? re: clinical notes

[toytoy80]

Hey everyone,

Hope you are doing well. I have a question. My file is pending insurance approval. i called today and they said they are waiting on clinical notes from Dr. K. I have never seen Dr. K since he is in CA and I am in CT. What possible clinical notes could he provide them with? I am sitting over here stressing out bc I had a horrible dream last night that I was denied. Is anyone familiar with insurance wanting this and how would Dr. K's office provide them. I have Anthem BCBS

I am back and forth with insurance and doctor's office. Dr. K's office is saying they have provided all that they have and the insurance is saying they need patient hx. I am really at a lost what to do here. I have never spoken or saw Dr. K. I have only spoken with his assistants and the nutritionist. Can anyone offer some suggestions? I called my PCP to see if I can get my patient fact sheet (patient history) but I don't know what to do.

[Deleted]

I know you are on the other side of the country, but quite seriously, I would consider a trip to LA to have a consult with Keshishian so he can provide the necessary clinical information. He will almost certainly require an EGD that HE does before surgery anyway - I would talk to him about coming out for a consult and EGD, which will help him prepare a killer LOMN, and give you a chance to talk to him pre-op and to be comfortable with him.

Give his office a call, and see if you can schedule a one-day visit for both the consult and EGD. Consider flying JetBlue into Burbank for a good fare if you are flying with less than a 14 day advanced purchase.

[toytoy80]

I was thinking along those lines but a one day trip will cost me almost $800. When I spoke to assistant she said she will have Dr. I write a letter of medical necessity and submit that to them. I also have the eggs that was done in NY in November, should I send them that?

[toytoy80]

Sorry EGD

[toytoy80]

Jan 5, 2012 12:29:22 GMT -5 toytoy80 said:

I was thinking along those lines but a one day trip will cost me almost $800. When I spoke to assistant she said she will have Dr. I write a letter of medical necessity and submit that to them. I also have the eggs that was done in NY in November, should I send them that?

Thanks so much Diana. I called Dr. K's office and for some reason the initial fax didn't go through. All they received was initial page so they are refaxing over the 69 pages now (I think that should be enough lol) but I am not calling insurance anymore it has stressed me out too much. Thanks again for all ur help.