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

Hi Rob, I know its been awhile since you posted this and I hope your still here. Have you found a surgeon yet? Did you have your surgery yet? Im in WV too. Would love to get this forum a little more active. Let me know how your doing. Maybe we can be friends.

Like Brenda, I am sorry I am just now seeing this post. I haven't been online for quite some time.  I hope this issue has resolved for you and you have been able to have surgery.  It is so frustrating to have weight loss surgery because insurances see things differently-- because this surgery is "elective", they hold up so many obstacles for patients to get approved that they hope you get discouraged and decide not to have it.  Medicare made a decision back in the early 2000's (I think around 2003 or 2004) that anyone with Medicare who wants weight loss surgery MUST have it done at a facility that is certified as a Center of Excellence, which means their program does great work and has great outcomes.  If you type in Bariatric Surgery Center of Excellence, it should give you a link to who all is certified in your area.  Again, I hope you have gotten to go ahead and have the procedure, but if not, don't give up.  Where there is a will, there is a way.