So Frustrated with Insurance

I went to my initial seminar for WLS the first week of December.  BEFORE I went, I contacted my insurance company and found out their requirements just so I knew what was in my future.  At the seminar, the nurse said we could go ahead and do any of the requirements that were possible before our initial consult with the surgeon.  In December, I saw my PCP, the NUT, and had my pych evaluation to get ahead of schedule.  When I met my surgeon for the first time on January 17th, I received the list of what was left to process (sleep study, pysch eval sent to office, and endoscopy).  I was told that the sleep study and endoscopy would not hold up scheduling a surgery date.  I called the psychologist that day and had him fax the evaluation right away.  All of my info was received and sent for approval at least two weeks ago according to the bariatric center (nurse and insurance coordinator).  I contacted my insurance company to ensure they had received everything.  I was told nothing was received.  I then called the bariatric center and was told that a lot of times the customer service people at the insurance company don't have access to the right information.  So, I called the insurance company back and was given another phone number to called that was specifically for bariatric surgery claims/approvals.  I called that number and the ONLY option you have is to leave a voicemail for a callback.  I received a callback over 24hrs later which said that the center needed to fax the submission to a specific number and nothing had been received yet.  I call the center back and they insist everything has been submitted and is "pending".  A week later, I still have not heard anything.  I called the insurance and left two more voicemails (one on Friday and one yesterday) and have not received a callback.  I am not expecting a 24hr approval - I just want to know that everything has been received!  I'm so frustrated that I 1. can't talk to a live person when I call, and 2. have no idea where my personal medical information is floating around within the insurance company.  Am I being unreasonable to expect a callback with SOME kind of information (even if it's that they haven't received anything) after 48hrs??

No, you are not being unreasonable.  Sorry you are having such a hard time. Maybe get the exact number from the insurance company of where to send the paperwork to then give that to the bariatric office and ask them to resubmit.  Good luck!

Thank you!  I did exactly what you suggested over a week ago.  I waited a couple of days and then called and left a voicemail with the insurance company asking if they had received anything.  No response.  I left another message on Monday.  No response.  I emailed the insurance company to ask how to escalate customer service issues and was told a supervisor would contact me.  No contact.  Grrrrrr....

Ugh, that stinks! Dealing with insurance is difficult. 

I know it's a pain!  I couldn't tell by reading your post if you needed to complete the 6 month required diet/exercise program as a requirement from your ins.  I have to complete a monthly visit to both my PCP and NUT, plus all of the other things you mentioned, psych eval, etc.  My surgeon's office said that after all of that had been completed after the six months, then that would submit all my paperwork to the insurance company for approval.  Just wondering, did they require the six months?

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Hi there.  No, I was not required to do the 6 month supervised program.  In fact, I was given the impression that my approval would be quick and easy.  The requirements were just PCP approval, a statement from the surgeon that my past attempts at weight loss were sufficient, and the psych eval.  I had everything completed early and stayed on top of having the psych eval sent to the surgeon's office.  My paperwork was submitted 4+ weeks ago and the insurance company is still refusing to acknowledge receipt when I contact them.  However, the insurance coordinator at the surgeon's office contacted them and they said it was received and being reviewed.