WHAT ELSE CAN GO WRONG????

Hi everyone, I've been waiting since the 18th for my PCP to send further information to the insurance company requesting how many years I've been obese and the weight loss attempts. So, I called the PCP today to check on the status of it all, and SHE HAS GONE ON VACATION FOR 2 WEEKS! She knew that I was needing this information to be sent to the insurance company. I could just cry. I really would like to have this surgery done over the summer while I'm off work. But at this rate, it seems like it's never going to happen. Another bit of bad news is that Dawn, the wonderful insurance lady at my surgeon's office has left Dr. Steely's office. Friday was her last day. Now they have a new girl in there and it appears from my conversation with her today that she just doesn't have the experience that Dawn had. And I can't help but think that she's not going to be pulling all the strings for me the way Dawn did. Dawn was a go-getter and she knew just what to say and how to word the documents for the insurance company to receive the info they needed in order to get approved. Can this get any worse? I suppose it can, but mark it down plain, and mark it down good; if I'm rejected by my insurance company, I'm going to Mexico. I'll go into debt up to my eyeballs if I have to. I just finished reading the profile of another OH member named Amanda who applied in Jan. and got all of her ducks in a row, insurance approved and surgery within 29 days! And she didn't even have any co-morbs! I'm happy for her and glad it all worked out so well for her, but I'm so sad for me. I've actually been thinking about having this surgery for over a year; I'm so ready to get healthy and get on with my life. I feel like I've not really been living because I'm trapped beneath this burden of flesh. Makes me long for my Eternal Home, ya know? Won't have to worry about this physical body there!! Well, my next course of action is to get a copy of all my medical records from the PCP and send them to my insurance company myself. That's what I'm going to do tomorrow. Wish me luck and pray real hard that this works! Forgive me, for my past 2 posts have been doom and gloom. I apologize. Melodie 297/274/160

Melodie, I just got my approval & surgery date today. I KNOW the waiting game, been there, done that. Try to keep your chin up & remember that this has to come in God's time. He know's when we are ready to go thru this. I hope that you will keep the faith & try to hold your head up high. I have been waiting over a year. Trying to find a surgeon, all that good & wonderful stuff. I wish you the best of luck in your journey for a happier & healthier life. Sara.

Congratulations Sara!! Thank you so much for your encouragement and I wish you well on your up-coming surgery. Wow, if you can wait a year, I guess I can too....but just let me say that I don't wanna!!! I know, I'm a big, spoiled baby Melodie

Hi Melodie, without the letter from your PCP, your insurance will deny you immediately. Wait until she gets back, then have your surgeon submit everything at the same time. I was at it for 3 years, God works in his own way, when the time is right, not when we want it to be. Just be patient and remember all good things come to those who wait. Work on a flower garden, or spring clean, anything that keeps your mind busy. Time will pass fast. May God travel with you on this new and exciting journey. Kathy

I am so sorry you are haveing to have this be a long drawn out process. I understand !! I had to swith surg centers and look for a new Dr right after I had sent in all my paperwork !! Medicare is soooo much fun Hang in there . I finaly have an appt date with my surg but it is not till Aug so still I wait . Laura

Hi Laura Thank you so much for sharing your experience. And I thought I had it bad! I'm sorry you have to wait so long too. Lord, I think I'd dry up and blow away if I had to wait until August!!! That's my worst character flaw.....no patience! You are handling it so well; you sound so patient and understanding. Thanks for sharing that with me. Melodie

Hi Kathy, Thanks for your reply ~ It's good to see you back on here! This letter that is needed is not the original letter of request....that was received by the insurance company (PHCS) on 4-10-06. This is further information that the insurance company wants from the PCP. It needs to list how many years I've been obese as well as giving more information regarding previous weight loss attempts. I called PHCS and told them that the PCP didn't get the information to them before she went on vacation, and I asked them if it would help speed things along if I gave them a copy of all of my medical records. They said yes. However, one OH member suggested that there may be some kind of information within my records that would be grounds for immediate denial. She suggested that I have my surgeon's office submit the records because they will know what kind of incriminating info. to look out for. So, I called my surgeon's office and asked the new insurance clerk, Nancy, if she would submit them to the insurance company and she said no, that it must come from the PCP. But she's new, as I stated in my original post, and I wonder if she knows what she's talking about? Anyway, I don't know if I trust her to be on the lookout for any incriminating information....man, I wish Dawn had not left!!!! One thing that concerns me is how long will the insurance company wait for the PCP to respond? I know after a certain period of time, they will close the case and deny the request. I need to call them to find out what that time period is. BTW, I've been planting and working in the yard like crazy as well as spring cleaning....it's not helping! Melodie

Hi Melodie! I know exactly where you are coming from. My worst flaw is my impatience. I am trying to do better though. I have waited over a year for approval. I feel like my life is on hold. I can not make future plans or do anything until this part of my life is decided. I am looking to have insurance approval in the next two weeks. It is supposed to be resubmitted to my insurance company next week (next week seems like it is never going to get here!). Staying busy helped. Keeping my mind off of the surgery and what I was waiting for helped. I haven't been on here to post too much lately because I didn't want to think about it every day. I agree with Kathy, it will come at the right time. There is a reason for everything. What is meant to be will be. Don't doubt it. Stay strong and keep moving forward. I plan on having surgery in Mexico if I don't get approved this time as well. I have done a LOT of research and it seems like a great option when you can not get approved here. My husband is supportive about it. So, I know I have a fall back plan. However, I am going to fight my insurance company before going that route because there is no reason they shouldn't approve it. We shall see. The waiting game is the worst. But we will get there. Good luck with everything and keep us updated. Keep your head up and think positive - as hard as that is to too. Just know that you are not the only one going through it and eventually what is meant for you will happen. Misty