Urgent Help Needed -Critical Eye Surgery for My Wife Insurance Delay

@lrlrl I had retinal problems a few years ago and my retinal ophthalmologist told me that the condition I had , vitreomacular traction, could cause a macular hole. It never happened but if it did I would know because of the symptoms that included a sudden change or loss of vision. He said it is an emergency and should be treated quickly. May 2 seems like a long time to wait.

If this was my situation or someone in my family I would call my primary care provider's office and ask to speak with the office/practice manager. This is the person that oversees the business end of the practice including the facilitation of referrals for out-of-network insurance coverage. I'd ask when the practice manager can get the forms signed and out to the insurance company and then contact my insurance company and ask if the forms have been received. If there is still a delay I would keep calling the practice manager and ask again about the forms.

I agree that you and your wife would not want to risk her vision or postpone treatment. You can say this to the practice manager at the primary care provider's office.

Does this information help?

Would it be possible to speed things up if your wife had the surgery done by an in-network eye surgeon? If yes, maybe your primary care doctor, ophthalmologist, or optometrist who is in-network could recommend someone. You could also research those eye surgeons who are in-network and within the needed specialty yourself. With regard to the urgency of the surgery, have they told you how urgent? In other words, within a few days?

My wife cannot have a face down procedure due. We are meeting with Dr. Matthew Starr on May 2 for a preliminary set of tests to determine what they feel is needed in Rochester. Thank you

I don't know where you live, But Margaret Wong in Norcross or Atlanta is wonderful, skilled, and easy to talk to and understand. I had an infection in my right eye after cataract surgery which almost blinded me. And I had to have retina surgery several times and then had a cornea transplant. She is good for the awful things that happen.

We live in Iowa and go to Rochester.
I went for several weeks 3 years ago and faced the same issue with Unity Point staff.

There are no in-network surgeons. I will not put her through needless pain because the health care system wants purposely make I to make as hard as possible .

Thank you.
I plan to call Mayo billing tomorrow once again and keep bugging her PCP.