Please join hearts, hands and prayers for our Sherry who's having gastric by-pass tomorrow. Sherry's not having the by-pass to lose weight; her stomach is in trouble and she needs the surgery to survive. We want for her: fine care and quick healing. Polly
Oh, Polly. How kind of you to remember. But the surgery has been cancelled.
I stopped at the PO after church to get Saturday's mail. There was a letter from the insurance comany that said they would not approve benefits for the claim. They said they had requested information from the surgeon's office and had not received it, so they now deemed the surgery "not a medical necessity." I scheduled nearly 4 weeks ago. There is no reason that the doc's office could not have their ducks in a row and have everything set up by now. It sounds to melike just plain sloppy paperwork and clerical incompetence. The ins. co. said if I wanted to appeal the decision (I have to)...I have to complete this paperwork and it will take 14 days. Have you ever heard such a story? If I had not picked up the mail, I might have gone ahead, showed up tomorrow a.m. had the surgery then gotten an awful surprise that I was responsible for the entire bill.
Sometimes things happen for a reason though. I really believe that. Thank you again.
Sherry
I believe in Guardian Angels. Maybe yours didn't want you to have surgery tomorrow. Maybe your insurance company clerk is an incompetent sloth; can't make that call. Just know that we hold you close in our prayers. Polly
"Sherry" < > Please join hearts, hands and prayers for our Sherry who's having gastric
Oh, Polly. How kind of you to remember. But the surgery has been cancelled.
I stopped at the PO after church to get Saturday's mail. There was a letter from the insurance comany that said they would not approve benefits for the claim. They said they had requested information from the surgeon's office and had not received it, so they now deemed the surgery "not a medical necessity." I scheduled nearly 4 weeks ago. There is no reason that the doc's office could not have their ducks in a row and have everything set up by now. It sounds to melike just plain sloppy paperwork and clerical incompetence. The ins. co. said if I wanted to appeal the decision (I have to)...I have to complete this paperwork and it will take 14 days. Have you ever heard such a story? If I had not picked up the mail, I might have gone ahead, showed up tomorrow a.m. had the surgery then gotten an awful surprise that I was responsible for the entire bill.
Sometimes things happen for a reason though. I really believe that. Thank you again.
Sherry
HOrrible! That insurance companies would do something like that; that the doc's don't bother to do the paperwork; and what a shock indeed it would have been to have to pay the entire bill. However, I'm sure that it's only a delay and not a complete cancellation. When you're scheduled next time, let us know, and we all keep our fingers crossed and will light a candle for you (My grandma used to do that for us kids whenever we had a major exam or probably, too, when we were in hospital. I didn't know until years later when she did that for my youngest brother during his final exams at school. She was a wonderful granny, although my dad hints she was a dreadfully strict mother.) Anyway, good luck to you for getting your surgery approved and soon!
U.
"Sherry" schrieb im Newsbeitrag news: snipped-for-privacy@j2g2000yqf.googlegroups.com... > Please join hearts, hands and prayers for our Sherry who's having gastric
Oh, Polly. How kind of you to remember. But the surgery has been cancelled.
I stopped at the PO after church to get Saturday's mail. There was a letter from the insurance comany that said they would not approve benefits for the claim. They said they had requested information from the surgeon's office and had not received it, so they now deemed the surgery "not a medical necessity." I scheduled nearly 4 weeks ago. There is no reason that the doc's office could not have their ducks in a row and have everything set up by now. It sounds to melike just plain sloppy paperwork and clerical incompetence. The ins. co. said if I wanted to appeal the decision (I have to)...I have to complete this paperwork and it will take 14 days. Have you ever heard such a story? If I had not picked up the mail, I might have gone ahead, showed up tomorrow a.m. had the surgery then gotten an awful surprise that I was responsible for the entire bill.
Sometimes things happen for a reason though. I really believe that. Thank you again.
Sherry
{{{{{{{Sherry}}}}}}} I've heard of surgery not being approved, but never because the surgeon's office didn't give the insurance company the information. Shame on whoever let this slip through the cracks.
On the other hand, I'm with you. I think there's a reason you're not having it today. We may never know what that reason is, but I have to believe it's for the best.
Good luck on getting the information submitted as quickly as possible so the surgery can be rescheduled and you'll be on your way to a healthier you very soon. We'll keep you in our prayers.
On Sun, 31 Oct 2010 23:35:01 -0500, Sherry wrote (in article ):
Sorry about the insurance company, but not surprising at all. I've recently had a claim denied for something even insurance company admits should be covered, because doctor's office made a typo in the paperwork.
Maureen
Oh, dear, and I'm sure you had ramped yourself up emotionally and mentally for the surgery. Dealing with the speed bump now is a time for roller-coater feelings. We are all here for you.
Be sure to let your doctor know - I bet she/he would like to know who didn't send in the correct paperwork! They may need to review their procedure for that. That happened recently at my dr office, and when I had to go for a second opinion down in Los Angeles, I hand carried my own set of documents. Good thing, since they never got what had been sent. The set I carried had to be corrected, because they gave me part of someone else's chart [found that before I left my dr office]
Let us know when it is rescheduled.
G> >
Oh, Polly. How kind of you to remember. But the surgery has been cancelled.
I stopped at the PO after church to get Saturday's mail. There was a letter from the insurance comany that said they would not approve benefits for the claim. They said they had requested information from the surgeon's office and had not received it, so they now deemed the surgery "not a medical necessity." I scheduled nearly 4 weeks ago. There is no reason that the doc's office could not have their ducks in a row and have everything set up by now. It sounds to melike just plain sloppy paperwork and clerical incompetence. The ins. co. said if I wanted to appeal the decision (I have to)...I have to complete this paperwork and it will take 14 days. Have you ever heard such a story? If I had not picked up the mail, I might have gone ahead, showed up tomorrow a.m. had the surgery then gotten an awful surprise that I was responsible for the entire bill.
Sometimes things happen for a reason though. I really believe that. Thank you again.
Sherry
Positive thoughts, HUGS and prayers are on their way to you. There must have been a "higher" reason for the delay! Still, Why, oh why, do the insurance Cos. and Dr.'s paperwork providers put the health of their patients at such risk???? There's got to be a more efficient way to do this, in this age of computer tech-savy world..... OR, maybe that's the problem! Keep us posted, Sherry. You know you're in our thoughts. ME-Judy
Prayers and hopes that Sherry's surgery is successful and recovery is quick. -Irene
(((((Sherry))))) I don't know which you need prayers for most, the surgery or dealing with the insurance company. Either way, I'll keep you in my prayers.
Hugs, Sunny
sherry, so sorry to hear of the mixup at your surgeon's office. i worked for a surgeon for 18yrs and never once did we "neglect" to do the proper workup for a patient, including authorization for surgery. It could be the Dr's employee had an incorrect or "under-coded" diagnosis or procedure code. Was it to be a Roux-en-Y? or lap band or a type of gastrectomy? sometimes the Doc needs to get more involved with the process, ie: Dr to Dr review, etc. hopefully the reschedule will go smoother and you'll be on the mend. sending love and prayers your way. amy in SoCal
Hi Amy, It's called "partial gastrectomy with roux-en-y reconstruction". But the reason for it is hypertrophic pyloric stenosos, not obesity. I weigh 97 lbs. Talking to the insurance people, they said they received the claim, but no clinical data. They requested it and just never got it. I scheduled three weeks ago, so that's why I was upset to get a denial the day before surgery. I think both dr. & ins. had time to iron things out. It really stinks to psyche yourself up for surgery then get cancelled the day before. Thanks so much for the prayers. And everyone else here. I appreicate it. Sherry
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