Denied 6 times

Kathy Newton
on 9/24/04 7:16 am - LaVergne, TN
Hi everyone. Well I think I have set the record for the most denials from having surgery. Dr. Oxley's office informed my case worker, that he would prefer I go to a larger facility. I called two, Dr. Wright's office hasn't gotten back with me, Dr. in Chattanuga and in Dickson don't take medicare. If one takes medicare, but does not fill with Medicaid, so their payments has to be in cash. Like I just have loads of money from Social Security to pay that large amount. I found out that if I have to see a surgeon in West Virginia, in my home town, if they accept Medicare, then TN State Medicaid will pick up what Medicare doesn't pay, because I couldn't get it done here. They (the surgeon's office up there) are worried if something were to happen in case of an emergency, 5.5 hours of driving up there could be fatal. But then anywhere I go to have the surgery would be a long drive. But I don't want to borrow trouble anymore then necessary. With all this happening, my wheelchair decided to fry. So my PCP is faxing a presciption for a new one. Like I really need anymore problems. I need major prayers and support right now. I am getting so frustrated. Thanks, Kathy
TNkelligirl
on 9/24/04 9:54 am - LaVergne, TN
oh, Kath, I am so sorry, hun. I'll keep you in my prayers.
DixieFlower
on 9/24/04 11:17 am - Chattanooga, TN
Well I don't quite understand what the problem with the amount of travel time. I am 4 hrs away from my surgeon. When an emergancy arises I go to my local ER. If they feel the emergancy is WLS related (which they thought once when I was 6 weeks out) they get ahold of a bariatric surgeon locally. I mean even if you had surgery with a local surgeon it doesn't mean you might not move later down the road. Just means you will eventually either have to find a PCP that is bariatric surgery wise or a bariatric surgeon closer to you. *huggles* Its gotta get better
kristie T.
on 9/24/04 2:12 pm - monteagle, TN
im sorry kathy but i will keep u in my prayers and maybe dr wright will call back it can take up to a weel before they call back dont give up hugs kristie
TNkelligirl
on 9/24/04 10:24 pm - LaVergne, TN
Kath, Dr. Wright is the doctor doing my surgery and trust me, his secretary, Lisa, is never in too much of a hurry to get back in touch with folks. I'll keep my fingers crossed for you. Love, Kelly
Kathy Newton
on 9/29/04 1:03 pm - LaVergne, TN
Hi Kelly, it's official, I think I broke the record on most Dr. denials. One called this more from Nashville, denied, then Lisa from Dr. Wright's office called and because I was still half asleep and on pain meds, all I heard was she telling me that Dr. Wright will not be doing my surgery as I'm to high of a risk. Now the only one left on my list is Dr. Nease moving back to my home town in West Virginia from CA. He's top notch in doing servere high risk patients. He will be my last hope. I did find out that my power chair is still under warranty as far as the motor goes. So they are supposed to call me tomorrow afternoon to let me know when someone will be coming out to fix it. That's the only good news I've had all week. May God be with you through out your journey. Love Kathy
tinyTNgirl
on 9/25/04 2:21 am - TN
Kathy, dear heart, i'm so sorry you continue to have this problem. I wish I had wonderful words of wisdom for you. Or a magic wand. Please know that you continue to be in my thoughts and prayers. May God bless and keep you, giving you strength beyond measure during your difficult times. We love you! Melanie
lisageo
on 9/26/04 12:34 am - Murfreesboro, TN
Kathy I am sorry to hear this! I would get myself a lawyer. I went 90miles to get to my surgeon, so I know it can be done. I will keep you in my prayers and thank you for your support too. Lisa:wave
Kathy Newton
on 9/26/04 9:08 am - LaVergne, TN
Thank you all so much for the prayers and support. Maybe I just need to realize that I'm not supposed to have this surgery. Not being negative about it. I don't have half the comorbilities that others have, like heart problems, or weight exceeding over 500 #'s, so I don't understand why I keep getting turned down. I have sleep apnea, arthritis, thyroid problems, a hiatel hernia, and over 100#'s. And my blood pressure is relatively low. So what is the problem? Again thanks to all, Kathy
Linda R.
on 9/27/04 10:00 am - maryville, tn
Kathy I'm sorry you are still having to jump thur the hoops of Ins co. I would be frustrated also! But I just have a feeling you will get thur them all soon and will win!!! You have already showed you are a fighter and I don't see you quiting now!! Hang in and just take it one day at a time, you still have hope!!! Sorry about your chair too. I have and will keep you in my prayers. Love ya Linda
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