I have mentioned my insurance woes before. Well, we are now encountering a new issue.
I am supposed to have a partial hysterectomy due to unexplained pain when my uterus when it’s moved. This isn’t just a slight little irritating cramp. It is scream, climb the walls, can’t walk for days afterward, pain.
I grew up as a rape and incest victim. So, I only will see female doctors. I found an awesome one years ago. She did my tubal ligation when I was 21 and has done all that other stuff ever since. Well, a few years ago so moved her practice across the border to another state. It was no big deal because they still accepted our insurance and our insurance was okay with them. I have been seeing her for a little over a year on this pain issue. She did a surgery on me just last year in the hospital that she practices at.
I’m sure you can see where this is going. I got a call at work yesterday from my doctors secretary. My insurance had told her that they won’t pay for surgery out of state unless its an emergency. Do what!? They have before at this very same hospital for this very same doctor.
So I called my insurance company. They told me that all they could do is appeal the decision. There was nothing that I could do or she could do.
I called my docs secretary again and explained what I was told. The secretary said that there was nothing to appeal since this was a preapproval. So she sent me to the hospital billing department to see if they knew of some other way to take care of this. Stress alert!! They told me that I would have to prepay for my hysterectomy because they are denying the preapproval. They could still present the surgery to my insurance company and reimburse me if they accepted it.
I don’t think so!! I have a family and there is no way in hell that I can prepay for anything right now. No way!! This is why I have health insurance.
As much as I didn’t want to I called my companys health insurance agent. I have dealt with this dude in that past to only get misled and no results. I was forced to leave a message. Grrr.
But he called me back!! He couldn’t see what the issue was either. So he started working on it. I got two more calls from him before the day was over. He has the regional rep looking into it and hopefully by Monday we will have an answer. My agent thinks that when the doc’s office merged with another it changed their code and it’s causing issues. Instead of the doctors office fighting with it they are giving up and/or they can get more money from me prepaying than from my insurance company.
Kevin is pretty sure that this will all be okay and it’ll be fine.
But I’m terrified. My doctors nurse has already called to see if I wanted to cancel my surgery! I need this surgery. I can’t be in this kind of pain anymore. I want my life back. I want to be able to exercise and not be in pain for a week afterward. I want to run around after my kids, dance with them in the living room, wrestle with them when they are grouchy.
There isn’t a doctor in my town that I trust. There are only a handful of doctors in our area that can do this surgery and they are either men or are inexperienced. I trust THIS doctor. Plus, she is full of information, she loves questions, and she treats my husband like an intricate part of the process (which we both love). I hate our hospital here too. The nurses treat you like crap, the rooms are never very clean, the food sucks.
All I can do is pray and I’m not used to having to have that kind of patience.
Posted by FXSmom
Posted by FXSmom
