Awaiting Insurance Approval...tic tac tic tac tic tac...

After a very busy end of last week going back and forth to my pcp and following up on the phone with them, Saturday I went in and made sure my pcp's assistant got all the docs (clearance and hospital pre-admission form [good think I went because my pcp needed some info from me to complete a couple of sections on this form] , labs, my pcp letter to the surgeon, and pcp letter to the insurance) faxed to the surgeon on Saturday 7/16 and I kept all the originals (just in case). These were the last of the trail of docs needed for submission to GHI--psych eval, nutritionist eval, cardiologist clearance, and the GB sonogram have been at my surgeon's for quite some time now...and the pulmonologist clearance (including the sleep study report) they received about a week ago.... Yesterday I called my surgeon's office to double check that they had received everything and that, in fact, now they had everything they needed. The secretary who handles the insurance process was out to lunch, but the one that handles the actual claims checked my file and said that according to what she could see, it did seem like I have everything. However, she said she was going to leave a note for the other one to call me back in case something else was missing or just to confirm otherwise. From past experience, I have realized that the one who handles the pre-certification process is not very good at returning phone calls (at least, this has been the case with me, for whatever her reasons). So, today, I called again and luckily she was there when I called. I asked her and she confirmed that my paperwork was complete and that it was submitted to GHI yesterday PM. FINALLY!!! Yaaaayyyyyy!! ...now the most enerving stage of this process (at least for me) has begun...I don't think I can stop thinking about this or stop praying for God's intervention so I can get a quick approval...after all, here I am a little less than 2 weeks from my tentative (preferred) surgery date...yikes!!! I know it's pretty humid and hot out there, but I don't think all the sweat out of my pores has anything to do with the weather...it's the waiting....waiting....ohhhhh good Lord, help!! I keep asking myself, What are the chances I'll get this? I do realize though, It's all in God's hand... Wish me luck and keep me in your prayers, please. Thanks everyone for your support and patience! Dolly

Hi Dolly My thoughts and prayers are with you that you get your insurance approval quickly. I have GHI too and I received my approval in less than a week. I would have gotten the approval in 3 days, but they wanted a history of at least 6 month supervised diet showing all my weigh ins; my pcp wrote his letter but forgot to include all my weigh ins. I was able to have my pcp's office faxed that to me immediately; once I faxed it over to my WLS surgeon I got my approval for the following day. GHI is pretty good as long as you have all the required documents. God is in control and what he has for you is for you. Glenda

Hey, Glenda, thanks for your support...it means a lot to me I don't foresee any problems with GHI, I made sure I covered all my bases, especially the documented supervised diet/weigh-ins, which I started back in May of 2004 and have kept on top of by seeing my pcp on a monthly basis and making sure there's a trail of this. According to my surgeon's offfice staff, and as per my own preparation, I have everything they could possibly want to see and get, so the only reason GHI may deny me is if they want to mess up with my mind...lol Hopefully, this isn't the case... Thanks again for your prayers, Glenda... God Bless! Dolly

Dolly, Hun congrats and now the waiting begins. I have GHI as well and I was approved within 2 days. I called them every morning until I heard something. It really becomes real when you "hear" you are approved. I see you have the 6 month weight loss doc so that is cool, you should hear something by the end the week. ~crosses fingers~ My thoughts and prayers will be with you that you hear something awesome very soon. ~Hugs~ Keep us posted. Debra P

Debra, thank you so much for your support. It's always nice to hear from ya... BTW, how's your progress? Are you feeling better today...did you go??? Hope so, I know constipation is no fun (way back in my late teens and early twenties I had to go to the emergency room on a couple of times because of a combined crisis with constipation and gas...yikes!! I don't know if you are allowed to eat Papaya, you may want to check with your doc; Papaya is really good for that, helps you go. Check it out! I just talked to them (GHI) on the phone. Joyce, a very nice rep, told me that they just faxed a request for the clinical information on the procedure (???) to my surgeon today. So they're waiting on that...sigh.... you would think they included that with the ton of paper they submitted... I'll check with GHI again tomorrow... Funny note though...I called the surgeon's office and guess what the girl who handles the pre-certification said to me????? Give up?? Ok, I'll do tell... she said, "DON'T CALL, DOLLY, DON'T! The worst thing you can do is drive them crazy and put pressure on them. Let it roll as it is supposed to...they know what they're doing...etc...etc..." Yeah right! Haven't we all heard that one before!!! This is the woman that has only called me back once (and that was way back to confirm my initial consultation appointment date with my surgeon)... I don't think I'll leave it up to "them" who know what they're doing... I'm known for being very VERY IMPATIENT and PERSISTENT... I'll be calling until I hear something!! lol Have a wonderful day! Blessings Dolly

Hi Dolly, I'm glad to see that things are moving right along for you. Call GHI everyday until you get approved. You have to be your own advocate; we can never assume that everybody is going to do what they are supposed. We have to take of ourselves sometimes, even it shouldn't be that way. Are you going to the support meeting tomorrow night? I hope so. Is DH coming with you? Looking forward to seeing you. Joanne

Hi Joanne, nice to hear from ya!! How are ya doing? I heard you're cutting up some plastics already... GOOD FOR YA...WTG!!! Thanks for your comments...yeah, I'm planning on calling every day until I get a determination, whether positive (hopefully) or not...despite my surgeron's secretary's advice not to Re: support meeting... I believe both DH and I will go, but we have an earlier appointment though...if we can get out in time, we'll make it to the meeting. Hope to see you guys again... Have a nice day! Dolly

Hi Dolly welcome to my world. My paperwork was submitted to US HEalthcare on Monday afternoon. I called already yesterday to check up but the Claims lady laughed and said give it aat least a week. I am so anxious myself and am hoping to get approval ASAP. I would love to have my Surgery in August to get the Losing Rolling. But we waited overweight this long whats another week or two.

Thanks, Louis! I was hoping by today I would really have just 8 days to go--my initially preferred date was 7/28 but because my surgeon likes to operate on Mondays, only, I had to settle for 8/1...that if, GOD WILLING, I get my approval on time! Otherwise, I may have to put it off until September We'll see... I believe that if God wants this for me, it'll happen when the time is right... Have a wonderful day!! Blessings! And GOOD LUCK to you too...hope you hear something soon! Dolly