Question:
I'm having trouble getting through the pre-ins approval phase, need some support.

I'm still in the process of trying to get the tests done in order to have everything submitted to the insurance company for approval for surgery and I'm getting a little down about this whole process. I've been at it for three months, I've done everything they've asked me to do, taken every test, answered every question, had every exam but still there always seems to be more that I have to do. I decided on Bariatric Treatment Center because I liked the idea that they specialize in WLS, their hospital is geared only towards obese people and they have their own department that deals with the insurance company. I don't really have space here to outline my journey so far but I describe it in my profile. I'm getting very frustrated because it seems like this is never-ending...and my papers haven't even been submitted to the insurance company yet...that will probably be a whole other battle. I've considered the thought of going someplace else for my surgery but I keep telling myself that I've come this far with BTC and I'd hate to start over again someplace else. Time is becoming critical to me because the company my husband works for was sold, the sale will happen after January 1, 2000, and we don't know whats going to happen with our insurance or his job for that matter. Also, I'm 34 and haven't been able to get pregnant because of my weight...I'll have to wait from 1-2 years after the surgery to even start trying to get pregnant (I have a little over 200 lbs to lose) and who knows how long its going to take after that. And every day that I have to wait for this surgery I'm just that much closer to dying early because of obestity-related health problems. It's not that I want to rush into this surgery...I've been thinking about it for a year and have been researching it for almost that long. The tool I need to have a normal life is right there in front of me but yet I can't seem to get to it. I guess I'm just looking for some support from all of you. Support, suggestions, anything you can give me. Thanks very much.    — Kellie L. (posted on November 17, 1999)

November 17, 1999
My goodness can I relate to this problem. I went through BTC as well and it seemed like they just kept having me jump through hoop after hoop after hoop. Not once did they seem sypathetic to the process. One test led to another test all while the clock was ticking. I spent 2000.00 in total during this phase and fought with BTC almost every step of the way. I finally did have the surgery. Feel free to email me and perhaps we can talk. I feel for you I have been there. David
   — David M.

November 17, 1999
You are right about the BTC not caring how long approval takes. I think they have so many patients that they can afford to "not care" about scheduling your date in a timely manner. I too had problems with getting approval, not because of the insurance company or my family doctor, but because of the unprofessional manner in which BTC handles these cases. First I had a sales rep. He referred me to the Insurance coordinator (both of these are in Michigan) then I was referred to the person who actually schedules the surgery in Ohio. My chart got lost in the shuffle between Michigan and Ohio and no one seemed to care, nor did they answer my messages left on their voice mail. Finally, I called the hospital program coordinator (BTC) at the actual site of the surgery and she got me scheduled and ready to go. What a hassle. They didn't ignore me when I paid the $85.00 for the initial consultation, but from there on it was my insistance that something be done that finally got me my surgery date. Hang in there. When you don't get the answers you want, ask for a supervisor or someone higher. My family doctor even called the surgeon directly to ascertain what the hold up was. Be persistent, after all it's your life we're talking about here. You Insurance Company should have a nurse reviewer who can bypass some of the red tape created by BTC. Good Luck!
   — [Anonymous]

November 17, 1999
My last reply didn't show up....just checking to see if this works. Will reply later if it does!!
   — Jan H.

November 17, 1999
Hi Kellie: Are you comfortable with your doctor? Is he/she the one for you? If not, perhaps you should think about finding asomeone else. You can always take your test results with you, you shouldn't have to do them over. Good luck! Waiting is so hard! Jaye Carl, open proximal RNY 7-29-99, 74 pounds gone forever!
   — Jaye C.

November 17, 1999
Hi Kellie, I'm gonna try this again, the one I sent earlier didn't show up and I had to go to work....Wow, my heart goes out to you. It's hard enough waiting but not knowing e what your insurance is going to be in a couple of months, I can't imagine how you are feeling! I had a stumbling block but it was with the first Dr. that did my psych-eval. He said I was depressed and needed psycho-therapy for a while before I had the surgery...Dah! Try NOT being depressed when one is 200 lbs overweight, like I was too. The kicker was my insurance approved me but BTC wouldn't clear me for surgery until I was ok'd on the psych-eval. Dr. Schlesinger called me and explained this all to me and said I could go for psycho-therapy or see a Dr. Terrance Lichtenwald in Rockford IL. He was familiar with there program, (one awesome Dr) and he approved me with flying colors. I see you have BCBS, so do I and they paid for the first and second evaluation. I called my insurance company and they said I was entitled to a second opinion. The second one was allot more than the first one and they paid every cent. The hospital was a ppo and so was the surgeon so it was all covered 100%. I have to say I was really shocked to hear of the trouble you are having with BTC because I have had just nothing but wonderful and compassionate people. I know they are really careful to check out every aspect, as they don't want you to have any complications. I remember how very angry I was when I hadn't passed my psych exam. It sure made me feel awful. But now I can look back and know it was all worth the wait. If you need to talk, just e-mail me. I'll be thinking of you and wishing you all the best....Jan
   — Jan H.

November 18, 1999
I feel for you. I guess I am impatient. I would not have left this place in the dust. I started my quest with a seminar on 10/09 and sent my paperwork to my doctor on 10/11. The insurance company received the paperwork on 11/11 and the results will be ready 11/29. My surgery is 12/15. Sometimes these big outfits are more concerned about bottom line than the patient. It seems individual doctors tend to be more personable. Why not investigate a good individual surgeon and try to get on with this? You've been through enough, don't you think? God bless your heart, enough is enough. I'll keep you in my prayers.
   — Jen L.