I work in the health insurance field. The insurance company is trying to protect not only itself, but also you. There are certain procedures that are experimental that are not covered. They also want to make sure that the surgery is appropriate for your diagnosis. Although very few, there are unethical doctors. Also, in some instances, the insurance company does not have have a panel of drs themselves, but use an outside vendor. So the insurance company has to get all the records then pass them to the panel of drs for review. I know it can be frustrating -- sometimes you feel like you've fallen through the cracks. If it gets too bad, you can call your insurance company as well to check on the status of precertification of surgery. Sometimes the squeaky wheel does get the grease. Best of luck!
Breast Cancer Questions
How long of a wait?
Asked by little_fut on Tuesday, February 19, 2013
How long of a wait?
Whydoes it take so long for insurance companies to "ol" surgeries? don't they know how important this is? My doctors office just told me they rec'd approval for one part of surgery but awaiting approval for 2nd part. I didnt know there were two parts! This is my first surgery, a lumpectomy....
3 Answers from the Community
I don't know if this will help your anxiety level or not, but it is pretty common for newly diagnosed patients to envision a cancer growing voraciously inside them every day and they want it out ASAP. The reality though is that in most all cases it is far more important to do it right than to do it fast. The medical community does know how important this is which is why they want to get it right. I was diagnosed in November, 2011 with aggressive inflammatory breast cancer, stage 3B. I had surgery in April 2012. I am currently in remission.
The "second" part of your surgery is probably a lymph node dissection.
It does sound frustrating that they would approve one "part" of your surgery in advance of the other "part." I would wonder why they wouldn't just look at the whole situation at once. These other folks have given you good advice. I'm just chiming it to give you commiseration. I'm sure you're anxious to get this surgery behind you.