Des Your Village Need An Idiot - a follow-up

This is a cross post from the main message board. I want to especially let my peeps here to know that I appreciate all of your many kindnesses. +++++++++++++++++++++++++++++++++++++++++++++++++++++++ Last Thursday, I posted a rant about my little excursion into insurance hell, 5 days before I was scheduled to undergo RNY. The rant can be found here: http://www.obesityhelp.com/morbidobesity/messageboard/postdetail/1077278.html?vc=0 First, thanks to the many folks who shared their stories and provided encouragement. It's great that we have this home to support each other. Your kindness and wisdom was invaluable. So much for the mushy stuff... The update: On Friday, I found two heroes at BCBS-Federal who made my case their personal crusade and, unless a new foul-up occurs, I am on my way to loserland Tuesday as originally scheduled. For those of you *****ad my original rant, you know I am no fan of Big Insurance. The important thing to remember is that in every insensitive organization, there are good folks trying their best to make it better. I work for Social Security (currently in systems security and integrity - but I also use to manage). As a large government agency, we are capable of incredible callousness. I know there are some of you that hate us - and probably for good reason. But, in SSA, you'll also find many, many good people who will bend over backwards to help you. This is also true of BCBS-Federal. Personally, I think our model of funding health care is flawed and often puts an interest in profit over people - but, this does not diminish my affection for the two BCBS workers who saved my ass on Friday. The first person was Kathy, a customer service rep in Texas, who took the time to read my file (which was no easy task as my surgeon, his staff and I bombarded them with calls and information). I could tell from her tone that she knew I was getting shafted and she responded to my plea and put me touch with someone who was empowered to untangle the red tape mess I was in. Kathy passed the phone to Sam, who I believe is a team leader at BCBS. It's always a good sign when someone in a large organization will give you the direct phone number to their desk. It says that that person is accepting responsibility for your situation. Sam explained that the medical review board had OK'ed my surgery, but there were several steps that my file had to go through until a pre-certification could be issued. Sam said that he'd do what he could to get all these sign-off's accomplished so I could begin my pre-surgery prep this weekend. I called Sam back at 1:30, which was the follow-up time we agreed upon. He said my file was still in process and he was working on it and promised to get back to me in a few hours. At 3:30, Sam called back with my pre-cert number. He not only called me, he went the next step and called my surgeon's office. If WLS is a re-birth, Sam is certainly my guardian angel. I owe him. The next time I get a difficult personal situation at SSA, I promise to try and live up to his example. Through this all, my surgeon, Constantine Frantzides and his insurance guru, Jeri Kelly, were incredible. They invested a great deal of themselves into this. Dr. Frantzides personally got involved with BCBS and, just like Harry Truman, gave'em hell. This had nothing to do with profit - this is a great doc being an advocate for his patient. You should all be blessed with such a doc. I had respect for technical ability before (just do a little research on him; you'll see that he's THE MAN - THE MASTER for lap RNY). I am now in awe, not just of his technical ability, but his humanity. And Jeri, Jeri is just as special. She's smart and compassionate and tough and wise. She helped show me the way to be my own advocate with BCBS. I'm in love with her (if my wife is reading this - it's a purely platonic thing, though she is really, really cute - and hey, that doesn't hurt). OK, this has gone on long enough - I just wanted to say thank you to everyone...and let those of you having troubles, insurance or otherwise, know that there are good, good people out there who will help you. Have faith and keep a weather eye to find them. See you all in loserland on Tuesday! Cheers! Harbor

Yeahhhhh!! That is great! sounds like an incredible surgeon you have and are sooooo lucky to have one that really,really cares about his patients. Best of luck on Tuesday with your surgery! You're going to do great! I'll be keeping you in my thoughts and prayers !!

Lora - We will both be dancing in loserland soon! Thanks for the good wishes!! Harbor

That is great news! Thank goodness for people willing to go the extra mile. Good luck on Tuesday! Terry

Terry - Thanks for you kind words. This whole process has made me appreciate how much not only friends and family are there to help you - but, even strangers who'll share their concern and knowledge. It's really something! Thanks! Harbor

Ok....I get to say "I TOLE YA SO!!" and I'm really happy for you. I, personally, wouldnt wanna mess with Frantzides LOL BCBS was prolly shaking in their collective boots when they had to deal with him. He's a great surgeon, a great man and the most compassionate, caring, INTELLIGENT person you'll ever meet. Not to mention how great he looks..LOL!!! Anyhoo..youre in great hands..and I'll be thinking of you all day Tuesday!!! Who's checking up on you for us!?! Love and best wishes, K

Smartass! Well, you've earned the right as you were one of the first to turn me on to Dr. F. And yes, you are absolutely, 1,000 percent correct - he is a great, great man. Personally, I'm not as drawn to his looks as you are, but that's cause guys with beards aren't my thing. I will conceed that he has more than a bit of Sean Connery by way of Omar Shariff in his look. I guess some might find that appealing - if you like the type (and my wife certainly likes that type). If someone will volunteer, I'll ask Kay (my wife) to include you in her e-mail "yes, he's doing fine" list. This can be shared. Everyone has been so kind, I don't want to impose - I hope to be doing my own posting about life in loserland soon enough. Ta! Harbor

You are absolutely right about our insurance systems. It's all about not paying for claims that COULD save millions of dollars in the long run when related to WLS. What I don't understand is "It doesn't take an Einstein to figure that one out". We need a triage of people to go before congress and plead our cases and show them what morbid obesity does to a person. And more importantly why this happens. Unless you're scarfing down 6 KFC dinners for lunch, this is not your fault. I am not saying we didn't have a part in the pounds process. But a lot of this problems are related to genes, environment, and being dealt bad cards. I am thrilled you found some special caring people. They are out there, though hard to find. It's 2005, people need to be educated on the epidemic of obesity and we need to educate the insurers and the employers as well as ourselves. Good luck, I am so happy for you. Make sure you find out what they are going to pay. You don't want surprises in the end. Talk over the coverage, and all that is and isn't coverage. Remember it's negotiable. Barb