeg]

It's amazing how the insurance companys have set standards that hospitals and doctors have to adhere too.Instead of treating every patient differently,they treat you like a insurance code,its very disgustion!!Hope you'll get what you need and feel better quick!

Thanks!

 

[KIRSTIN'S MOMMY]

I hope you get a resolution quickly Peggy, and I'm very glad to hear that it isn't anything serious! Good luck, I know the insurance companies can be a tough bunch to deal with.

 

[OceanAnnie]

To me, I wonder what is the difference between advising you and letting you know what they will cover. IMO it's splitting hairs. You need to know what's covered and will make a decision based on the information they provide. What you do with that information is your business. Why provide the codes and make it difficult for you to "access" the information? They should give it to you straight. I have so little patience for that bs!

I've gotten the run around recently too. Different matter, but same sort of head ache. I submitted forms for reimbursement (someone keyed information wrong & it cost us money). It took over 6 months and regular calls to get the money back.

Document every call and who you spoke with. Refer to you documentation as needed. Ask to speak to managers/supervisors, it does help. Good luck! I hope everything goes your way.