Insurance

October 14-October 28th

I needed a referral from my Doctor to go out of state to meet with a doctor as well as to have surgery. I had a referral written by the secretary to the orthopedic surgeon from CT (she was less than helpful through this entire ordeal). The referral was written, but rejected because she wrote "there is no one in this area of CT to perform this procedure" so the insurance company takes that as there is someone else I can go to for this surgery, whether they've done 1 or 100, they don't care. So now Dr. Millis and his assistant Erin had to appeal the denial..this also takes a few days. It was back and forth for a few days, then it was the weekend-meanwhile I'm making trips back and forth to Boston to give blood and have pre-op appointments etc. not knowing if the surgery is going to happen. So I'm told the surgery is approved, I call my insurance and they still say it's rejected...so it came to the day before surgery and I had not heard anything. We decided it would be better off if we cancel the surgery and wait until everything is taken care of properly.

I was later notified that the surgery was approved for Oct 28, but they send out a letter in the mail. Like that's going to help me when surgery was less than 24 hours, they can't call or fax me the documentation? What a headache! Dr. Millis said he MAY have an opening for Nov. 29, otherwise it won't be until early January. I decided January 3rd would be the day so I'd be able to upgrade my insurance and what not. By now the pints I donated to myself had expired so I had to give 2 new pints and my pre-op was scheduled for Dec 28th. I gave one pint of blood on Dec 10 in CT at the Red Cross and they sent it to Boston and the second pint at my pre-op. Naturally we get a HUGE blizzard the day before my appointment, but there was no way I was changing that appointment.

December 2010

However: I received a call mid December from the Patient Financial department telling me I needed a referral from my PCP for the surgery and they won't give one because I haven't had a checkup in over a year. WAIT A MINUTE. I thought my surgery was approved. Then they tell me it was approved, PENDING a referral from my PCP. Why was this the first time I hear about this? So now I have to rush a checkup with a new PCP (as mine had lost his license for writing himself prescriptions for drugs). I have a checkup, explain everything to my new doctor and she writes a referral. Great. I'm finally good to go!

I go home for Christmas, receive another email from the hospital saying there's not enough time to approve the surgery under my new insurance policy. AHHHHH!!!!  Come January 1, my company had open enrollment so I changed my policy to allow me to go out of state without a referral. So I called my insurance company 3 times and they told me the approval would roll over after Jan 1st to the new surgery. Well the hospital didn't agree and since Jan 1 was a Saturday and my surgery was scheduled for Jan 3 (Monday there was no time for it to become approved. What...are you kidding me...I have to re-schedule this damn thing again? I have had my emotions all over the board I don't even know what's going on. I'm stressed beyond belief and ripping my poor husbands head off for no reason, except these people are pushing me over the edge! I re-schedule to January 12 (of course ON Jan 3 the surgery for Jan 3 was approved...I even volunteered to sign a waiver...they refused me). Now I had to wait ANOTHER 2 weeks. I just wanted this over and done with so I could be on the road to recovery so I can get my other hip done. In the meantime I'm still in pain...duh!