Wednesday, January 4, 2017

For Those Who Love Cliffhangers

After hearing an automated voice say that the wait time was over 20 minutes and that I should leave a call back number (which never seems to get a call back) multiple times...

After trying to call between an appointment at Dana-Farber and HBOT at The Rothfeld Center and not getting through...

After being put on hold but hung up on instead...

After waiting on hold as long as I could on two different occasions...

I was finally able to get through to Mass Health around 4:00 this afternoon.

They received the prior authorization request dated December 29.

And their response...

...has been sent to the Wound Care Center.

I was told to contact KK's primary care physician to find out what it is.

That didn't make sense to me, but I called Dr. Hunt's office anyway.

They didn't have the response.

I believe they meant that I should contact the provider that requested the prior authorization, so I called the Wound Care Center at 4:20. I got their voicemail (even though their hours state that they are open until 4:30). I asked them to please call and let me know whether Mass Health approved or denied the prior authorization so I would know whether or not I would have to go through the appeal process with HPHC. As I hung up, I resigned myself to the fact that I have to wait until tomorrow to find out whether or not we have prior authorization.

Then my phone rang just before 5:00.

Could it be the Wound Care Center???

Alas, no, but... was Mass Health.

It was Deion from the research department who has helped me before -- or at least tried to -- back in March. He asked me to explain what has been happening. As I recounted the Wound Care Center's "policies" as I understood them, he interrupted me and said that is not how it should work and that they should apply for prior authorization from both insurances at the same time. I did explain that Sherry told me she would request the prior authorization from Mass Health yesterday and that I just confirmed that Mass Health received it. He, too, was not able to tell me what their response was. He asked for the Wound Care Center's phone number. He said he would follow up with them tomorrow then get back to me...and he gave me his phone number in case I need more help.

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