Question:
Help please! I can't get my surgeons office to submit to insurance ?

I called my surgeons office to check if I was submitted to insurance on Friday and the office nurse told me that they didn't have my pulmonary function test I told them it was on a prescription pad note, she said they needed the actual report, which is fine but don't you think if they needed something they should have called, it was 3 days after my consult. So I called my Pulmonoligist and had them fax ME the report and I faxed it over to the surgeon and then called to make sure they recieved it, she said they did get it but it's not what they usually get still she said it did say that I was clear for surgery from a pulmonary position but she would have the doc review it if it was enough. I asked her to call me back and let me know what he say's, if it's what he needs or not, she told me he's not in the office today and it's a holiday weekend. I called the surgeons office on Tuesday 2/21 to check if the doctor was in today, she told me yes and she would have him review the pumonology report to see if they can submitt to insurance! I asked her to call and let me know if it was ok or not she said she would! Well no call all day tuesday and I waited until late afternoon yesterday to call and she told me no he hasn't reviewed it yet but she would put it on his desk with a big note "can we submit to insurance?" and would give me a call. Well I know it's still early in the day yet but no call and I don't want to annoy the surgeon or the office staff but I don't know what to do several of the women from my work have had this surgery and all have stated are insurance is one of the easiest to get approved through literally maybe 1 or 2 day turnaround max it just has to be medically necesary(sp) which I already have 3 docs saying it is in report I gave to the surgeon. How can they approve it if they don't get it, it has been 9 days since my consult and I turned everything in that day he told me he would submit it the next day cause everything was in order. I don't want to be a pest but I wanted to try and have my surgery by 3/20/06 as my sister is having spinal surgery that day and I wanted to be on my road to recovery so I can help her with hers. what to do, what to do? any Idea's is greatly appreciated! Thank you!    — HAILEY (posted on February 23, 2006)

February 23, 2006
I know it is frustrating, take a deep breath and I will sugest you call the pulmonologist and have him call your surgeon direct. That way you will not seem pushy to the office staff at the surgeon's office. Plus they will most likely allow both Dr's to speak directly with each other, that way they can clear this up with a simple conversation.
   — Ulises Robles

February 23, 2006
Ive been in process for 10 months, on wls surgery the attiude is its no emergency, we are at the bottom of the priority list for processing.
   — walter A.

February 23, 2006
5 words. Squeeky wheel gets the oil....!!! Who cares if it annoys them they will eventually get tired of you calling and do something about it. After all it is not their bodies that they are dealing with it is yours. I am 5 yrs post-op I have heard others and myself included say this time and time again. You have to ride them, motivate them or they will drag things out to over a year or better. What you are doing now is the right thing. I would call them everyday untill I got my answer. It might seem a little forward but hey its not like you have'nt waited long enough in your life feeling the way you feel. Your WLS friend, Jo Michalko
   — Jo_Michalko

February 24, 2006
In light of what the prior poster said about the squeaky wheel. . . , be careful. You have to be sickenly sweet when you make your calls to find out where you are in the process. It could all backfire in your face if you catch an office girl or doctor on a bad day. Good luck.
   — ChristineB

February 24, 2006
I work with doctors all day long and the best thing to do is keep calling the office and have the pulmonoligist call also. If you can't get through to the doctor try the nurse in the office. Believe me when a client keeps calling we all get frustrated and make the doc's do what we want. I also suggest calling twice a day once right after thier lunch and again just before the office closes. These are two good times because it is generally when the doc's look at incoming information.
   — Juju B

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