Just saying Hi

I just wanted to stick my head in and make sure you all are doing ok. I got denied a second time by BC/BS today so I'm even more depressed. I just am beginning to feel like this is never going to happen for me. I know, I know, some people may say I should be patient; easy for them to say when they are already post-op. It's gotten to the point that even though I am happy when I see someone has finally gotten a surgery date on here, there is this small part of me that's jealous as hell, too. I have spoken with another doctor's office as I am defiantly not impressed by what has went on thus far at Vanderbilt. I just feel like the doctor's office should be the one doing all this work to get me approved by my insurances; but so far, it has been me doing the faxing and calling while dealing with Dr. Wright's office. I filled out the new doctor's patient registeration online today and spoke with the office nurse and the insurance lady who said I wouldn't have to repeat my psych or nutritional eval. Congrats to those who have lost and good luck to those with surgery happening soon. Kelly

Hi Kelly, ya i know what you mean,it just really gets to be more than i want to with.Drs and the insurance people.In my case i can not find a dr to take my ins.tenncare.The one dr i had all my hopes in just said no b/c of my age........ i mean really 50 why i just don't understand.But they can do what they want i guess so i am still looking.And i get a little jealous to but i try to be more happy for them and i know my time will come.Hopefull,good luck to you and hang in there it will happen for you to. Eva

Eva, Well that sucks; have you called Tenncare and asked them to find you a doctor?

eva have you tried centennial medical center with dr daivd dyer i attend a seminar on 9/7 with him and does patient up to 60 yrs old and he will take ur tenncare if u r approved and they will help u get approved all u have to do is get them all the medical records and mail or fax them and then they work with tenncare to get u approved best wishes hug kristie

Thank you so much Kristie i will try dr Dyer and thank you to Kelly and yes i have a case manager with tenncare trying to help me find a dr. thier are just not many drs that will take it. thanks again Eva

Hi Kelly, can I join you on the disappointment-depression bench? My hair is falling out from the stress and nerves. Last Friday, the Dr.'s office called, I have to have 3-5 years of Dr. supervised weightloss attempts. I don't have that, because I was going to the VA medical Center. Today I called Medicare, about this, no one could give me a straight answer. I called again later, and got someone else. They don't need nor will they give prior approval, until they receive the bills. Part A is for hospitalization, and Part B pays 80% of the Dr.'s fees, then Blue Care pays the 20% left over. No prior approvals are need and they do not certify that they will or will not pay. Until the bills arrive. If they deny me after surgery, then I will have to pay all of it, eeeeeeeeeeekkkkkkkkkkkk. Social Security doesn't pay me enough to even open an account, let alone pay 20,000 plus. In the four years that I have drawn SSA, and a small VA pension check, I have made $9700 a year give or take, mostly take. I will have made a total of about this amount this year. I can't even file taxes. Time I pay the bills, I barely have enough to get me thru the month, and only $10 food stamps. Now I have a car to get me around, drove tonight for the first time in a year, Robert went with me, just in case, had a hard time getting the right leg out because of my hip. There's barely a thumb space between me and the steering wheel. So now I have to figure in car expenses, insurance, tags every year. So buying groceries will probably consist of liquids and soft foods after the first of the year. It will be rough. Especially when Robert moves out. It's a good thing I have to quit smoking, can't afford it, after Oct. 1, so Robert has 5 days to thoroughly clean the living room. Smoking has to be done out side starting Oct. 1. That's the dead line as I have to be smoke free for 30 days before he will do the surgery. So I am looking for a date in November. That way baby Newton will be born in October, and my surgery hopefully in November. So yes, we have earned the right to be jealous, disappointed, depressed. But our day will come. Love ya, Kathy

Kathy, Sure you can but I think we'd be best suited if we stay on the "fight 'em hard" bench but sometimes I just lose the oomph needed to deal with all this. But hey, we'll get through this together. Kelly

hi kelly, were you seeing a doctor at all in the last 5 years? did he weigh you everytime you went in? did you and he/she discuss your weight. were you on any diets that you may have mentioned to him/her. thats all it really takes if he/she is willing to write you a very good letter. I have bcbs as they wanted 5 years for me as well. approval did not come easy but it did finally come. I am still pre op though with surgery just around the bend in october , but it has been 2 and a half years sice I began my journey. It will happen for you too. but patience is a big factor , that and perserverance. Dont take no for an answer.

Joe, My present PCP has been my doctor for 4 years next month as that is when I went to work for CIGNA and yeah, I sent them every medical record he had which related to problems from the obesity (arthritis, etc) and they still denied me. I'm in appeal with CIGNA (my first one) and just waiting to get denied by them again as well. Kelly

try rewording your doctors letter so that it says he has been treating you for 4 years for obesity , that he has examined you every ----- months and has discussed the diets you have been attempting etc, all to no avail etc. that should work for the pcp assisted dieting. as long as your doctor words the letter correctly. good luck. if you need legal mumbo jumbo letters I can help , just dont give up hope.