Friday, July 13, 2007

Argh.

This just in from BlueCross:


"Our records indicate a predetermination was reviewed and denied on

05/09/2007. Medical documentation was not submitted showing our

medical appropriateness requirements have been met. As of today,

07/13/2007, BlueCross BlueShield of Tennessee has not received an

appeal of this decision. Please contact your physician's office and

request that they submit the documentation requested for additional

review."


My audiologist told me the last time I was in her office (mid-June) that the appeal had been filed and they were waiting to hear something. Who in the world do I believe? I think this is standard procedure. It happened when I was waiting to hear about my first implant....I heard nothing at all until I got involved personally, and then they both pointed fingers at each other, saying "We didn't get any paperwork!" , "Well, we SENT it...we'll send it again!" and then I had to wait another month before they could review it. Ugh. The most frustrating part is that I sit here trusting the two of them to get the job done, to at least stay on each other until something is accomplished. Should I HAVE to get involved here? Apparently so. I feel sorry for folks who aren't willing to get involved. I'm not normally pushy, but when it comes to the big things, I'll jump in and make noise when I have to. I know some people aren't that way, though...who fights for them?

Since the appeal process, once started, can take between 30 to 60 days (I believe), I might as well just go on with my life and try not to think about it for a while. I am going to stay involved until I am absolutely sure that everyone has the paperwork they're supposed to, and then I'll just cool my heels for a little while. Don't have a choice, after all.... :)

Thanks for listening to my little vent. Ugh!

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