 Surgery cancelled 2 days before surgery date
I've been lurking on this site since August of 2007, but have never posted. However, I needed to share what happened to me today.
I've done EVERYTHING the doctor has wanted. I sat through 2 of the orientations because my husband couldn't come to the first one. I called my insurance company twice to verify the surgery was covered. I was told both times I would have to be pre-certified (evidence of medical necessity from the surgeon's office - I have a BMI of 43 & 2 comorbidities), but that my insurance would cover it. I even got copies of ALL my medical records incase they needed weight records. I went all the way back to 1994! I could come up with 13 years of weight history!! I was told that I had to lose 5% of my body weight, I lost close to 10% in 6 weeks. I have been ready for this surgery ever since August.
My husband cleared his schedule (which is difficult for him to do) for the week of the 7th (My surgery was scheduled for April 7th). And, at 5pm Friday night when I was at work, I was called by my surgeon's secretary to tell me that she had to cancel my surgery. My insurance denied my surgery not because it wasn't medically necessary, but because they said they never got the surgeon's paperwork for the surgery. The secretary faxed all 25 pages back in March, received a fax confirmation sheet that the papers went through, but she didn't follow up with a phone call until the last business day before my surgery on Monday. My insurance company claims that they never received her fax.
I didn't follow up with the insurance company because I couldn't control the paperwork submission - and I figured that I would receive notice if they denied me. I NEVER thought that the doctor's office wouldn't follow up with my insurance company if they didn't receive ANY word from them. So, my surgery is now cancelled.
I do feel badly for the secretary though, the surgeon is pissed off at her. He told her that she is to get on the phone with my insurance company on Monday - get authorization - and put me in the next available OR spot. He only does surgeries on Mondays, but is going to do my surgery the next available day, Monday through Friday. We'll just have to see though, I'm not making the mistake getting my hopes up again until I'm being wheeled into the OR.
Sorry about the long first post,
Marlene
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