WLS Programs... why so much aggravation?

Kenneth,
Thank you for your suggestions.  I have already spoke to Jaime and she is the one that has made this so frustrating.  She will NOT go ahead and try to help me out.  I talked to her several times in the last 2 months.  I will continue with my path with Vandy but I plan on seeking other programs as well.  Thanks again for your input.

Cin

Gosh lots to respond to here.... 

1st.  I was still going through a program and submitted all my paperwork.  Denied.  Why? They needed the final document that proved I had completed the program.  I had to wait a few weeks to finish in order to provided that document.  Turned around and got another denial.  Why?  They said they did not receive paperwork.  I had to call, show them that they did receive it, call again, call again... reason after reason.

Once a person gets denied so many times, they then have to file an appeal.  It is better in my opinion to get IT ALL IN at the same time.  That way they don't have any grounds to deny you.  If they say "we didnt receive this" you can say yes you did, show the proof, etc.  That way its as easy as them fixing it in their system, its not a true denial.

Another thing.  When it comes to programs.  I have heard people bash EVERY program in this area.  Baptist? Yes.  Centennial?  Yes.  Vandy?  Yes.  There are all reasons for errors to be made.  People are human, office staff members have personalities that sometimes do conflict with patients' personalities, some environments are more laid back when patients need/want a more take charge approach, and vice versa.  

And then there's the issue of insurance!  Sad to say, yes they do dictate where we receive treatment for the majority of the time, unless we have lots of funds to pay out of network fees.  Is this the fault of the bariatric program? Not always!  (But, I've seen a lot of folks get angry with the bariatric practice when it had nothing to do with the practice... but insurance).  Plus, they are a business and can decide to say "We don't want to be in this network as it just does not pay enough."  Insurance is a tough game if you haven't noticed...  I've been in healthcare a long time, mostly on the billing side...  and insurance companies ARE the ones who MAKE the profit while doctors offices, pharmacies and hospitals make less, less, less.  It causes many frustrations to everyone involved.

Bottom line:  if that's where you think you need to be, should be, know in your heart you need to be there, then jump through the hoops.  Is it hard? Yes.  But all I know is that I started with one program, (and I will not bad mouth them, its just not where I was meant to be), and ended up at another.  Both are respectable programs.  Both have successful patients, and both have some not so successful patients (but the success doesn't rest solely in the responsibility of the surgeon group...  patients have choices...)  anyway.  Off my soapbox.  

Let's move on to another subject because people get very sensitive when the topic of surgeons come up. 

since your insurance approves baptist, i would go to them. they are actually pretty fast when you have everything done. They have a free insurance evaluation where you can just walk in and they will see if your insurance will approve it. Only then you will see the surgeon.
My experience with baptist was awesome! My surgeon is Dr. Spaw. he did the vsg last year and then the 2nd part of the Duodenal Switch this last July.

This just doesnt sound right to me. You say you have finished everything but then you say you havent done the nutrition class yet. I didn't use Vandy but I had to complete all my insurance requirements and my surgeon's requirements before submitting to insurance. I cant imagine your insurance approving you if you havent had the nutrition class yet. If you submit for approval and everything isnt complete, you could get a denial. Then there would have to be an appeal which will take much longer than just waiting to complete everything to submit to insurance. Why arent you setting up the appointment with the nut? Why do you have to wait until April? Rushing into surgery without being completely prepared for what happens after, including the valuable information you get from sessions with a nut, is never a good idea. Everybody who has had surgery had to jump through hoops to get there. It is part of the journey. In fact, the people who have surgery without jumping through hoops, people I've seen post on the main board and some blogging friends, are failing their surgeries because they didnt spend enough time preparing. I personally, think you should be patient and finish whatever is required by your surgeon's office.

Karen

Karen

WLS is one of the most frustrating things I've ever done.
 
The surgery it self is a breeze if your mental game is on the after care is a breeze.

But the insurance filing well make a preacher drink!
I understand the necessity of each requirement especially looking back.
In order for a hospital to retain the The Standard of Excellence they have very strict policies to adhere too.
 
So in every case the individual including myself look at their situation with blinders on and not the BIG picture. If they dilute the rules it places the entire program in jeopardy. 

Once you complete your required programs then I will advise you to be diligent stay on top of the insurance be polite but yet assertive.  You are and will be your best advocate.
 
Thanks for your questions not only will they help you but others who might have the same questions.

  C'ya Bob

It doesn't sound like you are having to do anything different than the rest of us did no matter where the surgery was done.  I went to Vandy because I knew their reputation.  I definitely had a couple of glitches with the paperwork, just like everyone else I had to have everything completed before insurance submission.  I don't think the April date will be a problem for you unless they are really booking that many months out for surgery.  It shouldn't be more than a month or 2 for your date once you have approval.

Hope it all works out for you.