Insurance Woes

Sorry, I just needed somewhre to vent.

I'm getting a little worried.  My clinic submitted my case for insurance approval late last month. It wasn't the best case because I was missing a weight record for 2011. (Aetna requires a two year history). I didn't have a weight history for 2011 because I never went to the doctor. I did go to the hospital once, but my weight wasn't recorded.

The insurance coordinator at my clinic told me to submit photos of myself in 2011 because I didn't have any weight history and that it should work. I called Aetna this morning and learned that the photos aren't good enough and they want a record or I'll be denied.

I remembered this morning that I went to the doctor a few times in late 2010 (sometime between October and December) and my weight was recorded. I am currently going back and forth with my old clinic to retrieve said records. Let's just say that is a major headache.

I hope these records are good enough to get my case approved. My insurance coordinator said that it should be enough, but I'm a large worrywart and have gone through the pain of denial before.

Fingers crossed!

I'll send a prayer up for you! I understand being a worry-wart, because I am too!! Good luck with everything!

 

 

Thank You so much. I'm still trying to acquire the records and it's frustrating, but I have faith that everything will succeed.

You're welcome!! What is the hold up with acquiring the record? I understand it can be super frustrating!!! :-) It will all work out the way it is supposed to! :-)

 

 

The office where I'm trying to acquire the record from is filled with....not-so-nice people (to say the VERY LEAST) who act like it's a sin to for a client to ask for the fax number to their office. I was told that I needed a request from my surgeon's office for the records or else I would have to pay around fifty bucks for them. (???).

I had my surgeon's insurance coordinator fax over a request and I'm currently trying to call their office to see if they received the fax so I can come pick up the records. I've been trying all morning. :/

Thanks again for the encouragement. I'm a few moments away from pulling out my hair, haha.

Nicole,

Some doctors office(s) get a 0 by-way of communication and friendliness, it's sad!!

A lot of offices in Maryland charge for patient records, unless it's medically requested.

What is the name of the office? Have you tried to google for a fax number?? I sometimes find this is the best OR call a provider associated with them and see if they have the fax number.

:-) I've been there, done that! Good luck! ;-)

-Sarah

I finally managed to get in contact with the office and they said that they couldn't read the handwritten request and that my DOB wasn't included, so they faxed it back to my surgeon's office saying they didn't have any records.  I contacted my insurance coordinator so she can fax over another (hopefully typed, haha) request with my DOB included. Things are finally moving in the right direction.

 

Thanks for the luck!

Good luck with getting that record! If they deny, then appeal that foolishness!

FWIW, I was required to have 5 years' worth of history. They didn't say consecutive years. Did you have any urgent care visits. I used some urgent care records for proof, as well.

Finally, this might give you an angle should you need to appeal- can you think of any other serious diseases for which a patient would be required to show they've had the disease for x years before they qualify for treatment?

I will definitely appeal if it is denied. I hope that I will be able to get the records over before I have to do that.

I don't have any urgent care visits--only one hospital visit where my weight wasn't recorded. I wish I would have gone somewhere to be weighed. :(

Thanks for that angle. It's very true--and quite sad. I will hope for the best. Thanks for your kind words. :)

Keep up the good work on staying on top of the matter and making sure the records get faxed.

My question is what happens when the doctor office doesn't have a scale that goes high enough to WEIGH YOU? So you aren't weighed, or not accurately weighed...ever? I had to go to a junk yard to get my accurate weight, and I did so on my own....my doctor at the time didn't seem concerned with not having my weight.