[Ouch!]

OK, right now I am really frustrated at the whole situation.

I have Tri-care Standard military insurance. Before my initial appointment with Dr. Zigler at TBI I called to make sure they would cover ADR, get codes, and anything else I might need to know insurance wise. I was told a procedure code and that ADR was covered.

To make a long story shorter, after I scheduled surgery the end of May for July 19, I spoke with the person at TBI who gets the pre-authorization for your surgery. I gave her all the information I had including the Tri-care approved codes. She said she would take care of it, but the code I had was an old one. I said that is the one they said they were using.

Today I got a call that TBI cannot get authorization for my surgery. (They already filed my office visit wrong & it was denied.) I called Tri-care, was told Humana had to do the approvals. Called Humana. They said it was still in the system. That TBI only filed yesterday & it can take 7-10 days for a decision to be made. Since, I gave TBI all the info & scheduled surgery over a month ago, why are they just now trying to get approval??

So, when I thought it was all taken care of, now I find it is all up in the air!

The lady at the Humana approval office said if TBI used the wrong codes, it could be denied & harder to fix. TBI has said the code I gave them is old & not in their billing any more.

I am getting nervous enough over the surgery & everything without all this last minute insurance hassle.

Now that I have ranted, does anyone have any suggestions how to proceed next?

Thanks,

Jane