Does Your Village Need an Idiot? - redux

I'm re-posting this from the main board cause I just that P.O'ed -- +++++++++++++++++++++++++++++++++++++++++++++++++++++++ I am/was scheduled for lap RNY with one of the best surgeons in the Chicago area on 3/8. As you all know, it takes quite a bit of psyching yourself up to undergo elective WLS. It's a trade off. You intellectually frame the argument that the risk of staying as you are is greater that the risk, pain and accommodation you have to make to have the surgery. This afternoon, on my second to last day at work, the surgeon's office calls and says BCBS-Federal won't let the surgery go through. It's not that I don't qualify. I do. They just have a new procedure (as of 3/1) that requires a new level of sign-off. They want to ensure that I have submitted enough material to justify the medical necessity of my surgery. The ironic thing is, just to avoid such a bottleneck; we submitted this material with our original request. In other words, they already have what they are requiring, but now they actually have to read it and take action on it. So...I am on the phone with a customer service rep with BCBS - she's looking at my electronic file and she's telling me to go ahead with the surgery. Meanwhile, another BCBS rep, who probably is sitting two desks away from rep one, is on the phone telling Evanston Hospital that I am not authorized for the surgery. To call these guys clowns does a disservice to circuses everywhere. Does your village need an idiot? I know where they come two for one! Everyone agrees there is a health care crisis in this country. Want to see the poster child of unnecessary medical bureaucracy - just take a stroll to Dearborn Street in Chicago and visit the headquarters of BCBS - an organization more concerned with producing commercials saying "they care" (with soft guitar music), than making folks well. Hanging is too good for the *******s. They should be made to wallow in the purgatory of their owm paperwork. Tomorrow, when I should be cleaning up my desk and making sure that the folks who depend on me are taken care of, instead of that - I'll be on the phone with Moe, Larry, and Curley trying to get them to move my file from desk to desk so it has the important stamp in place to justify what my plan says that I am qualified for - WLS. I am luckier than many. I will eventually be covered. I am a bureaucrat and I will tie them in their own paperwor****il they pay just to get rid of me (my favorite line from today was, "I hope you have all day for this call, cause I do."). But, for those of you struggling to qualify - know your enemy. Madame Defarge knitted their names into a scarf - it is a lesson we should all follow (for those who forgot A Tale of Two Cities - she was a cruel revolutionary whose hatred of the aristocracy fueled her tireless crusade. Madame Defarge spent a good deal of the novel knitting a register of everyone who must die for the revolutionary cause. Unlike her husband, she proved unrelentingly blood-thirsty, and her lust for vengeance knew no bounds.) On that bloodthirsty note - have a good evening all. The games resume tomorrow. Cheers! Harbor

Sweetie hang in there make em choke on their paperwork and let us know what happens.. Your in my thoughts Debby

(my favorite line from today was, "I hope you have all day for this call, cause I do."). I'm very sorry you're going through all this red tape. However, I see that you have the right attitude and it WILL happen. I'll be thinking of you!!! Katie

Oh man that sucks! I'm probably going to end up in the same boat. I'm scheduled for 3/30 and have yet to get "official" approval from my insurance. My surgeon's office doesn't think it will be a problem but I've refused to let myself believe that it will actually happen until I get the official 'ok'. I hate hate hate BCBS. They are the worst insurance company ever. In fact, as far as I'm concerned they are just a fradulent company that fails in every explicit and implied fiduciary obligation. I even changed employers just to get a different insurance option...not an easy decision. I used to work in the same building as the IL BC/BS back when they were over on St. Clair in the mid 90's. Used to share the same cafeteria and everything. Now the thought that I used to engage in small talk in the cafeteria line with these people is enough to turn my stomach enough the point where I might not need WLS surgery anyway! Hang in there Harbor!

Harbor, Unfortunately, our village has several idiots;) Have faith in Frantzides' office. He is RELENTLESS and they will probably end up ok'ing you just to stop his phone calls!! LOL I love your 'Hope you have all day" comment...really...hit them with their own stick!! And remind me never to **** you off. Keep the faith!!! It WILL happen. (remind me of this post when I'm denied for my plastics, will ya!?)

Sorry Harbor, We have enough issues to go through without having to deal with this. But to pull this at the last hour just plain sucks!!! I have heard nothing good about BCBS of IL. I was lucky enough to have BCBS of CA and had no problems. Well, that was last year and this year my employer chopped up or benefits so bad I wouldn't be able to get the surgery. Good Luck to you and if you go in for the surgery, please have someone post for you so we know you are on your way to a better wonderful life. Take care, Kathy 330/299/185