I called the insurance company this morning to better understand the letters I received over the weekend. According to customer service, the medical group signed up as a HMO preferred provider but not as a PPO preferred provider. Being astounded didn’t change her mind.

She told me I could always check the insurance website to find a preferred provider. I told her the medical group was on their list and it makes me specify which plan I have when asking for providers. She didn’t have a good response for that but she gave me two other imaging places that were on the preferred provider list.

Then I called the medical group and told them I would need to change where I have the scans done. She said they absolutely WERE a preferred provider for any plan but would check on this. She called me a little while later and asked me to fax the letters to her because she needed to show them to someone.

The medical group called someone in the Utilization Management Department (UMD) at the insurance company and they went back and forth most of the day over this. The UMD person felt that the letters were sent in error and wanted a set faxed to her, too, so she could check them out. By the end of the day, the medical group person helping me hadn’t received anything definitive.

Since my MRI is scheduled for tomorrow, I’m going to have to decide what to do at least by noon. One problem is that I have appointments in the morning and can’t spend the time chasing the insurance company for a decision.

As it happens, I got a call from Dr. Opth’s admin. She said they had a cancellation and I could have surgery on 11/17 instead. However, since my friend who’s giving me a ride is on vacation AND I have my work planned around Thanksgiving week, I passed and kept my original date.