MAsshealth ?

I'am a little confused right now.. I have been going to NEMC now since Aug, back and fourth spending hours at a time up there ..And i finally have my consult and now i have to wait For insurance approval .Why dont they have you see the Surgeon first so that while your waiting and doing all the pre op testings and meetings by the time your done you dont have to wait . it seems really backwards to me. it would make more since to start with surgeon first so that you can find out if it will be approved before you waste your time , energy & money.I guess i thought it was all set because i had all my referalls . Does anyone know how long MAsshealth takes . This waiting is driving me crazy it's like my life is on hold and i dont know what to do .. I need to get back to work and dont know if i should start a new job or not .I had been out of work b/c of injury and just had back surgery so now i dont know what to do . If i start a new job and tell them i am having major surgery soon they will probaly not hire me . I know other people have waited longer than i have getting to this point but I'm inpatient i guess .... Thanks all for listening Lisa B

Hi Lisa, Yes it does seem a little backwards. first I had to go to an orientation, then met with the surgeon who said I was eligible for surgery, then while waiting for approval letter did several preop tests. I started in aug. and have a date set for 12/9. The best part was that I recieved a package in the mail will a list of all of the appointments that I have preop and I already have 2 scheduled for post-op. This weekend I actually recieved my letter of approval, but i suspect the Dr.s office may have recieved an approval first. I have 2 more appointments that I am aware of ........ one Novemeber 15 for a weight check in ( I need to lose 15lbs) the other on Nov. 30 my bloodwork and meeting with both the Anasteisiologist (sp) and meet with the surgeon one more time before the big day. I don't know if I will be put on a liquid diet at that point. I'm not sure if you lose the weight we wants you to if you still have to do the liquid diet. As fas as Masshealth goes, I have read a lot of posts from people that said they really didn't have problem getting approved. Try to keep yourself busy. It is a losn process. but trust me it goes by really fast. Did your surgeons office give you any indication as to how long of a wait it is to have the surgery? I was told in August that he was scheduling for December. You may want to ask. I'm going to have my surgery at the Brigham and I can not tell you how woderfully organized they are. It has been pretty stress free as far as waiting for them. deb

all they have told me is it will probaly be 6 to 8 weeks my surgeon just said as soon as he gets approval he will schedule surgery. I talked with Masshealth today and they told me it takes about 14 to 21 days for approval as soona s they get papers from Surgeon . I'm going to call the surgeon office to see if they sent out the papers yet. I guess i have to be on there butts..lol thanks Lisa B.

I am going to mass general for surgery on 12/2/04 Dr ferguson... we are lucky in mass, the 2 yr lists in other places would make me crazy. I called in early August, got an appt the next week to meet three doctors, fill out a book and it all took 4 hours. so what..they had to get to know me. ok then i had to go to t seminar, did that, then went back to get the yes from allthree doctors. Then i had to go have anultrasound in my gaul bladder, standard procedure, it was fine. then they had me go give 15 viles of blood, did that at primary care. then i got my date 12/2/04. this monday i met my surgeon ist time--- love him. tommorrow,i have 3 appts again with the 3 doctors again. Then 4 more appts all before the end of November. today i called out of curiosity - asked if i have been appoved by blue cross, they said no!. i thought i was since i know bue cross "covers" this surgery, and my ppo sent a letter, and the three doctors all said i could after discussing it amongst themselves. so now i am confused too. maybe since i met the surgoan, he writes a letter and i wait 21 days? ok, so why did your doctors tell you to loose weight before the srugery, isnt that why we are having the whole thing done? mine told me to loose to so he could see my liver easier or so0mething in there...

I was told that I had to loose weight for a couple of reasons. 1) to show that I am ready to make a life style change 2) to be healthier for the operation apparently your liver shrinks when you lose weight and it really helps during surgery. Also I think if you are exersizing it helps helps with you breathing. I try to walk.

HI Lisa, I think the reason they wait is so that they are sure you are ready mentally for the surgery and you have attended the required sessions. Plus, they want to be sure you lose some weight before surgery. I had my surgery done at NEMC and found that they were very good about sending in the paperwork in a timely fashion. I had to get approval from my insurance company (HMO Blue) and I received the approval within a month of my appointment. My surgery was almost 2 months to the day that I saw Dr Tarnoff. Considering some of the time tables I have heard from other hospitals, NEMC has a very quick turnaround time from start to surgery. Sue B

MassHealth has 21 days to approve or deny. I got my letter of approval on the 21st day.. exactly.