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Surgery Cancelled on day of, due to Prior Authorization

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Betty

State: Texas
Congressional District: TX36

Diseases

Ear / Nose / Throat Disease

Issues and Challenges

Betty has encountered: Insurance Issues, Prior Authorization

My Story

I have been sick with Chronic and Acute Sinusitis since December. Three months later, after several bouts of antibiotics, I need sinus surgery which has been scheduled for almost a month.

The day before surgery at the last minute, my Dr had to finally give up and cancel the procedure, because they were unable to get prior authorization. At the last minute, the Dr for the insurance company said they would need a peer-to-peer done to approve the complete surgery desired by my doctor and I. Now I will have to be sick and on another set of antibiotics for another month.

While this is the first time I have had a procedure cancelled or postponed, in the last 2 years, I have had multiple surgeries that were pending prior-authorization the day before and one was pending while I was being prepped for surgery.

I have also needed a back surgery, that was put off for injections that insurance required (even though the dr knew they would not work for my condition), only to cause permanent nerve damage in my right leg and foot which would have likely resolved itself if I would have had the surgery in a timely manner.

It seems that Insurance companies have gotten way too powerful. When I tried to call my work provided UHC member service, I was given the runaround, transferred here and there, and the people on the phone would not give me their complete/ real names, nor the Doctor's state residence/email/phone and more than likely not a their real name either. They would only say that they do not have to disclose any of that information to me, only providers. I see that many people have it worse and come up against life threatening problems due to Prior Authorizations.

My Motivation and Inspiration

Everyone needs to be aware of how overly powerful big insurance companies have become and how profitability has taken over our health.

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