On the edge of giving in. I am soo disappointed in my bariatric advocate!!!

This is my first post and unfortunately it is not a pleasant one.  I have been going through the process of trying to get approved for soooo long.  I have completed the 6 mo. supervised diet,  I have done all the tests and evals. My bariatric advocate held on to my paperwork for 3 weeks and did not process it, because she was on vacation and got behind.  Then she sent paperwork in and told me that insurance wanted more tests.

I asked her to check with insurance and make sure that the EKG test was all that was needed.  She confirmed and said that YES thats all that is needed.

 I have had more contact with my insurance than my bariatric advocate has.   I called insurance this evening and learned that I had been denied.  They denied me because I had not had a cardiac and pulmonary test done.  Why didn't my advocate just tell me to do it in the first place?  I could have done that by now.  I addressed this with her and she apologized.  HOwever
I still feel like my bariatric advocate is sabotaging me and not being firm in communication with the insurance company!  I feel like my insurance company knows that the bariatric advocate is not on top of her game and so they are just running the advocate around in circles.

Everyone involved goes to sleep at night except for me.  I have the mind to just go to the ER tonight and get a cardiac and pulmonary test done.  Would this be wrong?

If you made it to the end of this thread, then thanks for listening!!

I'd go to her supervisor and ask for a new one.

It is quite unlikely that any ER will just allow you to walk in and request routine tests.  They are there to provide EMERGENCY services.

If the "bariatric advocate" is not advocating for you, do it yourself.  There is nothing to keep YOU from contacting the insurance company to find out what they require for approval, what tests they are waiting on, etc.  If you truly want this sugery, be proactive and take control instead of giving in.

Lora

Shame on her for not doing her job. I guarantee you that her boss/officer manager/surgeon needs to know she's not following through with the process like she's supposed to. She's there to make sure your claim is paid and processed and the paperwork needed is provided.

I would not go to the ER to get the tests done because you may need them done through a certain doctor or different cir****tances for your insurance. But I would LEAN HEAVILY on the insurance person and report her to her boss as well - and I wouldn't have qualms about it. Remember, the squeaky wheel gets the grease.

Granted that insurance companies are all very different, yet this series of events differs greatly from my own.  I didn't have to get a cardiac and pulmonary clearances until after insurance approval, and only a couple of weeks before my surgery day.  Why waste the money on the test, both of which ensure you are healthy enough for the surgery, unless you are approved?  Thus, I cannot understand why the insurance company would deny you for not having them?

Don't give up sweetie. Keep pushing for what you want/need.
I agree with J.Jim that insurance companies operate different.
Medicaid requires an h.pylori test(negative) before they approve a patient.
After approval, Dr. Lee has all of her patient testing done at the hospital. Please do not give up!

My insurance is Molina which is a provider through medicaid
The test you speak of I have had completed. Having the patience test done at the hospital makes so much sense. For medicaid to make me have the testing done before the surgery does not to me I'm going to hang in there anyway thanks for the encouragement

 I fully understand... I had to switch doctors because his was a stupid witch... was told since Jan. they had sent my paperwork to find out all she sent was a coversheet.. my new doctor has a great lady in the office and i love them already!!!

Thank you for listening dragon lady and much praise to you for your success with your weight loss

make a decision not to give up now. venting about it is great, congratulations for getting this off your mind and out in the open.  now, make a plan and take control.  find out if you can get another B. advocate.  if not, go directly to the ins company, bypass general customer service, get a specialist on the phone, have them send you their requirements for WLS clearance.  then work with your surgeons office to schdule the clearances.  you can check out my profile, i posted all the clearances i needed pre-surgery in my first blog.  you can make this happen for yourself.  get in the drivers seat and either make the B. advocate work for you by being the nice but squeeky wheel or fire that person and move forward on your own.  you can do this.  this is the most stressful time.  i cried countless times during my pre-qualification days, the stress can be almost unbearable, but it is just short term while you fight the "red tape".  good luck.  keep venting here, it helps!