I've also been told I have little tact, so if this offends you simply ride on.

Monday, May 11, 2015

Claim Denied

For those wondering how my surgery went?  Well, it didn't.  I received a call on evening of May 5, 10 hours and 40 minutes before my scheduled surgery telling me my insurance denied my claim.  The excuse given was that my insurance company had recently changed their criteria.  Now I do know, for a fact, that insurance companies do change criteria, sometimes quite often.  What has me more then a little concerned was that I agreed to the surgery back on April 2.  What I'm hearing from a lot of people is it should not have taken 33 days and some 13 odd hours for my surgical team to find out about this denial.  There is a last ditch effort in which there was a Peer to Peer doctor review to get a quick approval on an appeal.

So here I sit waiting while my FMLA slowly runs out.

Oh, and they know I'm not very happy.

And I keep think back to Tiara, and how she had such a difficult time getting my FMLA (leave of absence) form processed correctly.  Why?  Because on one of the times that I called I was told that she was in charge of forms.  Would someone whose responsibility it was to fill out all forms be the one person to file an insurance claim?  I'm thinking it probably is.  Which leads me to believe that she did just a shitty job filling out my insurance claim.

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