I was told "your doctor was notified on Mar 18th that further paperwork was needed so your case is pending until that paperwork is received."
I asked, what paperwork was needed?
She said, you'll have to call your doctor for that information, all I can see is that more info is needed.
(I'm thinkin, really? YOU need the paperwork and YOU don't even know what it is?)
I said, ok. So, um, is April 2 and I've been calling in every other day for status updates, so why am I just hearing this now?
She said, I can't explain that
I said, well this just makes me sad
She said, well have a Happy Easter.
Ummm....ok....thanks? I think? (says Lori scratching her little (huge) noggin...I've got the worst widows peak and highest forhead in the world!)
So I get off the phone with ins co and call my advocate to see what's going on.
She answers the phone.
I say, ins co said "blah", do you know what's going on with this?
She said, ins co told us on Mar 15 that all paperwork was received and that they have a complete file. She said I can also tell you that your file would not have gone to a medical director (which it did end of last week) unless the file was complete. The case workers make sure the file is complete and then pass it onto the medical directors for a decision.
We then had a long conversation about insurance co's and how ridiculous this all is.
I like my advocate.
Somewhere in that conversation she says, ins co's have specific things they have to say for each successive phone call. Apparently what I heard today was next on the list of "standard responses". This poor little "customer service rep" was just saying what the computer told her to say - even though it had no relevance to the truth.
I LOVE IT!
So...ummm...why am I calling?

HOLY COW! I gotta tell ya...this is one part of the journey I'm not looking forward to. My approval is kind of a crapshoot as it is so I'll undoubtedly get the runaround. So sorry you have to put up with this.
ReplyDeleteInsurance companies love to take your money, but getting money from them is like taking away a banana from a rabid monkey. Before I started this whole process, I called my insurance company three times to ask if they cover it and how much.. they told me 3 different answers. Patients should never deal with their insurance companies alone. I'm glad you have someone to help you with all of this mess.
ReplyDeleteHey there!
ReplyDeleteThanks for following my blog and catching up with my story.. I really thought I was already following you..I wasn't ..and now I am.. :0)
Booo to insurance!! :( But yay for advocates.. that's must have been heart sinking to think your paperwork wasn't complete!
I'm crossing fingers and toes for an approval asap!
Thats really annoying! I'm glad you feel comfortable with your advocate though. Fingers are still crossed for you!
ReplyDeleteJust keep repeating the mantra-- "It'll all be worth it one year from now. It'll all be worth it one year from now..." Repeat as necessary.
ReplyDeleteI've lost 85 lbs since my surgery, with another 50 to go officially. (Another 25 is all I really want, but doc wants more.)
Hang tight, Swimmer.
I've been MIA for a few days, but just want to add my thoughts to this post, even though I'm late. INSURANCE COMPANIES SUCK BIG TIME. Okay. Just wanted to share.
ReplyDelete