Insurance issues - probably not having surgery on Monday

Thanks Jen!

I just responded as well under the BCBS MD post. I was supposed to have surgery on Tuesday and didn't get my approval yet so postponed. Yes, work/life was stopped, I said goodbye, and Mistee called at 4:40 (after 2 days on clear fluids) to complain about how she had to call and call my insurance co. and never never knew they would take so long. I had been calling too and they were annoyed at the CHRIAS process as well, since what surgeon books up and schedules your life without approvals?? (good point!) So sorry, Joni, they've stopped the cloc****ep telling myself its not a denial (had 2 years of exclusionary clause with 2 old insurers, so I know about that), just a postponement, but yes, my worklife is tough to walk away from. I'm in sales, so if I'm not there, I['m not really making $$ and I don't know if I'm postponed a week or month or what. Anyway, I'm sorry this is happening to you too, and even sorrier that we're just a number on a piece of paper to both parties. Me too, looking for someone to blame. But I want this surgery and I'm still trying to find out when someone will get my paperwork out of Case Review. Good luck. Try to see this as a journey, not a destination, and this is just a flat tire on the way. Carol

Hi Joni, I was absolutely FLOORED when I just read this, so I can imagine what you must be feeling at this point. It's such an emotional upheaval to get all this done and to get your head in the right place, this last minute stuff is bad. I just wanted you to know that the small part of you that is still holding hope, is being joined with a LARGE part of me that still holds alot of hope for you to have this done. I, along with many others here, are pulling for you to be able to have this done. I'm hoping this is just a small bump in the road for you because you are gonna be great, I know it! Now as far as all the insurance mumbo jumbo goes, definitely get some answers from PMRI today. Also get ahold of your primary, do they record your weight every time you visit? Did she discuss weight issues with you on any of your visits and give you medical advice about weight loss and health benefits of losing? I would think all that would count for something and she really needs ( in my opinion ) to get her pen in gear or her phone finger dialing and start backing you up so you can get the help you need. I will keep a good thought for you and hope you get this resolved. Hang tough Joni, it WILL happen for you. Linda Joni's insurance company

Thanks Linda. I did get some answers from both Misty and PMRI today...which of course weren't the same. PMRI seems to thing that I'll need to go through a whole 3 month regimen, but Misty said that if the records from my PCP aren't enough I'd just need another 6 weeks of monitored nutrition. I think I'll go on what Misty says...she knows the insurance companies. My PCP is faxing everything over today...we'll see how it goes. Regardless, I'm still having the surgery, if there is a delay, so be it. I'm in a much better space today than when I posted last night. And..I still hope we're on for dinner tomorrow night!

I Have my fingers, toes and eyes crossed that all comes thru like it's supposed to. Yep, still on for dinner, I wouldn't miss it!

WOW!! This is unbelievable! I'm pasting my response from my BCBSMD posting here because it's relevant to this too!! Yes their booking practices suck!! I think that both CHRIAS and PMRI are getting rich off of us because they know that we're in depserate need of help and are willing to do whatever it takes to get the surgery. So we end up paying hundreds of dollars in co-pays ofr visits to these specialists, $1200 to PMRI for these classes which to me were helpful but extremely repetitive (could really have been completed in 3 visits not 6) and then BAM!! Like a ton of bricks they hit you with a surgery date get you all excited only to pee in your cornflakes later on when you find out that a surgery date does not automatically mean that you're approved for surgery. I say we all write a letter or a petition or something. It may not be much help to those of us in the struggle right now but it may save someone else some headache down the road.

Yeah, I'm not a big fan of the booking process, but what can you do? I'll keep working toward my goal, I've overcome bigger obstacles, I can overcome this.

Joni, My heart hurts for you and I pray this will work out in a way that will make you excited again. Lemme tell you a bit about my journey. In November as I was making my appointments for clearances I was so upset that I couldn't get in to the pulmonogist until the end of February because that was not working on my needed timeline at all. It caused all my other appointments with PMRI to be delayed which of course caused me to get a later surgery date than I was wanting. What could I do? Nothing. The delay was not to my liking. And now in looking back.... In January we found my thyroid problem. We had time to work on that problem and get it corrected and pretty much then stay within the timeline that was forced by the long awaited appointment with the pulmonologist. Sure, my date was moved twice because of the thyroid, but that was precautionary and it was not drastic moves. From the 15 to the 22, then from the 22 to the 29 when I had my surgery. Sometimes there are reasons we cannot see. Sometimes there are things we don't know about that still need to be take care of. And most times, we can't see this clearly until it has become history. I visited work today. I had planned my surgery to fall after a major project and before the beginnings of 3 others. The delays have caused me to be out during the 3 others. Today my boss said. You are so lucky you are out right now. These projects are a bear. I just smiled and gave him a wink and said.. perfect timing eh? I believe in all my heart there is a perfect time for all of us and the things we do. I am praying that your perfect time will be soon. I am praying that you can again feel the excitement of this time in your journey, it is a leg of the journey that can be worth the wait. Love you girl. Gigee

What beautiful and inspirational words. Thank you Gigee. I look forward to seeing you for lunch on Sunday...hopefully I'll be on clear liquids.