After spending Thanksgiving and the following weekend depressed and deeply concerned for what I would have to do to continue to last on this ankle, Monday morning finally came and my phone finally rang. I was driving to work, watching the clock contemplating the time all the key people in the process to do this appeal would be in their respective offices tending to my situation.
My phone rang and it was my work office wanting to divert me to another clinic to fill in for the day. The clinic was an extra 45 minutes away, so that gave me more time on the road, which was good for me to clear my head more before seeing patients. As I got closer and closer to the clinic I watched the time inch closer and closer to the possibility of more news. My gas gauge was blinking at me on empty and I still had 10 miles to go, so I had to stop for gas. After filling up, I got back in my car to head further on down the road, my phone rang again and this time it was my doctors office. This call was from the billing gal and she asked if I could contact my insurance company for the information my doctor would need to send the insurance company a request for a "Peer to peer appeal". This appeal is where my doctor is given the opportunity to consult with a doctor staffed by the insurance company to review procedures and determine medical necessity when the parameters are outside standard procedure. She told me this was his only day in the office to get this done and we needed to get all the necessary information quickly to take care of it in time. I immediately called the insurance company and spoke to a representative who worked diligently to find the number my doctor could call and have the process expedited via telecommunications rather than by mail. My anxiety was through the roof and the small spark of hope buried deep down came alive. I relayed the information back to my doctors office and played the waiting game again.
About two hours later the doctors office billing gal called again to say they could not get through to anyone with the numbers I gave her. My heart sank, I had no solution for her, she said they would just keep trying. I continued to work with my phone attached to my hip, waiting, and waiting, and waiting for another call. Nothing by lunchtime, nothing by 1pm, nothing by 2pm, nothing by 3pm. At 3pm I finally had some time between patients and decided to make the call myself. I rang through to the billing gals voicemail, so I called the doctors administrative assistant next, who very plain and matter of factly said "let me see, I did get an email from Dr. Haddad earlier that you were approved." That was it. I was stunned and said "I am...are you sure?" she replied with "if you want Barb (billing gal) to confirm it I can transfer you." I told her no, that I just called and she did not answer. I was numb once again.
Over the weekend I had resigned myself to not having surgery and stopped all planning and now, in less than 3 days I was going to have the surgery after all. As my mind ran a million miles a minute for about ten minutes I finally switched in to "get er done" mode. I had to kick the plans back in gear and get all the necessary details back on track for surgery as previously scheduled. But for sanity sake, I called the insurance company to double check and be sure they were registering the approval now also, and sure enough the girl on the phone gave me the details "I see that Dr. Haddad called in at 12:45pm and the appeal was approved at 1pm."
I have the best doctor ever. He is truly my hero!
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