Tuesday, June 12, 2012

The Squeaky Wheel Gets The Grease

People keep telling me I need to make sure I am being heard and stay on top of things to make sure I am a priority... well I have been trying... but it doesn't come naturally to me to be "persistent/insistent".  Well... today I had enough.

I called my insurance company today to see if they got the paper work that was sent last week. They told me there is nothing in my file yet and that it would only be updated once the appeal was evaluated. I asked how long it would take... they said 30 days from receipt. I asked how I would know if it was ever received.. they said I wouldn't and my dr's office would have to follow-up.

I hung up and called Sue (the insurance person assigned to my case at the surgeon's office). She told me it is sent to a p.o. box and it takes 3-4 weeks for the insurance company to even get it. She told me not to bother calling until the 6 weeks was up. I was pissed.

I got off the phone and called the insurance company back. I talked to someone who was extremely nice (and actually took pity on me) and explained that my doctor's office is not properly advocating. She told me there was very little she could do but she would put me on hold and try to get me through to the executive  office. She did... they told me the doctor's office should have filed an urgent appeal that takes 72 HOURS from receipt to be reviewed.

It is now 3 weeks past my upper GI. The paperwork was sent on Friday. I am pissed so I called Kelly (one of the account gals at my insurance office).  I trust her, and though this isn't her department, I thought she could help. I explained that I was calling her because I trusted her and I am frustrated.  She was horrified.  She said this is totally being mismanaged and told me she would transfer me to the office manager. She was already gone, but Kelly assured me she would make sure she called me back right away tomorrow morning. I left a message explaining the situation. I feel like I might actually make some progress.

In other news, I puked 2 times today.  I read CJ's post about choosing Lap Band and if it was a good decision.  I have been thinking about this all day.  And even though I hate my band... and probably would have never chose it if I had a better option, I still think I made the best decision at the time.  I am not sure I would ever suggest the band to anyone though.

1 comment:

LDswims said...

I'm glad you are squeaking. It sure takes a lot out of us to do that, but it helps and in situations like this, it's worth the energy. I am glad you called your friend. I hope that goes somewhere. I am praying for a quick decision and positive resolution for you!