Author Topic: Denial letter - 3 days before my pre-ops  (Read 2087 times)

ColleenS

  • Full Member
  • ***
  • Posts: 102
  • Do not fear, for I am with you. Isaiah 41:10
Denial letter - 3 days before my pre-ops
« on: April 16, 2017, 06:27:11 pm »
Has anyone else had this happened to them and get it resolved in a day or so? I would not be happy to have to reschedule everything if it takes more than a couple of days. I am pretty sure this will get resolved - hopefully, tomorrow. Apparently, they wonder why I could not have the procedure done at a lesser level care or an ambulatory care? Ha! Ambulatory care - outpatient? I am traveling out of state, but it is in my network PPO. So aggravating though - but I feel this must happen quite often ::)

I have read where it seems standard after 3 days of hospitalization to have to resubmit the claim. Seriously, just another thing we need to have to deal with
Surgery date 5/2/2017 @ Vanderbilt Translab approach with Drs. Haynes & Chambless. Love them :)
Success: removed 99.9% of tumor; no facial issues
Readmitted on 5/7/17 for CFL, had a lumbar drain inserted; CFL repair surgery on 5/14/17 and sprung on 5/15/17.

Patti

  • Sr. Member
  • ****
  • Posts: 313
Re: Denial letter - 3 days before my pre-ops
« Reply #1 on: April 17, 2017, 01:33:39 pm »
Wow!  I hope you get the issue settled!
4 cm AN removed 12/2000
subsequent brain swelling
removal of part of cerebellum
face, scalp,tongue numbness and partial paralysis
no corneal sensation and no tears-frequent eye issues
cognitive issues
Regrowth (3.1 x ..86 cm) treated by SRS on November 6, 2015

alabamajane

  • Hero Member
  • *****
  • Posts: 586
Re: Denial letter - 3 days before my pre-ops
« Reply #2 on: April 17, 2017, 01:34:47 pm »
Colleen,
I did not have this happen to me but have you contacted or heard from anyone at Vanderbilt or at your doctors office? I'm pretty sure they could help you resolve this,, it has happened to others I have read about. It's sad and  just adds to your Stress!

Good luck,,
Jane
translab Oct 27, 2011
facial nerve graft Oct 31,2011, eyelid weight removed Oct 2013, eye closes well

BAHA surgery Oct. 2014, activated Dec. 26

ColleenS

  • Full Member
  • ***
  • Posts: 102
  • Do not fear, for I am with you. Isaiah 41:10
Re: Denial letter - 3 days before my pre-ops
« Reply #3 on: April 17, 2017, 02:19:59 pm »
I have contacted Vandie and they are working on it. Still waiting for the word to proceed with my pre-ops that are scheduled on Wednesday of this week  :-\
Surgery date 5/2/2017 @ Vanderbilt Translab approach with Drs. Haynes & Chambless. Love them :)
Success: removed 99.9% of tumor; no facial issues
Readmitted on 5/7/17 for CFL, had a lumbar drain inserted; CFL repair surgery on 5/14/17 and sprung on 5/15/17.

ColleenS

  • Full Member
  • ***
  • Posts: 102
  • Do not fear, for I am with you. Isaiah 41:10
Re: Denial letter - 3 days before my pre-ops
« Reply #4 on: April 17, 2017, 09:07:43 pm »
Hurray! BC & BS has reconsidered and has decided my AN surgery is a necessity now - they have graciously agreed to let me stay in the hospital for three days. WOW! I am so glad I have paid for years and years to get this kind of hassle when I really need it. Anyway, we are once again a clear "go" for surgery.
Surgery date 5/2/2017 @ Vanderbilt Translab approach with Drs. Haynes & Chambless. Love them :)
Success: removed 99.9% of tumor; no facial issues
Readmitted on 5/7/17 for CFL, had a lumbar drain inserted; CFL repair surgery on 5/14/17 and sprung on 5/15/17.

alabamajane

  • Hero Member
  • *****
  • Posts: 586
Re: Denial letter - 3 days before my pre-ops
« Reply #5 on: April 18, 2017, 06:51:50 am »
See there!! Good for you,,, stress relieved. I hope you get out of the hospital in 2 days,,,  ;D

Let us hear from you, ,
Jane
translab Oct 27, 2011
facial nerve graft Oct 31,2011, eyelid weight removed Oct 2013, eye closes well

BAHA surgery Oct. 2014, activated Dec. 26

ColleenS

  • Full Member
  • ***
  • Posts: 102
  • Do not fear, for I am with you. Isaiah 41:10
Re: Denial letter - 3 days before my pre-ops
« Reply #6 on: April 18, 2017, 07:14:26 am »
Thanks Jane!
Surgery date 5/2/2017 @ Vanderbilt Translab approach with Drs. Haynes & Chambless. Love them :)
Success: removed 99.9% of tumor; no facial issues
Readmitted on 5/7/17 for CFL, had a lumbar drain inserted; CFL repair surgery on 5/14/17 and sprung on 5/15/17.

 


anything
anything