Scrooge McDuck

All this insurance crap is seriously dampening my holiday cheer. I took today off of work so that I could de-stress somewhat before the big GRE exam tomorrow morning. I took another practice test (scored well!) and then went to meet the nutritionist at 1pm. I piddled around town for a while, did a bit of Christmas shopping, and then met my mom & sister for Rachel’s first fitting in her wedding dress.

Y’all, she looks gorgeous! The dress is very ornate (at least for my taste) with lots of beading and a cathedral train, but it suits her perfectly. I brought my bridesmaid’s dress and had to have it altered pretty significantly even though I ordered it a size too small when I tried them on, so that’s a victory!

Mom, Rach & I finished by having dinner together at Outback and spending time with them was awesome as always. I wonder how much things will change when I can no longer finish up every event with massive portions of food. Guess I’ll just do a lot more talking and a lot less eating!

That is if I ever make it through the insurance bullcrap. The Kurt dude from Healthcare Management Services finally called me back today, and wanted to know which facility my surgery would be taking place in, what the date would be, and if I had adequate support at home during recovery. I explained that I couldn’t answer about the date, that my surgeon’s office is waiting on pre-determination instead of pre-certification blah blah blah. He was completely baffled, and I explained that they needed more than authorization, they needed someone to review my medical documents against my medical policy and then give the go-ahead. He said “that’s exactly what we’ve done. I see you had your psychiatric evaluation with Dr. Marcil. Your 6-month diet with Dr. Richter and Dr. Aung. Alice Baker is your nutritionist. We have already reviewed all of this and you meet the requirements.” OH MY FREAKING GAWD. I knew it.

So I called Odalys at the surgeon’s office. No answer. No answer. No answer. No answer. No answer. The sixth time I called, I was able to speak with her, and I explained what happened. She said, “they can tell you you’re approved all day long, but until we get the letter we can’t schedule your surgery.” I said, “ok, well have you spoken with anyone since last week?” she said, “no, but we were closed two days after Thanksgiving and they’re supposed to give me a call back.” I said, “look, instead of waiting for them to call you, do you think you could call them instead? They’re telling me everything that can be done has already been done.” She grabbed my file and said she’d call them.

Think I heard back from her today with any kind of update? Of course not.

I’m really baffled. When I talk to Odalys, it seems like the insurance folks are idiots. When I talk to the insurance folks, it seems like Odalys is an idiot. Maybe I’m the idiot for not somehow making this all come together more effectively.

So I ask, what would you do in my situation? I’m getting absolutely nowhere! My mother thinks I should email the office manager and let her know what’s going on. I’m hesitant to do that since tattle-tailing isn’t really my style, but it is quite clear that Odalys isn’t a very effective advocate for me.

The only plan I’ve got right now is to give Odalys until Friday around noon to be proactive and call me (for ONCE) before I start getting more demanding with her. I’m tired of having no answers.

Better ideas?

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One Response

  1. Meg, I would totally give her till Friday and then demand to speak to someone else in the office, ie. office manager etc. In all honesty, I would effen lost it on her by now. Someone, either the insurance company or the seemingly idiotic Odalys (not you!) needs to call the other party as you being the middle person is in no way working. Someone, other than you, needs to step up to the plate and Git er done!

    Open up a can of whoop ass, girl. They deserve it!

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