← Return to Autonomic Disorder and Coverage for Mayo's Pain Rehab Program

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Thanks for the support and suggestions. We learned about and were excited re the program in early October during our week at Mayo. He understands and wants to do the program (he missed 1/2 of school last year and wants to be a "normal" teen--not feeling sick most of the time).

an update. we have been trying to attend since mid-October. We were "qualified" by medical 10/13. Because of the holidays, we wanted to attend end of October. Short version: Mayo still hasn't submitted all of the codes they need approved--and finally told me so this week.

Starting in October, Mayo precert kept telling me they couldn't submit a precert request. It was "impossible."
My case manager said she couldn't help us without a Mayo precert request. I kept calling Mayo, BCBS, and posted here for help. (and the Mayo person kept leaving work early so i could only leave messages)

Mayo precert finally submitted the request November 6th. My insurance approved it that same day.

I learned of the approval when talking with our BCBS case manager the following week (nothing from Mayo). She gave me the authorization # and name of approver. along with the codes Mayo submitted. I started trying to get my son scheduled.

I contacted Mayo precert. they told me the BCBS approval wasn't based on accurate info.

I contacted BCBS--they said they approved the diagnosis/procedure codes Mayo submitted. BCBS contacted Mayo precert directly to explain the approval. (I did this three times because Mayo precert wasn't "convinced.")

Finally last week Mayo Precert admitted that they didn't include the correct codes in the November 6th request. And they would resubmit another precert request with the missing codes. (and complained about how hard everything was... I asked that we focus on solutions and stop complaining)

My teenager is still missing school bc of health issues.

And financially, the cost/out of pocket in January will be so much higher than in the 2023 plan year (deductible to meet, max out of pocket etc that will be reached this year). How can i get Mayo to submit the correct codes and authorize/schedule the program now???

I am beyond frustrated. Refusing to submit a precertification request to my insurance. When it's approved, not letting me know. And now, when I try to schedule, I learn Mayo "forgot" to include all of the correct codes. and will need to submit another request but can't give any information on when that might happen.

Should I just give up? Is there a supervisor or someone with more experience/problem solving ability who can step in? I have spent so much time trying to solve this (and I have a FT+ job and a kid who needs me). and i'm the one financially impacted. I wish I could use my focus, patience, energy and solution-oriented approach to fix this mess.

any suggestions are appreciated, thank you

(and my immature comment--i am out of patience listening to her complain about how hard her job is)

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Replies to "Thanks for the support and suggestions. We learned about and were excited re the program in..."

@kari3057, I understand your frustration. This does appear to be much more difficult than necessary. If you haven't done so already, it is time to contact the Office of Patient Experience to help intercede on your behalf.

Mayo Clinic Office of Patient Experience
Phone: 844-544-0036 (toll-free)
Email: opx@mayo.edu

I'm also sending you a private message.