No RFA for me :(

[atonicat]

Some of you may remember that was was scheduled to have one of two RFA's this Friday. Well the surgery center just called to inform me that they cannot get my insurance to approve it because my PCP has switched medical groups so his referral is no longer valid. Which is weird because my PM doctor is the one who ordered the RFA, not my PCP. So now I'm frustrated and upset because I've been waiting months to get this done. And now it probably wont happen until my insurance can straighten this out. I was really excited to get this done too. It's a real bummer that we live in a country where this can happen. It's also a real bummer that I have to work a job that ***** my soul right out because I need it for medical insurance. Pre-existing conditions are a ***** and so is our health care system.

[namnam46]

They will tell you everything.  I'm so happy that things worked out for you!!

Praying it gives you the pain relief that I have.  :).................Sherry

[atonicat]

I'm getting my right side done this time and then the left done next month. I'm not sure how many levels they are doing. When I got the diagnostic test done I think he did four different spots. I hope they will explain all of this to me when I go in!

[peekawho]

Good!  I hope the RFA's  work for you.

Peek

[namnam46]

I'm so VERY happy for you!!! I've kept you in my Thoughts ALL DAY!!!  NOW I just hope and pray that you will get the SAME pain free results that i have received from mine  :)

Thank you so much for updating us and NOW I can hardly wait to hear from you AFTER you have the RFA!!!

I meant to ask you how many are they doing on Friday and where exactly are they going to be?

I'm so glad that your NEW PCP has such good reviews.  I will be waiting to hear how you LIKE your New PCP ALSO!!

Listen girl, you've got a LOT of updates to do.  LOL

Looking forward to the first one..........Sherry  :)

[atonicat]

I actually got it all straightened out. I called my group and they told me the referral had expired on the 3rd so she extended it. She also told me that there was no reason why my PCP should be involved and that the surgery center was just confused. My PM was the referring doctor. So I'm back on for Friday. It was kind of good that this happened because I needed to switch my PCP anyways and my new one has pretty good reviews online.

[peekawho]

I hate insurance messes.  I've had plenty.

The RFA is done by the PMP, and should not need a referral by your PCP, as you already know.  
(Sometimes if you switch PCP's, a month needs to go by before you can actually use them for referrals or anything else--check with the insurance company.)

Have you asked to speak to a supervisor when you call the insurance company?  To me, this seems like a glitch on their part.  A supervisor might understand the issue better than whatever flunkie you are talking to when you call.

Also, be sure that the FACILITY where you are having it done is a covered FACILITY.   When I had mine done, the referrals went through just fine and dandy, and then 3 months after I had 3 RFA's done, I got a bill for over $20,000.  The facility was "not approved".  So they retroactively denied my claim.
It took a lot of screaming and throwing of fits to unravel the issue, but it was entirely the fault of the insurance company, and eventually they covered it, but I was told that I could not have any more RFA's done at that facility in the future.  

I repeat:  I hate insurance companies.  The system could not be any more broken than it is now.  I always wonder when people say we have the greatest health care system on earth.  They must not be people who use their insurance very often.  

[namnam46]

PLEASE let us know what you find out.

Remember we're Thinking of You and your in our Prayers.........Sherry

[atonicat]

I don't know. I have to call my medical group tomorrow to find out if the referral number is still valid. Then I have to call the surgery center and tell them I switched my PCP to one in my current group and hopefully they can get my insurance to cover it.

[namnam46]

Yes, it is a BIG, UNNECESSARY, headache for you to have to go through.

But GOOD FOR  YOU in making those calls so quickly.  You were REALLY on the ball.  I HOPE and PRAY that you will be able to get the RFA  as SOON as they can do it.  Is Friday STILL a viable date IF they can use the same number?

[atonicat]

I did call the surgery center and tell them that. They said for some reason that the referral has to go through my PCP. I called the insurance and they were really confused so I called the surgery center back and they told me if I switch to another PCP in my group that they can probably use the same referral number. So I called my insurance back and changed my PCP. Now I have to call my insurance group tomorrow and make sure my referral is still valid.

This is a big unnecessary headache.

[namnam46]

Hi atonicat,

You need to call the surgery center and REMIND them NICELY that your PCP was NOT the one that referred you for the RFA!!!  See if this will help at all. ALSO, contact your insurance company and let THEM know who referred you.  Do it TOMORROW.  It sure won't HURT anything.  

I wish you the best and PLEASE let us know what happens with it.  As I said before, I HOPE that you will get the EXCELLENT results that I have received.  I'm now into my TENTH MONTH with NO PAIN from my 6 RFA's!!!  I feel SO very fortunate to have had this and such a GREAT Doctor!!

Best of Luck to you in your efforts!!!  PLEASE keep us updated..........Sherry  :)