Ins Now Wants What! (Long Vent)

Ok, so today I was supposed to get an answer on wether I was approved or not.  Did it happen? No!  I called around 5:30 from my department holiday social.  I am officially getting the run around once again. Ins Lady:  Did you ever do a 6 month supervised diet?   Me: Ummm, what do you mean?  This is not one of the requirements that you asked for 2 months ago. Ins Lady: Your diet history shows that you where on diet pills back in 2000, how long was this for?  Me:  About 7 months, But I have done Weigh****chers off and on for since 2000. Ins Lady:  Weigh****chers counts as supervised diet.  I need a weight history for the last five years. Me:  Umm, I have not been to the doctor since 2000.   Ins Lady:  Can you write down your a journal history of your weight for the last 5 years and fax it to me tomorrow? Me:  Sure, no problem Ins Lady:  When I get that then I will send it up for review, and we will see what happens OK, Now I am upset, depressed, and crying at my holiday gathering that I worked so hard in organizing.   I am now wanting to asking these questions:   1.  When I talked to her on Friday, why did she not ask for it then? She said she had everything   2.  If it was something that the reviewer wanted, then why did she not call me earlier so I could   do it and fax it right away from work and it could be reviewed?   3.  What else do you ******** need?  I am truly getting tired of this...  I told my husband when I got home, so help me if she jerks me around again I will be going to her supervisor, and so help me.  If the military insurance wants to give me the run around, I will be more than happy to contact my senator.  It is truly amazing what playing politics can do with the IRS and the Military jerking you around.  So, now I sit here needing to finish my final assignments, but I am depressed, and angry to the point of just going to bed.  I know that it was not going to be easy, but geez when I am the one who is very proactive in making sure that I am approved by getting everything they need it.  Ok, so now I apologize for being whiny but there was no other place for me to go and talk.

Hang in there Wendi - It's not just military ins.. It's everywhere.  Most of us have had the same expereience.  They really do want us to throw in the towel and say screw it.  But don't give up the fight.  it will work out but in there time not ours. Calvin is currently going thru the same thing.  I went thru it too.   HUGS, Christina

Wendi, Hang in there, your insurance is no different than any other.  You think you've met all the requirements, your doctors submit and the spawns of satan rise up and ask for more.  They even ask for the same things over and over again.  All insurance is big business, they hope to not cover you for anything if they can avoid it.  Like Christine said, they want you to go away.   I ended up paying myself because I wanted the surgery and went through hell and back with BCBS, I was blessed that I could pay.  I stopped the fight because my health was in a downward spiral and I didn't have the energy to continue fighting. I understand how you feel, but keep up the fight.  I am so happy I had the surgery, yet I still want to kick myself for letting the BCBS BASTA---- get away with not paying. GO GET THEM!!!! Mary

I know how you feel, really. They are doing the same thing to me, I have recieved 4 different letters telling me all these things I have not done, when they are right there or we,My Drs office and I would not  of  felt  it okay to submit.  My next step will be a lawyer, I need the surg. for health issues, not because I have nothing else to do and I'm bored, so thought I would get a Lap band, I am 59 yrs old and  would like a few more years to see my 7 children grow up and have their own families.  I guess my hard part to understand is why and who has given them the right to decide on if you need this, if you have the paperwork that shows you do, and the support from your own Dr. who would do it I"m sure if they knew how?????????????Hang in there, and I must say the only thing that get me through some days is "I BELIEVE"   B.J.

Thank you everyone for your support.  It is truly a frustrating thing, and I have one of the easiest to get approved by (Tricare)?  This afternoon I have faxed what was requested, and when I got home last night I finished my finals for class, then I went digging.  I found 4 years worth of Weigh****chers membership cards with my weights.  So, I sent them.  So now I am once again being told it went to the reviewer.  So I am once again in the waiting mode.

Wendi, Hang in there. The insurance girls at thte Kane Center always seem to want the impossible. They kept after me about the phych exam. I finally sent them the paper where the insurance payed for it. Did you ever ask tri-care to send you a copy of what they require? Thats what I did, so when Bessie started asking for things, I could show her where it said what was required by them.  Keep your spirits up. Hugs,  Lisa

Lisa,  I asked several times and no one could answer the question.  When Maggie initially called them the told her they only needed the request for authorization, psyc eval, and letter of medical necessity.  Then after two weeks they asked for more.  As a mater of fact when I called Tricare this afternoon to make sure they got the informaiton, I sent to them.  She said that she thought she had the information... My opinion she is doing bits and pieces to drag this out.  If I find out they need something else, I am going to somebody''s boss.  This is not necessary, and the only information in the benefits and exclusions is that I needed to be either 100lbs over ideal body weight with comorbidities, or 200% over the ideal body weight.  Tricare has found out that if they needed something, the person handling my file will call me directly, because I can get her an answer within minutes and not days.  I hate to say this, but I think I have done more myself than what has been done by the Kane Center which is OK because that means I am being proactive with getting my act together and I am serious about getting this surgery.  Sorry, I am on what my husband calls the war path.  I have gone through the upset and crying phase.  No I am angry and will do everything to win the battle. 

Dear Wendi: I call this the "Wizard of Oz Syndrome"  you bring them what they ask for, and they ask for something else.  I went through the same thing, and I handled all my appeals and paperwork.  The surgeon's office would not have done as weel as I did because they were not invested in it as I was. Hopefully, you will hear good news soon.  they can only put you off so long.