Surgeon's Office -- Attention To Detail

Shelby · 01-31-2006, 04:24 PM

This is my first post and hopefully I will be among the banded soon!

My insurance covers lap band; I meet their criteria; I have meet all the requirements; I am confident with my surgeon's abilities.

My concern is the level of attention to detail within his office. Yesterday I found out I was denied because the Lap Band Coordinator did not include all the reports. Also found out they never requested these documents when I finished my '6 months of physician directed weight loss' in October! I thought I was involved. I thought I was on top of things. I thought everything was on track. I didn't expect to be denied. And I certainly didn't expect to be told when they sent my documents for approval it was not even read before hand!!

Lesson learned... I am sooooo all over this! She may have thrown away my 1st request but she will not throw away my health and happiness.

Jammin & Losin · 01-31-2006, 04:35 PM

Shelby I'm so sorry you got denied!! Sounds like to me you need to put up your dukes and FIGHT!!! :boxing: Don't give up keep trying and in time if you are meant to be banded then it will be !!
Cheers to Health and happiness

dovie6523 · 02-01-2006, 09:01 AM

Shelby: What office?

Shelby · 02-01-2006, 04:49 PM

Dr. Hagood's office. I really like him and a friend of mine had lap band surgery with Dr Hagood (along with other surgeries) and has nothing but great things to say about him. And I'm right there with her. I just don't want any more errors on processing my approval. I believe the gal is probably overwhelmed with the volume she is working with. But - no excuses. I now have her attention, she's working with me and keeping in informed - so hopefully it can be resent to Cigna by the beginning of next week.

sleepyjean · 02-03-2006, 12:08 AM

Quote:

Originally Posted by Shelby

My concern is the level of attention to detail within his office.

I can relate. My soon-to-be surgeon has an outstanding reputation, but the people in his office could use some work. Yesterday, I took off work early and drove all the way over there, only to discover that they'd given me the wrong appointment time. I had to reschedule, but they don't have any availability until the end of the month.

Besides that, when I called to schedule a consult with the surgeon, I was told to be there at 8:15 for my 9 am appointment. At no time did they mention that it was a GROUP consult and we'd have to wait for everyone to get there before we started. The consult didn't start until almost ten and lasted over an hour. After sitting there for two hours, watching other people come in behind me and get handed paperwork to fill out, I finally went up to the desk and asked if I needed to complete any forms. The lady was all "oops! sorry!" That would've been acceptable if I hadn't arrive a full hour before anyone else and if I hadn't been sitting right in front of her the whole time.

Shelby · 02-03-2006, 02:08 PM

It's just so frustrating isn't it. I understand human error and I'm trying to move on. But I'm having a hard time accepting that this is normal and because of the volume it's an acceptable mistake. I am guessing that I'm not the only one getting denied because of their volume!

Thanks for responding. I feel better just knowing other folks understand how I feel. I am so glad I found lapbandtalk! And if this is for me - it won't go by me!!

FunnyDuddies · 02-03-2006, 02:15 PM

You should appeal to the insurance company to get back your one chance. Let them know that the medical staff in his office did not include all the pertinent info, and that you should not be punished for the incompitence of others. let them know you are sending a copy to the state insurance board, and they should give you back that one try. If you have concerns about his staff, talk to him about it. They are his workers, and express how sad you are that now you have to wait for everything to be sent in again, with the added worry that it will be done correctly again.

At my old OBGYN the office staff were about as sharp as wet toilet paper. But I LOVED my doc!! He saved my life and my daughter's life during her birth due to his knowledge and experience. I would never change, even with my second on the way just because his receptionist didn't know how many days were in february. LOL Just say something, and express how much you trust and appreciate him, just not his staff.

MsButterKup23 · 02-04-2006, 12:14 PM

Sorry to hear this. I had a similar experience with Lap Band Solutions, they are idiots. I waited from April until August and they hadn't even submitted my paperwork to the ins company. My surgeon fired them and got someone in house to do his insurance stuff.

Best of luck to ya!

Shelby · 02-06-2006, 10:13 AM

Thank you for your advice and support. My plan is to reponse to each item on my denial letter which means I need another appt with my PCP so her comments can be entered into my file. I'm not just submitting the missing PCP report as the surgeons office suggested... the denial letter is asking for so much more. Then I will physically be in their office in front of the fax sending the documents - after everything is checked and doubled check. The coordinator is really working with me and I feel better about that. I've tried to talk to the surgeon but didn't get passed his assistant. I will talk to the doc - he's a great surgeon. It's too bad I had to become a speaky wheel in order for my claim to be handled properly.

leenerbups · 02-10-2006, 05:07 PM

I feel your pain.

I keep being told by the staff at my surgeon's office that they don't have the results for tests I have had done.

SO I have had them re-faxed to them TWICE. They still say they don't have them. I finally spoke to someone else today and she says they DO have them. But it seems the surgery coordinator doesn't.

(??!!)

SO I'm thinking I have it all straitened out and today I get int he mail that the recent blood tests they had me do show I am low in B12.

WITH another note saying they have not gotten the test results for this blood work.

YEESH! I had that test done 2 weeks ago, and how would they know I was low in B12 if they didn't get those test results?

I called and left a message saying just that.

All of this is really making me lose confidence in the office staff and because of your experience being denied, I'm going to make sure that the surgery coordinator is up on all that before submitting.

Shelby · 02-13-2006, 10:48 AM

Stay involved Leenerbups and double check everything. The coordinators are not walking in our shoes and have no idea how we feel.

It does make ya wonder if the office can't keep things organized - it has to affect the surgeons in some way. How can it not?