The title explains it exactly! THEY MAKE NO DAMN SENSE! I got a letter today from my insurance company. When I opened the letter it was from the department that covers "inpatient" stays. The letter basically says that they will not certify for me to stay in the hospital overnight after bottom surgery. When I read further it states that "The proposed procedure is normally performed on an outpatient/short-stay (ambulatory) basis and there is no documentation of a medical condition that would warrant an inpatient level of care". ARE THEY SERIOUS! This is freaking crazy! It is okay for insurance to cut into my penis and remix stuff but they can't keep me in the hospital overnight?! They pulled this mess with my hysto. For my hysto I was fine with it because I know people who had the surgery and went home the same day. That is the beauty of that hysto technique. This is a different ball game!
I think part of the issue is that the procedure is being requested for coverage by the codes and the individual codes are done as outpatient procedures INDIVIDUALLY but these are being done all at once which I think requires a little more than me just getting up and walking out after surgery!
The letter does go on and tell me how to appeal and send further documentation and that they respond within 15 calendar days which is a plus. This letter was also sent to the surgeon's office the date says 4/13/10 so I don't know if that was the letter that the surgeons office got before when they asked me to get the documentation from my local doc and stuff but I will call them tomorrow and see.
To be honest I am not worried because when I requested authorization for me to get T shots covered by my insurance they denied me. I wrote a letter my doc completed some form and now my T is covered til 2014 at which point I will just have to get re-approved.
I think it will all work out but now I have to spend tomorrow on the phone probably between insurance and the surgeon's office which would be fine if it weren't Friday and I wouldn't have to be on the phone also for work stuff. Oh well this is my penis we are talking about so I just have to do what I have to do! I will just go in early and get as much work done as possible and go from there.
In other news I finally found out why my student loans (which I have been paying off by the way) were weighing down my credit report. Someone Messed up and my consolidation loan was pending and eventually got disregarded by default which causes my largest loan to appear defaulted though I have been paying it off! I found this out when I was trying to get financial aid for my MBA program. Luckily after playing much phone tag I found out how to get my financial aid stuff in order and rectify the situation with my old loans. This will help boost my credit score BIG TIME and allow me to start my program as long as all documents are in on time.
Things are moving which I am happy about! I just wish they would move a little faster!
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