Approval

Aug 08, 2007

Intracorp called today. They are the medical management company that reviews all of GHI/BCBS claims for approval or denial. They left a message on my voicemail to call back. So.... I called back and the csr said oh yes ny state law requires that we call you with the outcome of the review of medical claims, and you are approved for gastric bypass surgery for 8/20/07. i said one word: "WOW...........!" I was stunned lol.
I told her the date was changed to September 4th because the surgeon would be on vacation. She said ok that's fine, I will change it in the file.
And that was that.
I can't believe it............It's now real to me.
Suddenly I'm thinking.. ok now what do I have to get done while I am still pre-op? What should I take with me to the hospital?

surgery date changed

Aug 02, 2007

got a phone call early yesterday morning that my surgery date of aug 20th must be changed because my surgeon will be on vacation that week. guess he didn't know this when i made the appointment a week ago.
 the new date they gave me is sept 4th... i will already be back at work at that time............so this means i have to take unpaid leave for surgery/recovery. i dont have accumulated days to fall back on.
needless to say i was disappointed. i asked if she had heard anything regarding approval, she said no it's pending, but we should definitely know before sept 4th. (i should hope so)
so between that and my computer totally crashing and spending the last day and 1/2 trying to wipe everything out and reinstall all over again..........i wasnt the happiest camper.
just venting

SURGERY DATE

Jul 28, 2007

Saw Dr. Holover on Wednesday 7/25. He looked through my chart and we discussed the findings.. and what was missing. (pulmonologist report, the nutritionist's report and the psychologist's report.. all three are right in his office so that shouldn't be a problem. i just hope they don't forget them when they submit to insurance.) I got my date for surgery: 8/20/07. Now they have to submit to GHI........which is a bitch of an insurance company to deal with for pre-cert. Hopefully if they deny me, it will be something that can be remedied quickly so my date does not have to be rescheduled. If I can have surgery on 8/20 then I won't have to take much time off from work.. if any. My first day back to work is I think 8/29.. and there won't be any kids for those first 2 days,,then there is Labor Day weekend. So.. I can probably get away with not taking ANY time off. If I have to reschedule, I will have to take off 2 weeks.. unpaid because i dont have any days saved up. that will suck. the upside is.. im not in the classroom this year so it won't be like my students are suffering. i am a resource room teacher..there will be 2 of us and only 35 kids.. so she could pick up the slack for those 2 weeks. 
My big worry now is insurance approval. Will have to wait and see. Waiting is difficult!!
In the meantime I'm nervous.. have read many posts about complications a year or more down the road and that scares me.


ALL CLEAR

Jul 20, 2007

so,, saw pulmonologist, Dr. Genovese, today. love that man... realllly nice. i recommend him. anyway.. he cleared me for surgery, although now i must get the CPAP machine and hopefully begin using it before surgery.

i also called the endocrinologist's office to see if my glucose test came back. it did........i have IMPAIRED GLUCOSE INTOLERANCE, the precursor for diabetes...

so........between the sleep apnea and the impaired glucose tolerance, i am HOPINGGGG my insurance approves me.

i go to see Dr. Holover, my surgeon, on 7/25 after which time he looks at all my reports and test results and tells the staff to go ahead and schedule me for surgery... and they also submit my stuff to insurance co for approval.

my primary care dr is supposed to have faxed his letter and the office notes of my 6 month supervised weight loss over to my surgeon's office.BTW.. i went to my PCP and we sat down and looked at each of the 6 weigh-in visits to see what he wrote.. he admitted to being terrible at office notes, but he did a really good job.. he wrote  something down for each one : what diet i was following, my weight loss, if any, and exercise. he was surprised himself that he had done such a good job lol. now hopefully they can READ his handwriting. very often HE can't read it!
so we're getting down to the wire now..........
i just cant wait until i know whether insurance denied or approved and can move on with life.
i feel like i am STUCK..........can't do anything or go anywhere (like vacation) til i know whats going on with this surgery.

This time around is a bitch!!

Jul 14, 2007

so.. i just got over the fact that i have to go for further testing before my pulmonologist and endocrinologist will clear me for surgery...knowing i have to take another sleep study to get the CPAP crap and to take a 2 hour glucose tolerance test... came to grips with it all... had my psych and nutritional consults which went well.........tried hard not to panic that i shelled out $650 for that... and then...............FRIDAY THE 13th:
 I had to go for a 2 hour glucose tolerance test because when I went to my endocrinologist consult and they took 4 vials of blood from me, he discovered my glucose level was 175.....the month long average glucose # looked good, but  he wanted me tested anyway.
.............i had asked him that day if i needed to fast before this appointment, that i wasn't told to do so and i had a doughnut on the way to the appointment. gee maybe that was why my glucose level was so high! 
anywayyyyyyyyyyyy so i go for the 2 hour test on Friday the 13th after fasting since 9pm the night before. they take blood a bunch of blood from you to start, you get 5 min to drink this sickeningly sweet stuff, you wait an hour, they take more blood.. you wait another hour they take the last few vials of blood.. im sure many of you have experienced this...
the waiting is by far the worst part.. but getting stuck 3x sucks too.
after the appointment, i eat and go shopping... get home and never once looked at the call waiting box to see if there were any message because i rarely get calls on my home phone.
well............ at 5pm i discover there is a message from Quest (the blood drawing center) "Lisa, i have some bad news, 2 of the tubes of blood cracked and you are going to have to come in and do this test all over again. we called your doctor and he said to do a redraw. call us before 3:30 so we can get you in here tommorow or monday."
i cannot begin to tell you how insanely angry i got.........i literally felt my BP skyrocket!!!
who does this happen to? how can they crack two of my vials of blood???
and damnit why didnt i give them my CELL PHONE #?
well.............i breathed, i went out that night... i drank i laughed i danced.. and i feel better.
i am going to call them at 8am monday morning (fasting) and tell them they MUST squeeze me in, that this is a huge inconvenience to me and i shouldnt be charged for ANY OF IT...
and i will be watching carefully to make sure i don't get charged twice for this. i'm really being put through the paces this time around.


pre-op purgatory

Jul 05, 2007

I'm almost done with all of my pre-op testing. Let's see. I've had: pulmonologist consult, sleep test, cardiologist consult, echo cardiogram, nuclear stress test on 7/7, endoscopy (today,) endocrinologist consult. I have to get my nutritionist and psych consults done on 7/12 and my PCP needs to write "the letter" that includes the 6 months of weigh-ins and diet history that will be the nail in the coffin of my denial, probably. He didn't write anything down in the office notes when  Iwent. I weighed in and he took my vitals and we talked... but he didnt RECORD any of it in the office notes. But............I will submit it all anyway and continue with another 6 months..this time he is writing details down. If I am denied, I will appeal. I will look into getting a lawyer to write a letter. I'll do whatever  Ihave to. Now I just have to relax and keep telling myself that someday I will get approved and someday I will have this surgery.


About Me
East Patchogue, NY
Location
24.8
BMI
RNY
Surgery
09/04/2007
Surgery Date
May 14, 2007
Member Since

Friends 62

Latest Blog 26
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