The person taking care of my house during this adventure sends me my mail once a week. I'd seen the packet from a couple weeks ago but put it aside knowing there was a bunch of stuff in it I actually wanted to look at.

Lo and behold: a notice dated 1/15 that the insurance company required more information from the surgeon before authorizing my hip replacement surgery. Note: said surgery was scheduled for the 23rd.

Also a note - the date of which I didn't notice - that declined the authorization for the replacement saying it wasn't medically necessary because it didn't meet several of the 9 or 10 criteria - ALL of which must be met to make it medically necessary - that were listed. And also that the hospital stay wasn't authorized because it could be done as outpatient or with a 23 hour stay as there were no comorbidities provided that would lead to the authorization of the stay.

Interestingly, there was *also* a note from the insurance company authorizing my stay at the rehab hospital for my non-medically necessary hip replacement.

Now first off: I *did* ask, repeatedly, if we'd gotten the pre-auth for the surgery and was assured we did not require one. Sounded very odd to me so I asked if we'd gotten the pre-auth for the hospital stay. Was told that's up to the nurse navigators (the ones I was not put in touch with until way too little time before the surgery). So I asked them if we'd gotten the pre-authorization for surgery and hospital stay.... which got the administrative nurse saying it was a good thing I asked because my surgery had been scheduled incorrectly and they were in the process of fixing it.

Secondly, I very specifically had expressed concern that the x-rays they took did not have a detailed report about the level of osteoarthritis, etc., as well as that my ADLs were radically affected by my hip issues (the notes said they were not affected, I wrote to them after the pre-op consult and said, "There's an error. Please fix." and they said, "There's no error."). Guess what two of the reasons for the declined authorization were?

Thirdly, if he proceeded with the surgery without getting the necessary pre-authorization AFTER I REPEATEDLY asked if the date had to move again because of a possible pre-auth issue (and after I reminded them that I DON'T LIVE HERE so, if it had to get delayed again, my stay here would be longer and cost lots of money) and I get a bill from the hospital? I'm sending it to his office SO fast and saying, "This one is on you; I raised a stack of flags ahead of time."

All that said, recovery seems to be going well. My rollator is too tall so I ordered one that has handles that can be set lower - but the one that arrived has a seat that doesn't lock down so it's unusable. Likely buying a new one before this one goes back. Which is unfortunate as I got it direct from the manufacture's "at home" site and it was priced way more affordably than from third party vendors... but I want it in hand so I can practice prior to the PT eval. Which was postponed because it was pouring and powerchair plus rain is no bueno. Thankfully, "tomorrow" (it's after midnight; it's technically today but I have not yet been to sleep and awakened again) it's going to be clear so I can get the sutures out and Friday it's going to be clear so I can get new labwork and see Dr. Hematology. Thank the Universe.

The next challenge is going to be getting PT to understand there is so much more to rehab than my hip, to figure out what physiatrist to see so I can get VERY long-overdue thoracic images taken, and then figure out what's next. Because, right now, research shows that it might take as long to recondition everything that has failed on my body (hip is probably 25 percent of the issues; no, Rehab people, it was NOT my hip that caused me to have issues with stairs!) as it did to decondition. Which means 7 or so years. Hip replacement is not the magic wand everyone said it would be. I knew that, even as I hoped otherwise. But unless my stamina comes back way faster than I think it will, and my ability to manage a rollator and so on over distance increases super significantly, powerchairs are not leaving my life any time soon. So yeah, that's another insurance hurdle.

To say nothing of the current reimbursement hurdles and so on. Fun times ahead. Onwards.