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tinhuvielI called UHC this afternoon and talked to a very nice man named Reginald. He informed me that a decision had not been made on my claim because they didn't have my medical records for review. I explained to him that everything should have been faxed to Care Coordination on 13 January to which he replied that the records may have been faxed to the wrong department. Now, how can they have my claim and not my medical records when they were all sent at the same time? I didn't argue though. I very nicely asked for the correct fax number so I could pass it on to the surgeon's office and bid Reginald a good day.
Forthwith did I call Dr. Ross' office. As is typical of my current bout of fantastically sour luck, Jean was out of the office. I gambled and asked to talk to Sue, whom I thought was also in the insurance department. She came on and seemed a bit put off that I was bothering her with this since she's the one who schedules surgery dates. Oops. So Sue forwarded me to Angie, who apparently was helping Jean with my claim. When Angie came on, I told her what Reginald said and she was surprised to hear that UHC didn't have the records. She told me that she spoke with Takita at UHC yesterday, who requested the medical records again, and she (Angie) immediately faxed them to Takita. I asked her what fax number she used. When she told me, I mentioned that I had a different fax number. This really bothered Angie, so she told me she was going to call Takita to confirm receipt of my medical records and then call me back to let me know what was going on.
About thirty minutes later, Angie called me back and assured me that UHC was in possession of my claim and my records and that they were working on a predetermination. The problem is that Reginald explained that UHC has fifteen business days from the time they have the records to make a predetermination, so I'm possibly looking at another 15 days before any resolution. Angie seems to think it'll only be a couple of days.
Given my current track record, I'm thinking I won't hear anything for weeks and, then, it will be bad news.
Hope for the best, expect the worst. Mel Brooks is the only one getting me through this chronic uncertainty.
Forthwith did I call Dr. Ross' office. As is typical of my current bout of fantastically sour luck, Jean was out of the office. I gambled and asked to talk to Sue, whom I thought was also in the insurance department. She came on and seemed a bit put off that I was bothering her with this since she's the one who schedules surgery dates. Oops. So Sue forwarded me to Angie, who apparently was helping Jean with my claim. When Angie came on, I told her what Reginald said and she was surprised to hear that UHC didn't have the records. She told me that she spoke with Takita at UHC yesterday, who requested the medical records again, and she (Angie) immediately faxed them to Takita. I asked her what fax number she used. When she told me, I mentioned that I had a different fax number. This really bothered Angie, so she told me she was going to call Takita to confirm receipt of my medical records and then call me back to let me know what was going on.
About thirty minutes later, Angie called me back and assured me that UHC was in possession of my claim and my records and that they were working on a predetermination. The problem is that Reginald explained that UHC has fifteen business days from the time they have the records to make a predetermination, so I'm possibly looking at another 15 days before any resolution. Angie seems to think it'll only be a couple of days.
Given my current track record, I'm thinking I won't hear anything for weeks and, then, it will be bad news.
Hope for the best, expect the worst. Mel Brooks is the only one getting me through this chronic uncertainty.
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Date: 2004-02-05 11:13 am (UTC)Would Angie be willing to chase them again after, say, 5? If they have a record of sending them on 13 January, then maybe she could wheedle a reply. (But if you try it yourself you'll probably just get the 15-day bit again.)