Weight Loss Surgery - Insurance Woes




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jburress
02-04-2003, 09:25 PM
I called my doctor's office yesterday to find out the status of my approval. They told me everything had been sent to insurance on 1/17. They told me to call insurance. I called insurance and they said the only thing they had was a fax requesting surgery. I tried to get in touch with people handling my case. I phoned and left a message and e-mailed. No response. My husband called me today and told me I had a letter from insurance saying they had no information on me and requested all the information I had sent to doctor's office. I called them again today, got put on hold and disconnected. I called back, got voice mail, left a message. I called later and was told I would have a return call within an hour. I got a phone call and told to call insurance again and told to speak to a superivisor. I did and the girl I was talking to refused to let me talk to a supervisor. When I got home I read the letter from the insurance company. It was a copy of the letter sent to my doctor and at the end it stated in capital letters that they DID NOT want me to call. Well, sorry! I figured if I was paying my preminums, I had a right to call them.


jiffypop
02-04-2003, 09:36 PM
ick!!! i think that your state's commissioner of insurance would be interested to know that your insurance company didn't want to talk with you!!! and you can certainly call the insurance company to tell them that you're sending this to the commissioner. and you can keep reminding them of that whenever they give you a runaround. keep good documentation.

as for the rest of it, unfortunately, there is no easy way. you just have to keep on them.

debkay
02-05-2003, 07:11 AM
Ditto what Jiff wrote......ick!!!

My insurance company pulled that crap on me also. I called and they told me they would only talk to the surgeon's office.........didn't sit well with me. I bite my words back and hung up. I agree with you, your paying the premiums not the doctor's office.

Once again I agree with Jiff.......keep very detailed records of who and when you spoke to each person. If things are not resolved to your liking soon.....fire off a letter to the insurance commisioner of your state. Insurance companies HATE THAT!!!!

Debbie


jiffypop
02-05-2003, 07:57 AM
<sigh> we're such an agreeable bunch around here. B**CHY when insurance companies get us, but otherwise agreeable.

ruth.. do i have to be moderated now???? for insurrection???

jburress
02-06-2003, 04:46 PM
My doctor's office called today and they need my PCP to give me a mini physical and write a letter documenting my weight. They also need documentation of weight loss program like Weight Watchers.

debkay
02-06-2003, 05:25 PM
What their asking for is not out of the norm.

I didn't actually have documentation of weight loss programs, but I had been in and out of the doctor's office weighing for years. When my PCP wrote my letter, she included as part of her letter, a list of all the past attempts I had made at weight loss. This seemed to be just what my insurance company needed.

Keep us informed
Debbie

jiffypop
02-06-2003, 07:54 PM
at the support group meeting, the leader said that she'd recently seen a 600+ pound man who, when asked about his previous weight loss attempts, said that he'd never ever dieted in his entire life, and that he was looking to this surgery so that he could keep eating and lose weight.

she threw him out of her office. THAT's the kind of guy the insurance companies don't want to finance. it's a set up for failure. but for most of the rest of us, we've been through it ALL!!!!