Yesterday was interesting...never a dull moment. I spent three hours on the phone after I found out (at the last minute) that I wasn't preauthorized. One of the insurance people I talked to said that it was too late to get authorization; I would have to pay half of the full price up front as the hospital wished--and in all likelihood not get it back. I spent half an hour on the phone with her, and the best news she could give me was that I could apply for a reimbursement but that I shouldn't expect it because hospitals don't usually reimburse unless the surgery is preauthorized.
Well, if the surgery were preauthorized, I wouldn't need to pay up front, and I wouldn't need a reimbursement. Right?
Time was running out. I needed preauthorization by the end of the business day, and it was already midafternoon. Aaauuugghh.
At least I was able to get in touch with my case manager. She kept banging away on people until she found out what the problem was. She was told that my doctor's office had waited too long to send over my records; it takes five BUSINESS days to preauthorize, and my records had arrived only on Wednesday. But apparently, the records had been incomplete. The office did send the remaining records on Thursday. All set, right? I could be expedited in a day, right?
Wrong. Next, it seemed that my referral letters were not adequate. They were only "brief notes" stating that I was "an appropriate candidate." Um, no, these letters follow WPATH guidelines and are completely in order. I guess she went to bat on that one, too, only I didn't get the details. She was so disgusted, proclaiming, "It takes ten minutes to authorize the surgery. Literally ten minutes."
The afternoon dragged on. Finally, my case manager found out that my second referral letter HAD GONE MISSING. Blue Shield had never received a copy from my doctor, and his people couldn't find the original. They had received it, but nobody knew where it was.
The clock kept ticking inexorably. My case manager told me that if I had a copy of the letter, I needed to scan it and send it to her immediately so that she could forward it to the representative in charge of expediting my authorization. I had a copy and knew exactly where it was, so I ran to turn on the computer. Then, my doctor's office called. "We can't find the letter. Do you have a copy? You need to scan it and send it to your case manager." "Yes, yes, I'm waiting for my computer to wake up."
I was authorized at about four o'clock, waaaay too close for comfort. But I have confirmation from both my doctor's office and my insurance provider, and I have an authorization code to give to the hospital in case I have any trouble there.
Sheesh...
