Reasons for Denial

Hi everyone again....well this is what I heard from my PCP who spoke to Staywell/medicaid...I don't have enough co-morbidities to warrant weight loss surgery...so being almost crippled from the osteo-arthritis in my knees and being over 200 lbs over weight with a BMI of 56 isn't enough....when I called Susan at Dr Murr's office (surgeon) to tell her what they said, she was quite short with me and told me there wasn't anything she could do to help me other then to tell me to get high blood pressure or diabetes or such which she said was impossible so good luck...so what does that tell ya..:angry:..I truly felt like she gave me the old brush off because I am a medicaid patient and don't have any regular insurance, .so now I go on to plan B which is to keep my appt for my consult with Dr Haicken next thursday....what I need to know if there is any other Staywell and or regular medicaid patients seeing dr haicken and what are your co-morbidities...also I have spent the entire day writing a letter to staywell...do you think I should mail it to them to reconsider or wait and send it with my new packet that will go from the new surgeons office...plus a very dear friend of mine also wrote a letter....I am so depressed and disenhearted right now....I want off the system so I can get work and be a useful citizen again...I don't want beauty I want healthy....sorry just a pity party for myself...and thanks to all that replied to my earlier post and for the encouragement and support...love you all April

April, I really feel for you hun. But the least you need to do now is get depressed. Get up out of that computer chair and look in teh mirror and tell yourself you are GONNA FIGHT THIS!! Yes you might need a second opionion....you might need to find a better doctors office. In any case dont get down....get UP!! If it will make you feel better, right that letter to them. I have heard that a lot of people do that, it could not hurt though ONLY IF you want this doctor to do your surgery. I wish you the best my friend. I hope that you will soon find some peace with a doctor that will work with you in getting you approved. YOU DESERVE IT! Beckywhowillbekeepingherfingersandtoesandlegscrossed forMsApriltogetaquickapproval!

Becky you are the greatest...I am just feeling sorry for myself today...I am going to the 2nd surgeon because I found out he happens to be in the Staywell Network so I am sure he will know how to work it to get the approval....I hate feeling yucky so will only let it happen for 1 day only...thanks again Becky and how are you doing?... Love ya and your support April

Thanks April... I am doing jsut fine. I went bck to work this past Saturday and am ready to be off again but I know that want be happening anytime soon. I dostill have a sore ankle and am having to wear a brace for now cause it tends to still sweel by the end of the day--but is walkable. SO far I know I have lost around 55 pounds and counting. I have not weighed in around a week now so maybe I will have more gone--who knows-- Good Luck my friend and do keep us all posted. Email me if I can help you! Becky

I can't believe this!! And to top it off..this Susan was not sympathic at all. And to suggest to get diabetes or high blood pressure - I wouldn't wish that on anyone!! I think she was rude. Keep the appointment with the 2nd surgeon and let's hope things go better. Don't panic just yet...so long as you have some options open keep your spirits up!!

April, do you have all of your test results from Dr. Murr's office? If you do take them with you? Talk to Dr. Haicken about Voc Rehab. that may be a possibility as well. I am so sorry you have been treated this way. It does not matter what kind of insurance you have ( or even whether you have insurance) you deserve to be treated with respect. Don't let this person get you down. You keep your head high and your chin up. It is going to work out.

No I don't have any records yet from Dr. Murrs, I have sent an email to that Susan that I want them though even if I have to drive there to get them...Dr Haicken takes Staywell...I have already quized them and the office person I talked to who was sweeter then sugar told me Dr Haicken is in the staywell network...so I think this was all in the plan for me to get denied for Dr. Murr so that I would keep my appt with Dr Haicken...thank you for the well wishes and this too I shall survive through and carry on... April

If you have trouble getting your test results from Dr. Murr's office just call all of the places where you had the tests done and ask to have the results faxed to Dr. Haicken's office. You may have to fax the individual places a release of information so they can legally send the results to another doc. Doing it this way would probably be a whole lot faster than waiting on Dr. Murr's office to get around to making the copies for you.

OOOHHH NO!!! I am so SORRY April! This sort of denial upsets me so much. You need this surgery badly and you deserve it. Now, have you a good cry, mope and whine for a few hours and then GET UP and move forward. It sounds like you have done the above so let's look at your prospects. You say you have an appt. with another surgeon... by all means GO to that one and see if they are better at working out the insurance. I would hold off on the letter that you wrote until you go to the new doc. They can put that in your packet that they send in. I know it hurts and I know it is tempting to just sit down and quit but you MUST get up and fight and I know you can and will. You will get your surgery. It might just take a little more work than it should. Hang in there hun, we are all here for you and want to support you through all of this. It will get better. Feel free to email me if you want to talk. I am thinking about you... Sallykate P.S. have you looked at any of Jan's letters on her profile? You might want to consider using one of those. They are really good! Just plug your name into them and the correct data about yourself.

Here is the lovely Miss Jan's profile (ty Jan!) http://www.obesityhelp.com/morbidobesity/profile.phtml?N=H1082657991