I've been submitted - and now my stomach is in knots

You've all been so patient with me, both here on the board and also in PMs. Thank you for that.

I finally gave up on waiting for Gagner. He wasn't corresponding with me, and it was frustrating me beyond words. He's an excellent surgeon, no doubt. But I need someone who will take the time to correspond with me, and he wasn't doing a great job with that part.

I emailed back and forth with several revision surgeons... even spent 45 minutes on Skype with one... and finally decided to go with Dr David Greenbaum in NJ. I emailed him on Sunday evening ... received a lengthy note from him on Monday morning... emailed a boatload of PDF files to him that afternoon...  spoke with him by phone on Tuesday ... and was told he mailed my submittal to Aetna on Wednesday. Refreshing. Speedy, because my testing had been completed as I was preparing for surgery with Gagner..

I spoke with Aetna, today, and was just a tiny bit freaked out when I found they'd entered my info into their system on the 16th, and so far no one has been assigned the case. She said the decision is usually made within two or three days of receiving paperwork, but they tell you two weeks so you don't expect anything quite so soon.

So you gotta ask yourself why she told me that.... ~laughing~ ... because now I'm expecting something sooner.

I have no idea if revisions are a stickier approval than virgin tummies. The Aetna rep mumbled to herself as she was reading through my file notes, and I heard the word "risk." Of course I'm making myself crazy thinking of the possibilities.

Dr Greenbaum has been incredibly communicative. When I commented on how much I appreciated that, his response was, "At the point when I get upset about someone asking intelligent questions about how THEIR insides will look after I'm done messing with them, I will begin looking for a new job,"

as I'm waiting for word from my insurance company, it seems that everyone else in the ENTIRE FREAKING FREE WORLD is getting their dates!!!!!! .. ~laughing~ And of course I'm genuinely thrilled for each of them. I just want to know if insurance is going to make me fight for my surgery or not.

~commences nail biting~

Edited to add: I called Aetna this morning, and spoke with my patient advocate. Nice woman who has *had* WLS. Apparently Aetna routes most or all of the WLS pre-auth requests to three women in the department that are WLS patients, themselves. Could explain why they’re so quick to grant approvals, huh? Lucky us! Anyway, my advocate had an RNY in November and has lost 78 pounds.

 

We spoke for about 30 minutes about my original surgery, what research I’ve done in preparation for this one, and what my motivations are. She’ll look at my files on Monday (she’s running a couple days behind, which explains why I haven’t heard anything), and then with her recommendation, will forward my file to the “Big Kahuna" who makes the final decision based on my submitted information and the advocate’s recommendation.

 

I don’t want to jinx anything, but it sounded positive, and it sounds as if I’ll hear something next week.

 

*whew*

Oh Kathy, whilst you're still not entirely "there" yet, this sounds very positive!!!

I start crossing fingers for you that this is the final round of your pre-op battle.

You are sooo going to be approved!

Its so exciting!

Denise

I can't believe YOUR surgery is this coming TUESDAY, woman! You're going to sail through it and be home and sipping broth in not time!

~hugs and stuff~

Thanks so much! I can't wait to join you guys on the loser's bench!

And our Denise .... off to HER surgery this coming Tuesday. Can you believe it?!?

I am so excited and nervous for you. It was only a few short months ago I was nail biting over my paperwork review. You have been diligent in all of your research and I am just sure that everything will be approved and soon you will be flying out to NJ.

Best wishes!!

~M

Eeeeeeeeeeeeee!!!

THANKS for that.

One word:

Fan-freaking-tabulous!

Amy

I can't *wait* to cross over to the other side of this journey, Amy! Thanks for your excitement~!