Kathy S - WLS Journey - BCBS I LOVE YOU!!! Plastic Surgery Approved...
***PLASTIC SURGERY UPDATE!***
November 29, 2005
MY CHRISTMAS MIRACLE!
I called the 800 number and left a message for Susan to whom denied my case. I thought I would not hear from her. The message I left was asking if she would be so kind to find some time to call me. I wanted to find out if there was anything I could to assist her in approving the case. I also let her know I worked with the health insurance companies all my life (true) and understand they have guidelines.
I didn't think I would hear from her. My cell rang and by the time I could get to it I missed Susan's call. DRAT, at least she called me back. I had my list of all my issues in front of me and called Susan back.
YOU ARE NOT GOING TO BELIEVE THIS! I started to babble in a very nice way, giving her a day in the life of Kathy S with all my skin issues and she stopped me and said, Katherine (she kept calling me Katherine), she said I have a lot to say so just listen.... off the record I have a brother that had WLS and lost 350 pounds. So I know what issues you are having, I SHUT UP!
She said the state of MN has a law that they have to decide in "10" days to close a case. She said when she got the letter from the PS office she also got the letter from the PS and my doctor. She said they 'Faxed" the pictures and they came out as black blobs. She said they were running out of time and asked them to fax the pictures again to her fax machine by her desk. They came out as black blobs. She said the PS office said they mailed the pictures to her, but she had to close the case as the 10 days were up.
When she got my voice message she went to pull my case and the mailed pictures were attached to my file. She said, when she saw those pictures she took them over to the Doctor that had denied my case and showed them to him. She said she told him we have to do something for this poor women. She said "KATHERINE WE ARE GOING TO APPROVE IT ALL" , "EVERYTHING THE SURGEON ASKED FOR". I was speechless. I think I babbled something like the "the arms"? She said yes, I said the "breast"? She said yes EVERYTHING!!! I started to cry......and kept saying thank you, thank you, thank you. I told her the words of thank you did not represent the pain and suffering she was removing from my life, she was giving back my life. She said she was sorry for the first denial and it was their pleasure. Ladies and Gents, this is BCBS!!!!!!!!!!! This is a MIRACLE!!!!!
When I hung up the phone I just screamed!! My poor 76 year old Aunt that is visiting didn't know what was going on. I told her and she was in tears. My son came up and said Mom you really deserve this. I called my husband and told him the news. He said he was so happy he could just cry. I THANKED him for having the job he does and the insurance they provide as this would not be happening if he wasn't working and a company that had such great insurance.
I can't tell you what this means to me. I NEVER thougth PS would be so important in this journey. I thought these people were nuts when they posted about it. I thought why are they not just happy with losing the weight and wearing a size 10, 8, 6...
But you really are not complete until this last step is taken.
What a Christmas I am going to have. Thank you, thank you, thank you!
Take care,
Kathy
Updated thoughts - I can remember this day as if it was yesterday. It was a miracle but sadly I don't think it would have turned out the same if it was today. Insurance companies just say no, no matter how bad you are and close the book. I was so lucky to have a claims adjuster and doctor that cared about the human and not just the $$$$. I am not saying it's impossible and if you have open wounds and sores as I did don't give up!!
HW:330 - GW:150 - MW:118-125
RW:190 - CW:130
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