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View Full Version : Frustrated with Insurance: update on my foot



Meli
April 30th, 2013, 12:28 AM
About 3 weeks ago, I jumped up to run across the room and answer the door. I took three steps and heard/felt a loud pop that hurt like crazy! I hobbled for several days, saw the PA who kept asking about how I twisted my ankle. Another week of extreme limping and I went to see my doctor, who said I had sprained my Achilles Tendon with a possible small tear. He wanted me to go to physical therapy for two weeks, see if it was helping, then decide whether or not to send me to a podiatrist. So he sent over a request for a pre-authorization to my insurance company. So far, so good.

Last Friday, a week after seeing my doc, I called the doc's office to see if we had the pre-auth. Nope, not yet. So I called my insurance carrier directly to see what the status was. They said didn't need a pre-auth, just a referral. Called the doc's office again to tell them, and they said they'd send that request right over.

Called again today. Doc's office hadn't heard from the insurance carrier, said it's taking up to 3 weeks to get a response since UHC took over TriCare. So I called the insurance again, explained my injury, explained how long this was taking, that I may need to see a podiatrist, and that all this limping is causing the arthritis in my knee to go into overdrive and they WOULD fix it now. She took about 2 minutes, then gave me the approval number I needed. She also advised to ahve the doc send over the referral for the podiatrist, just in case.

So, 10 days after the doc told me to spend 2 weeks in PT, I now have permission to go. This is insane!

Ugh. Sorry. Needed to vent.

Musical_Starling
April 30th, 2013, 12:52 AM
Oy. Insurance companies can be great, but their rules and clauses are usually such BS. Some make you jump through hoops while others don't allow you to lift a finger and have it all done and taken care of before you even ask. But it's still better than no insurance at all!

SuzyQue
April 30th, 2013, 12:56 AM
So sorry for the hassle, but that seems to be the way of insurance! You have to have it for the big emergencies, but what a hassle for the day to day stuff, it seems. I hope the PT does the trick and you won't have to keep doctoring this foot, but be prepared for some pain along the way. I think nothing causes more pain and tiredness than a sore foot! I hope you feel better soon!

bubba
April 30th, 2013, 01:51 AM
There is nothing like foot pain...it affects your entire body! I have been limping since last October when it felt like my foot exploded. Thinking it would get better, I limped around for a few days till I could barely walk anymore. Went to the doctor and had to start wearing a ortho boot to my knee. Seems I had two bone spurs in my heel causing plantars faciitis and another in my achilles tendon that felt like a little man in there with a knife trying to escape. I finally got to quit wearing it 24 hours a day about a month and a half ago and now only have to wear it occasionally. After suffering thru a steroid shot in my heel, which was sheer hell, it seems to finally be getting better and I can wear almost normal shoes again.

I will be here in Washington cheering you on....it will get better!!!

K. McEuen
April 30th, 2013, 01:59 AM
Ha, we have TriCare as well. We'll see what problems we have with it from now on. I know a few years ago when they told me I would have to wait 3 weeks to see an orthopedic surgeon for my broken arm, that I threatened them with going to the ER of every hospital in town every day until I was seen by one. Needless to say I had an appointment 2 days later and surgery a week after that because it wouldn't stay set.

auntiemern
April 30th, 2013, 02:10 AM
UGHHH!!!! I know what yo mean. I need to contact my secondary insurance, because they haven't paid anything on my recent medical bills. Heck having my toenail removed (took all of 15 minutes, including the shot to numb it and the wait) cost $750 and they haven't paid their part yet. They WILL be getting a call from me ASAP.

Momofmonsters5
April 30th, 2013, 02:23 AM
Tricare is so not fun to deal with and Tricare Europe is worse to deal with. They have gone all electronic here nothing is done in person you even email your doctor and all meds are refilled over the phone they won't do any in person....craziness

Meli
May 1st, 2013, 12:45 AM
In the past, I have been nothing but pleased with TriCare. In fact, this is the first time I've had trouble with them. I called the physical therapist today to schedule an appointment. I had the approval number which they need to be able to see me. They wouldn't schedule an appointment because they hadn't received a referral letter from my doctor. Who hadn't sent it yet because they're still waiting to get the "official" approval from TriCare/UHC. I gave up, called the doctor's office and scheduled an appointment with him tomorrow morning. I've started noticing numbness in my foot. bleh

Musical_Starling
May 1st, 2013, 12:57 AM
In the past, I have been nothing but pleased with TriCare. In fact, this is the first time I've had trouble with them. I called the physical therapist today to schedule an appointment. I had the approval number which they need to be able to see me. They wouldn't schedule an appointment because they hadn't received a referral letter from my doctor. Who hadn't sent it yet because they're still waiting to get the "official" approval from TriCare/UHC. I gave up, called the doctor's office and scheduled an appointment with him tomorrow morning. I've started noticing numbness in my foot. bleh

Oh for the love of God. What is it with these doctors and their referrals? Both you and Lonna are getting the run around. This is just nuts! I hope you can get something straightened out tomorrow, any pain that interferes with your legs or feet always sucks worse than a hand or an arm. Unless you walk on your hands I suppose, then you'd be in trouble...

MayinJerset
May 1st, 2013, 10:09 AM
Not too happy about our health insurance coverage this year. DH's health coverage changed last year, we paid premiums and were reimbursed by a 3rd party. 3rd party is because DH's previous employer cut back on their human services. Worked OK last year but they changed the 3rd party for this year. We've been paying premiums but no reimbursements so far, turned out they never sent us the forms to have it done. This is after checking with them at the beginning of this year and they said we didn't have to submit anything. Now I have to make copies of all of this year's checking account statements and black out everything except our payments and submit them to the 3rd party. Asked them how come I have to do the work to correct their mistake but they didn't reply.