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Wednesday, January 21, 2009

Not IF related, cancer related (that's my life right now)

So one, I got the email two posts below again today..uggh, annoying.

I've just had a shit day all around.

This morning I called the secretary at the doc's office I am supposed to see tomorrow and asked if they had received my medical records or the faxed referral yet. She said no to both so I started making some phone calls. I got the medical records faxed easily, thanks to the awesome nurses at Dr. A's office.

The referral is quite another story and what's kept me pissed off and on the phone all afternoon. The 'higher ups' at Kaiser decided to deny my referral! Yes, that's right, DENIED!! How might they do that you ask when I already supposedly got the approval? My question was that exact one. Apparently the head of surgery at my medical center approved it then it went to get final approval from another head of surgery and she's the one that said no. I called Dr. A's office and they 'coached' me on what to say to an appeals person. So I called and did an emergent verbal appeal through Kaiser. They said that my claim qualified for an emergent appeal so now it's being reviewed and I will hear within 72 hours if they will reverse the denial. The crappy thing is that my docs who want this referral for me no longer have a say so it's up to me to fight like hell (which I have no problem doing ;).

I've made my case to the appeal board and now I sit and wait (and stew) to hear back. I am keeping my appointment for tomorrow to see the thoracic surgeon and scheduling the surgery for next week. I am trying to stay positive and confident that the referral people will see it my way.

Just one more thing to add to the heap I guess.

I'll keep you updated...

3 comments:

Andrea

Screw those people, sitting in their conference room making decisions only worrying about themselves. I hope you get your referral.

'Murgdan'

The system is so discouraging sometimes. Depressing how they play with lives like it's all a money game.

...and I'm doing some 'research' regarding Kaiser in my own hospital right now...

I hope your referral comes through.

Bella

Arghhhh!!!! Are you freakin' kidding me?! Hello, this is seroisu & needs to be taken care of quickly. They are endangering you, so they can fight over who gets your money. This is absurd! Shall I write a letter? I like writing letters :)