Question:
HAS THIS HAPPEN TO ANYONE

i have spent the last 7 months doing EVERYTHING i was told to do to have this surgery. i have a BMI of 77 with a weight of 462 lbs. i have no heart problems and have been cleared for surgery by cardo dr., gast dr, psych dr. and nutrionist. i finally got to the point of filing for insurance coverage and now my insurance wants me to get a 2nd opinion from another dr. WHAT IS UP WITH THAT! at first the OTHER dr. said no, she is not my patient.....but the director of the approval committee for my insurance CALLED and asked him to see me? HUH........... according to both my dr. and the other dr. any insight into what might be happening is hugely appreciated. what could this mean? Signed, Tica (frazzled and freaking)    — Tica G. (posted on January 18, 2002)

January 18, 2002
Tica, I have not personally experienced that however many on this site has. Rather or not it is an insurance game or a unwritten portion of their policy remains to be seen. I have read about this happening several times to ppl here. It is rather frustrating and thats putting it mildly to have to go thru all this in order to LIVE. Valuable time is wasting while so many get caught up in red tape. Did you check others with your insurance in your state? Start there and email those ppl, surely someone will help. Trust me you are not going thru that agony alone.
   — TerryS

January 18, 2002
Do you attend local support group meetings? They may have some insight into this problem.
   — bob-haller

January 18, 2002
It's the way health insurers play the game these days...not just with wls...with everything. "Delay" "Delay" "Delay" They force you to jump through hoops to get approvals. You just have to stay calm and go through the process.
   — [Anonymous]

January 18, 2002
Hi Tica, I certainly think you have every right to ask and receive a prompt answer as to why the 2nd opinion is required. Just call them up and ask. They may be under some kind of threat to CTA...cover their *ss. Perhaps this is a new ruling for year 2002...you never know. At this point, you can just about be assured that you will get yet ANOTHER go-ahead from the 2nd opinion. I would be very surprised if you didn't. I know it is a pain in the neck to keep having to go to all these appointments. But this sounds like it would be the last one pre-op, so you may have to just grin and bear it, so to speak. But I would certainly ask first (nicely...plan what you're going to say first before you call and then take a deep breath). I'm sorry it's been such a long road for you. Read my profile and you'll see the interminable h*ll I've been going through myself. Hugs and good luck! Joy
   — [Deactivated Member]