3yrs later&still waiting but hope to get-r-done NOW!!!!!

First of all, I would like to say I am glad to be back here. I have been on a long journey and am ready for it to be over. But here is my story ; For the last 3 years I have been having insurance problems and to make it worse when I finally got insurance from the state they took it away. Then I go back to work and insurance doesn't cover it. Over the past 3 years it has been hit or miss. I tried dieting and weight loss pills but no luck. I am really leaving out a lot but the point is I have not had the surgery because Drs. change acceptance or approval processes and insurances do the same.   Fast foward to today. I am about 20pounds bigger and want an answer now. Not 6 months or so. I have kept up with it all and now I call Drs. offices and they want you to pay for things upfront with cash. I am covered 100% for everything. I am feeling like this is not gonna happen again. I do not understand why I must pay $500-2500 for things like nutritional support and mental evals when I am covered for that under insurance. Does anyone know of any Drs. in the area that will allow you to use your insurance for these fees?  Also, I have both United Healthcare and BCBS NC, they said I am fully covered, so will that cut my wait time down? I am basically going to start looking for nutriotionists and mental health evaluators in NC and start that on my own while I find a Dr. to do the surgery. At least that will help hopefully. I am currently out of work looking to change professions due to work injury. At the same time waiting to settle work comp case. So I have plenty of time on my hands and a huge desire for this to happen.

Hi Rae -

I'm sorry that this has been such an arduous journey for your so far, but  hope that it will culminate in a journey that brings you what you need.

Before you start working with a nutritionist and/or counselor to circumvent what they programs require, you should check with the various programs to see if they will accept it. Often they won't because they want someone who specializes in bariatric patients ... sometimes, they will though, so it's worth checking.  Also, you may be able to get re-imbursed for some of the fees. You can probably check this with your insurers. For example, I had my surgery at Duke. They have a $250 non-refundable program fee that will not be covered by insurance. It's just an out of pocket expense ... I'm going to see if I can take it off my taxes, but my insurance won't re-imburse for it. Then there is a $300.00 psych fee that covers the pre-op, 3 wk post of, 3 month post op, 6 month post op and 12 month post op psych appointments. At each appointment I get a 'receipt' that I can submit to insurance for reimbursement for that session. I don't know if your insurance will re-imburse for those or not ... I have UHC too, but each policy varies.

I wish you luck and success as you make your way. I look forward to getting to know you during your journey.

Welcome to the board,

Barb

Thanks so much for that info !!! I have been online looking up local doctors and such. Those prices are a lot more reasonable than the ones I talked to today. I have Duke on my list to contact  regarding doctors in the morning. I am in Grensboro and hate to see that other than the same group I started 2 years ago with, there are no new specialists in the city. So off to RDU or Charlotte I go.  But at least this time I have double coverage so if one falls thru the other will hopefully be there. Well thanks again, and btw,you look great!

Thanks for the compliment and I look forward to hearing that you've found a program that fits your needs.

Regards,

Barb

Hi Rae have you looked or talked to CCS?  They dont require any fees upfront outside of a program fee of 150 that is non refundable and not covered by insurance.  I was approved and have a surgery date with them, but I just paid my 10% coinsurance to them and that is all, but if your insurance covers it at 100% there shouldnt be anything you would have to pay except the non refundable program fee. Rahsheeda

Hi I actually am apast patient there with Dr. Weatherly for various reasons. And I talked to a lady there that said they have about a 6-9 month beginning to schedule surgery date timeframe. Since I am already a patient of theirs you woulld think somethings could be transferred or just updated. But the lady over the telephone said it will still take that long. I have no problem with the tests and time it takes but if I can do everything myself in 2-3 months, why should it take another 3-6 months ? But thanks for the info.

Hi Rae, it shouldnt take 6-9 months, I know people who have done it thru their center in 3-6 months.  If you can get your testing done and you have no problems with your insurance, no supv diets to do for insurance purposes then you should slide right through.  Have you already been to one of the seminars that is required? Rahsheeda

Yes, but it was a while ago. Over a year ago at Mcone hospital. I am still in their system and everything. I call and get the same lady and she tells me the same thing everytiime. I will call them today and ask what her problem is and see if I get anywhere. The $150 sounds much better for me since I am strapped to a budget while out of work. Thanks

Talk with her again.  Sometimes she does sound like she has an attitude.  Have you filled out the paperwork yet they gave you at the seminar?  If you have just have her schedule your consult with the surgeon of your choice, I think only 4 of them do the bariatric surgery and go from there.  Your testing if possible you can have all that done in a week to two weeks time period.  Dont get discouraged, It will happen for you.

Rahsheeda

You are soooooooooo right about the attitude ! I did have the consult and paperwork  but as I stated they said it was so llong ago I need to start over. I have had a busy day today with my kids school EOG report. Friday is even busier but I have the numbers in my purse so I will make calls in the car on my way. I have about 10 nutritionists and 15 doctors so hopefully I can get the ball rolling. But I am callin CCS 1st and see what they do.  So how lon did it take you and what tests did you need? The only problems I have are high blood pressure and migraines. Other than that I am just fat. And everyone knows that is a problem in itself.