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BuzzyBee View Drop Down
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    Posted: 10 February 2009 at 11:23am
Your Health Insurance provider to push through a claim for pre-approval # within a couple days? Usually they state their policy is 5 working days BUT the lady I spoke to on the phone with from there said that they can push them through faster if its urgent.


My surgery is booked for Monday 16th, I need to get the hospital forms WITH pre-approval # on it back before Friday this week ...I've faxed through all the required medical reports, letters etc etc early this morning, just rang to follow up and the guy told me I was 'expecting too much' and that they have standard 5 day policy and he'll 'see what he can do' in the meantime.

Somehow I feel like that isn't a good enough answer, I need that pre-approval # ASAP otherwise I somehow have to come up with 8.5grand for the op, OR I have to remain in pain and wait for the next possible booking which is a month away

What to do?
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MrsMojo View Drop Down
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Points: 8202 		Post Options Post Options   Thanks (0) Thanks(0)   Quote MrsMojo Quote  Post ReplyReply Direct Link To This Post Posted: 10 February 2009 at 11:29am

 You can only ask.

5 working days is quite a long time but possibly they say 5 days because they want to exceed expectations (under promise/over deliver is a well known customer service ploy).

I would call them and explain the situation and ask if they could push the pre-approval through.  As long as you're pleasant and nice about it then they should be accomodating.
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ShellandBella View Drop Down
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Points: 2148 		Post Options Post Options   Thanks (0) Thanks(0)   Quote ShellandBella Quote  Post ReplyReply Direct Link To This Post Posted: 10 February 2009 at 11:31am
I don't know who you are with, but I'm with Southern Cross and have always got my pre-approval numbers over the phone...then they send out a letter to confirm, but I would then just ring the hospital and quote the number and that was all they needed, so not sure what you health insurance provider is going on about...If you have all the information and you are up to date with your policy, there shouldn't be any delay as far as I'm aware...


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clover View Drop Down
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Points: 2090 		Post Options Post Options   Thanks (0) Thanks(0)   Quote clover Quote  Post ReplyReply Direct Link To This Post Posted: 10 February 2009 at 11:32am
I agree with Mrs Mojo,
Call them back and politely explain why you need the number urgently and can they possibly get back to you by Friday.

You can only ask.
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lilfatty View Drop Down
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Yep I agree with Jo.

Also you have to try and remember that the person you spoke to probably has 50 people in the same predicament as you .. all trying to push through claims.

I would think that they would be able to do the forms etc, but dont want to promise "just in case" something crops up.
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I did it .. 41 kgs gone! From flab to fab in under a year LFs weight blog
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Snappy View Drop Down
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Yeah I was just about to say that usually you can do it over the phone? We got pre-approval for Janaya's urgent Paed appointment over the phone, then just sent in the paperwork once she had been seen. What happens to those who need urgent surgery? They surely dont have to wait 5 days!
Mummy to two beauties... Formerly Kaiz.
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Emily281 View Drop Down
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Points: 468 		Post Options Post Options   Thanks (0) Thanks(0)   Quote Emily281 Quote  Post ReplyReply Direct Link To This Post Posted: 10 February 2009 at 11:48am
Like ShellandBell I'm with Southern Cross and I've had pre-approval for all 3 of my surgeries over the phone and then get a letter to confirm. Who is your insurance company? I would think that most of them would have the ability to check your eligibility while you're on the phone?



Edited by Emily281
TTC#1: Jan 07
Aug 08: Lap found and excised Stage 3 Endo
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BuzzyBee View Drop Down
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I wish I was with Southern Cross, I'm often told by lots of people the company we are with is a real PITA to deal with, they weren't so bad with my tonsillectomy etc ...but thats 8 months ago now and I can't really recall what time frame we had to work within to get that #

I'm with Tower, can't afford to change either because of all my medical conditions ...too much of a liability
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clover View Drop Down
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I know that Tower can certainly do it in time for your op, leave it for today and ring them again in the morning 0800 754 754.
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jjands View Drop Down
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sorry if I'm repeating I did't read through everything but I got DH's pre approval through in 2 days with southern cross twice so I don't think it's too much to ask at all. They should definately have it done in time and not be putting more stres on you
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Bobbie View Drop Down
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Points: 6123 		Post Options Post Options   Thanks (0) Thanks(0)   Quote Bobbie Quote  Post ReplyReply Direct Link To This Post Posted: 10 February 2009 at 1:37pm
Chances are the woman on the phone was more senior and knows the reality whereas the other guy only knows 'the policy'.

Ring and have another try. Did you get the name of the woman you originally spoke to? If so ask for her again.

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Emily281 View Drop Down
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I think also that maybe some of them think that prior approval means prior approval in the sense that you get approval for the surgery before you book it so it doesn't matter if it takes 5 days. But I bet they all get theirs pushed through if they are in pain and need an operation.
TTC#1: Jan 07
Aug 08: Lap found and excised Stage 3 Endo
Nov 08: 2nd lap clear - given OK to TTC after next AF
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BabyKiwi View Drop Down
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When my DF had to have surgery done on his eye we received pre-approval within 5 hours! So it can be done!

Hope you managed to get it sorted!
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emz View Drop Down
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Points: 5321 		Post Options Post Options   Thanks (0) Thanks(0)   Quote emz Quote  Post ReplyReply Direct Link To This Post Posted: 14 February 2009 at 8:45pm
I received approval straight away for an op, I rang them at about 2pm one day, got the approval straight away and had the op the following day at 12pm! Just got the # on the phone then the insurance company and hospital sorted it out amongst themselves.
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BuzzyBee View Drop Down
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All sorted, letter arrived Fri afternoon and its organized with hosp. Now I'm just a bundle of nerves
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AuntieSarah View Drop Down
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Points: 1442 		Post Options Post Options   Thanks (0) Thanks(0)   Quote AuntieSarah Quote  Post ReplyReply Direct Link To This Post Posted: 15 February 2009 at 8:15am
Good luck for whatever you're having done tomorrow
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BugTeeny View Drop Down
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Points: 6676 		Post Options Post Options   Thanks (0) Thanks(0)   Quote BugTeeny Quote  Post ReplyReply Direct Link To This Post Posted: 15 February 2009 at 1:47pm
Good luck Steph
You'll be just fine

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fire_engine View Drop Down
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Good luck Steph - hope all goes well
Mum to two wee boys
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.Mel View Drop Down
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Everything will be fine Steph! Thinking of you tomorrow afternoon!
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