Torn, Depressed and plain Pissed

 

Hi everyone, Well, I don't know who to thank the most for my world turning upside down, Medicare or my doctor's office... before I mentioned that my paper work had been sent into my ins., well I got a call this morning from the doctors office. They informed me that medicare and medicad both require that who ever's doing the surgery to be CERTIFIED! and medicare won't pay because they are CERTIFIED! Ok I guess I don't know much about this to start with, but, I mean come on... first of all, how can you even be doing these surgeries and not be certified??? and secondly... it's been almost 8 friggen months since I started this whole venture... with testings, clearances and 6 months of medically supervised classes and just now they know that this is an issue??? I would think that someone at the doctors should've known this looooong before now.   So here I am, having everything done and ready to go... and no where to go... friggen pissed is what I am at this point, to say the least. So I am faced with two choices;   A. I try and find and get connected with a doctor/facility that is certified,   B. Wait, who knows 2, 3, or 4 months for them to get there asses certified.   I just don't know, I mean I worked hard and long to get to this point, with the emotions of it all, anxious, nervous at same time, but I am ready for it. I want it, I don't think I should or even want to wait them out... but, where I am located.. I can't afford to travel great distances to get this done and follow up care.. where I was going through is like 20 miles and I was dealing with that ok.   Your thoughts or any help with where I can go would be appreciated Rob

Sorry to hear you are having reimbursement issues.  Here is a link to Medicare's list of approved Bariatric centers.  Hopefully you can find one near you. 

Sorry forgot the link: http://www.cms.gov/Medicare/Medicare-General-Information/Med icareApprovedFacilitie/Bariatric-Surgery.html

Thank you for your help, I will check it out :)

YAAAY! Thank you again. I was able to narrow down and find a clinic and doctor, sweet! I am happy again :) lol appt set for feb28

Glad to be of help.  Good luck.  The DS is worth going through hoops to get.

Rob, my journey from first consult to surgery was 18 months. Yes, 18 months, and that didn't involve jumping thru hoops of medicare and medicaid. I am convinced to this day that the insurance company thought I would just give up and go away. 

 

I didn't . And I'm glad. Hang in there and keep after it - it IS hard work and one support leader told me that the pre op stage is, for some, the hardest. For me it got me ready for the patience needed for true and lasting successing. 

Best to you! Lynn

http://www.cms.gov/Medicare/Medicare-General-Information/Med icareApprovedFacilitie/Bariatric-Surgery-Items/Sacred-Heart- Hospital.html

Clarence Holland id the surgeon and is incredible. Sacred Heart is a Catholic Hospital and even though the location isn't great the hospital is.

Not sure your location but this is Allentown.

Sorry I just saw your on the wrong side of the state............well the right side for football, Steelers.

Look for a "Center of Excellence" They move the process along faster with insurances.