Eventually they gave up and went ahead with the surgery without authorization.
CHICAGO (AP) — The new year brought relief to some Illinois patients newly insured under the nation’s health care law. Others still weren’t sure whether they were covered, despite their best efforts to navigate the often-balky new system. […]
Paperwork problems almost delayed suburban Chicago resident Sheri Zajcew’s scheduled surgery Thursday, but Dr. John Venetos decided to operate without a routine go-ahead from the insurance company. That was after Venetos’ office manager spent two hours on hold with the insurer Thursday, trying to get an answer about whether the patient needed prior authorization for the surgery. The office manager finally gave up.
“I’m not a happy camper,” said Nate Zajcew, the patient’s husband. The couple signed up for a Blue Cross Blue Shield bronze plan through the federal HealthCare.gov site on Dec. 16. “I understand it’s just a matter of paperwork and yesterday was a holiday. I can be an SOB, too, at times, but since they’re going on with the procedure, it’s OK.” […]
In the southern Illinois city of Benton, 61-year-old Nancy Pace spent part of New Year’s Day calling Blue Cross Blue Shield to make certain she and her husband were covered by the silver plan they chose on the troubled federal insurance website. “When you get to where it says ‘Pay for your policy,’ well, that button doesn’t work,” Pace said.
Calling the insurance company worked: Pace paid and got her member number over the phone.
“I made a phone call. I pushed the right button and got a live person,” she said.