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Dear Insurance Co...You Stink! 4/7/10

I logged in to check on the status of my claims & authorizations today.   24 hours after the request for surgery popped up on the screen, it now says "not approved" and "does not meet requirements".   I'd like to know exactly what requirements I don't meet. According to my surgeon, pcm, and my own knowledge of my body, I surely do meet requirements.   My friend who has the same insurance and went to the same surgeon for a band in February, was 1/4" taller than me and 3lbs heavier with the same BMI & same co-morbidities and she had approval in less than a week.   I must just be "special". I get that a lot.   I bet my "Spidey Sense" about rocking the boat with the request going in earlier than the surgeon usually sends it must have been right. One time I would've liked to have been wrong!   I wish the woman I spoke with at the surgeon's office would not have sent it over when she did. I didn't ask her to - she said she'd do it. I thought I was completely approved & I called because I wanted to try & schedule some of the excessive pre-op appointments.   I reeeeallly don't get it - the insurance company approved the consultation, the endoscopy I have coming up in a couple of weeks, and multiple follow-up visits (when I first saw that those things were approved, I mistakenly thought that the extra visits included surgery & follow-up to that too).   Why would they say that I do meet requirements for those things & agree to pay for 'em, then say "oh no, you can't go any further". Puh-lease. They know darn good & well that the ultimate goal of a consult, etc w/ a bariatric surgeon is...surgery!   Sooo, that whole emotional yo-yo thing I mentioned recently...yoooooo down we go.   Great. Got tons of super news today. Yep, my DH is trying to have some R&R before the upcoming deployment (along with about half the members of the crew), but people from his work still manage to call him about whatever crisis is going on. The latest one will most likely have them deploying a few days/a week early. Dandy.   (My DH is one of the senior officers in his command, that's why he gets pestered, at home, when he's supposed to have a day off, if we go out of town, etc.)   I finally tracked down a Psychiatrist to do my consult with. I spoke with him for a few minutes this morning. Of course, he can't fit me in while my DH has time off & can watch our child. Even though I planned on paying out of pocket, he wants me to call the insurance company to see if they'll pick up the tab.   I really don't want to, especially in light of what happened today. I'm one of those honest types who just can't fib to him & say that I did it when I didn't. For all I know, if I said I just didn't want to call 'em, that might somehow reflect negatively on me. :wub:   On a side note, I gave him the list of the *five* things Dr. Oh requires from a psych consult and he said he was going to call & talk with them about it, because he thought it was "a bit excessive"! A-ha! So do I. So. Do. I.   I feel like I've got a soup sandwich on my hands here. Two steps forward, three steps back. Terribly afraid that the meager amount of progress I've made in this whole process is going to slip away.   The scale has finally started to move in the right direction towards that 10% weight loss that the surgeon requires. What happens now? If I continue trying to lose for Dr. Oh, then everything really does go down the tubes and I have to start over (who the heck knows how or with what doctor), I might actually have to gain to get back up to where I need to be.   Good grief. This is messing with my head so much. Why can't it be somewhat straightforward. Give me a plan or a list & I'm all over it. String me along & keep secrets from me & I'm more apt to fail and walk away PEEVED! :scared2:   P.S. Big mean insurance company, I despise you right now.   love, me
desperate4aband

desperate4aband

1
 

A New Beginning 4/19/10

I spent the better part of the weekend crying about the turn of events in my WLS saga. I talked to my DH about it (more than he wanted to hear I'm sure! ) He said that we could take a loan through one of his retirement savings accounts so I can still follow my dream :wub: I've always known that I'm a lucky girl to have trapped a good man like him! :tt2: I love him more & more every day. He knows the score with obesity. His dad has type 2. His mom had bypass surgery about 5 years ago. He saw her struggle for so many years, being beaten down by military doctors & the insurance company every step of the way. We've struggled together with our weight over the years. We're like that cartoon couple you see in the Slimquick commercials. :frown: I told him that I feel like being able to have WLS would be like a new beginning for our whole family (all 3 of us!) Y'know how the mom/wife is kind of like the glue of a family, well I know that if I could finally get my weight under control it would have a huge, positive impact on all of us. I could finally set a good example for my child - so that he can grow up with a healthier relationship with food than my DH and I did. We'll be able to "go" and "do" together. I know for sure that I've held them back from doing things recently. It wasn't with malice - I just don't want to go out walking in our neighborhood and risk more people seeing me & how huge I am. (Not to mention that I might make it one whole house away before I start huffing & puffing.) I've had people yell disparaging remarks at me when I was outdoors on more than one occasion. I know that I'm not the first & unfortunately won't be the last, but I didn't deserve it (nobody does) and I don't want to deal with it again. Today I had the pleasure of calling up Pacific Surgical to schedule a consultation. Yay! I spoke with Michelle. I remember her from the seminar I attended a while back. So much of what she said about her experience still rings in my ears. She was so nice! The way she treated me was the polar opposite of the way Karen did. Amazing how when you're a self-pay patient things can happen sooo quickly! I was able to get a consult scheduled for next Monday! Michelle said that it would be possible to have surgery as soon as May 11th! I think we're still going to shoot for a surgery date towards the end of July. My DH said that since we just paid off the last loan through his retirement plan, we need to wait 2 months to apply for another. He'll be back from his partial-deployment in time to help me with a summer surgery. I'll find out the nitty gritty when I go for my consult, but I believe that all I have to do for Dr. Neal is a nutrition consult, and I assume pre-op bloodwork. I'd imagine there's some sort of pre-op diet. Pre-op as in a week or two before surgery - not Dr. Oh's type of pre-op diet. Oy vey! He wanted a 10% weight loss in the months leading up to your procedure & two weeks of clear liquids prior to surgery. Not to mention that Dr. Oh had a huge list of other pre-op things that had to be done. Speaking of that, I need to call and cancel my endoscopy & follow-up. I really hate that we'll have to pay $ every month for the next few years, but... I have a feeling the return-on-investment will be priceless! :ohmy: I'm actually kind of relieved now. If I can have surgery w/ Dr. Neal, I don't have to make that arduous trip over to Federal Way, cow-tow to Dr. Oh & his excessive pre-op testing, and worry about coordinating all the babysitting I'll need to cover those appointments. When I tried to picture myself going through surgery & whatnot w/ Dr. Oh I couldn't quite "see" it; it didn't feel like that was the place I needed to be. I haven't had my consult w/ Dr. Neal yet (just the seminar), but already I feel that this is where I need to be. I'm feeling much better 'bout everything now!
desperate4aband

desperate4aband

1
 

Insurance Request for Surgery...Huh? 4/6/10

So I logged in to see what's going on with my insurance claims & referrals today.   I saw that there were four separate requests for surgeries rather than just one. So, do they have to spell out what they're asking for & cast a wide net by specifically requesting "bypass, v-band, rny, & LAP-BAND®"? Is that the way they do it?   I really hope that's how it's s'posta go & one of 'em "sticks", although I really do not want one of the procedures that actually rearrange your guts - I just want my guts to be "belted" :scared2:   As of a few minutes ago the status of all of 'em was "pending review". Crossing my fingers (and toes) that I'll get the thumbs-up...quickly!   I hate the ups & downs of waiting, being hopeful, disappointed, frustrated, excited, etc. Guess I swapped out yo-yo dieting for yo-yo emotions   Gotta *try* to stay positive & keep telling myself my new, healthy life *will* begin, and soon!
desperate4aband

desperate4aband

1
 

Grrrr! 4/5/10

So, since my husband has a few days off before leaving on his partial deployment I wanted to try & squeeze in some of the appointments on Dr. Oh's list.   Not so fast.   I called the office today & spoke with Karen. (I think that was her name.) She told me that I was only partially approved by the insurance. Super. I thought I was good to go for the whole dealy-o.   I take it that they only requested approval for the first few things - consultation, endoscopy & follow-up, and a couple extra office visits.   None of the other things can be scheduled until I have insurance approval for the actual surgery.   I think Karen might have thought I was wanting to schedule the surgery pdq. Well, I do, but... :thumbup: She asked when I expected to have surgery & I said I was hoping for mid/end of July. She said "ok, we're scheduled out that far" (like she was looking at a calendar & thinking out loud).   She said she'd fax the request over to my insurance company today. I kinda got the feeling that I was bothering Karen. I hate being a problem child. I strive to be as low-maintenance as possible, really I do!   Great. If that's not the normal evolution of things I don't want to rock the boat & risk getting kicked out of this exclusive club.   Since I'm already approved for the first few things, they'll most likely approve the surgery too, right? This is all messing with my head!   I really wish there was another surgeon on this side of the state who would accept my insurance.   Pac Surgical is a heck of a lot closer to me & I recall from the seminar I attended a while back, they don't have nearly as many pre-op requirements. Unfortunately they don't want to deal w/ my insurance. Not many do...   I'm so frustrated. If my husband's boss wouldn't have waited until two days before the start of the leave period to approve the plans, I might have actually been able to get the ball rolling much earlier & schedule stuff while my husband is available to take care of our son.   I'm thankful that I have a friend who said she'd help me by watching my son, but I'm one of a dying breed who doesn't like to impose on other people by dumping my child on them... I'd rather that my husband try to take care of these sorts of things ourselves.   I do appreciate her offer of help, and I will need it now that things aren't going as smoothly as I'd hoped.   I feel like I could cry from frustration. :tt1: Definitely can't revert to my habit of eating out of frustration, because one of the many pre-op requirements is losing 10% of my body weight. I've been told that Dr. Oh YELLS at patients who aren't losing appropriately.   As a side note, if anyone from Dr. Oh's office is listening (I know, not likely)... It would be extremely helpful for patients (probably staff too) if a timeline or list of appointments, events, and expectations was handed out at the consultation.   A lot of my questions would've been answered by something like that, and I wouldn't have bothered the staff with my phone calls.   Once I have a handle on things, I think I'll post one here on my blog so it might be of help to someone else.
desperate4aband

desperate4aband

1
 

I *puffy heart* Dr. Neal! 4/26/10

I had a consultation with Dr. Neal at Pacific Surgical today. Yay! He has a skeleton crew at the Bremerton office, so the lady with all the nitty gritty details will call me tomorrow to go over everything.   He answered all of my questions & looked over my new patient form as we talked. He was super nice!   After my brief experience with the way Dr. Oh does things, I was relieved to hear the amount of pre-op work that Dr. Neal wants.   He told me that most patients do a full liquid diet for the two weeks prior to surgery to shrink their liver.   After he examined my abs he said that I didn't need to do the liquid diet! Since my upper abs aren't as fatty & flabby as the lower ones, I can skip it. Yay!   Other than that, I'll need to see a nutritionist (I saw the names/locations on their site) and the typical bloodwork that everyone does right before any surgery.   The whole appointment was smooth & quick. The office is small, but clean and modern/new. I was there for maybe 40 minutes total (I arrived a little early). There was one patient with the doctor when I got there & two others came in for fills, but that was it. I like it when it's not crowded!   The receptionist took the forms I printed off their site & filled out. She also weighed me before the doctor saw me. Once I saw him we chatted for a few minutes then he had me go to another room where I could lay back on an exam table so he could check my abs. He also had me take deep breaths & listened w/ his scope.   We went back to the room we started in to wrap things up. He had the receptionist call the Olympia office to see what time Michelle would be able to call me tomorrow to go over the details.   That was it. Ahhhh. Yep, this feels right. I feel much more sure of my decision than I did when I visited Dr. Oh's office.   If I had to come up with a "con" or negative thing for today's visit, it would be that the available parking stunk. Next time I won't even pull into the driveway, I'll just park on the street.   If that's the worst part of the experience, sign me up! :biggrin:
desperate4aband

desperate4aband

1
 

Yep, my insurance co. still stinks! 4/8/10

In today's mail I got two letters from the insurance company. One was the written denial of surgery...the other was the approval of one pre-op test & a few office visits.   Cute.   The approvals were done about a week ago, but the denial was entered um, yesterday. Yep, 24 hours later I'm actually holding the mailed letter in my hot little hands.   So they drag their feet on mailing approvals, but are all over it *thisfast* when there's a denial. Super!   I really hope it's going to be straightened out quickly & as smoothly as can be. I don't know if I need to call the doctor's office or insurance company. If so, what do I say? I don't know if someone will call me...or if it won't be addressed until my next visit & I get reamed by the dr when I go for my endoscopy.   I can totally see it happening, given what I've read and been told about my surgeon's bedside manner. I'll probably get blamed for telling "Karen" to fax the surgical request over. Yeah. Like I can *make* someone do that. I never asked anyone to do it.   It was a matter of:   Me: "Hi! I'd like to try & schedule some of the pre-op appointments if I could."   Karen: "Are you approved?"   Me: "Yep. I mean, I think so."   She asked for my last name & pulled my file.   Karen: (Indignant) "NO! You are NOT approved. You are only approved for the consult, endoscopy, and office visits. None of the other things can be scheduled until you have insurance approval for surgery."   Me: "Oh. Does that include the nutrition class too?"   Karen: (Still indignant) "YES!"   I mentioned my sob story about my DH being on pre-deployment vacation & I was hoping to squeeze in any of the pre-op appts if possible while he was available to watch our child.   Karen: (High & mighty) "And when were you expecting to have surgery?"   Me: "I was hoping to be able to do it mid to end of July, if possible."   Karen: (As though she was thinking out loud) "Ok. We're scheduled out that far. Let me fax the request over to them." (Irritated sigh)   Me: "Oh, ok. Thank you."   We hung up.   Grrr! So much about this whole process is bothering me...a lot. (As you can probably tell if you've been reading my blog. :thumbup:)   I know it bothers me deeply because I want this surgery soooo badly & there seems to be very little I can do to move the process along. Heck, there seems to be very little I can do to even get straight answers.   Hard to stay positive.   I'm prepared to fight. I've had to fight this insurance company before on prescriptions. I did win that battle.   Just wish I didn't have to fight. Why can't it be a remotely smooth process?
desperate4aband

desperate4aband

1
 

Mayjah Aggravation! 4/16/10

I missed a call from Karen on 4/14. She called right before 5pm. She said she'd be in the office until noon the next day & to call so she could go over the insurance info w/ me.   Almost made me question whether I was hearing from the same lady I spoke with before...this one was kind of nice. ??   I missed her by a few minutes the next day so I left a message.   Didn't hear back from her so I called today and finally spoke with her.   Ugh.   The way she was talking at first was like this was the end of the road & I should just give up since I don't have the co-moribidities on the list of 5 or so that my insurance acknowledges.   I mentioned that they approved the endoscopy & whatnot and asked if I should go ahead with it. She tried to discourage me. Grrr!   I was about to cry... I told her that I *really* want this & my options are very limited as far as finances/physicians, so if there's any chance to make this work, I want to try.   Kind of sounds like they don't want to make any extra effort for me - or at least Karen doesn't.   I mentioned to her that a dear friend of mine had surgery with Dr. Oh in February.   My friend has the same insurance, is about 1/4" taller than me, started out within a couple of pounds of where I did, and didn't have any of the co-morbidities on the insurance's approved list. She has lots of "little" ones, as do I. They're legit co-morbidities! They're on the lists of every other bariatric surgeon I've looked up. (We both started out at the same BMI even though our insurance doesn't go by BMI...) We're both SAHM's with only children. Heck, the major difference between us is our hair color!   My friend was told that if a patient has enough "little" co-morbidities then surgeries tend to get approved through our insurance company just the same. It worked in her case.   Karen just said "I don't know... all of the requests and claims are handled the same way... Maybe your friend had diabetes." I told her that I knew for sure she did not have diabetes.   I made an appt to go back to my primary next Thursday morning. I don't know if she'll be able to tell me anything about my bloodwork that will help me for surgery.   I was prepared to fight the insurance company, but how can I and what difference is it going to make if the surgeon's office isn't going to help?
desperate4aband

desperate4aband

1
 

Monster Update ...for anyone who is interested :)

Didn't realize how long it's been since I've been on here.   Well, towards the beginning of June I received my loan money & paid the individual fees to Harrison Hospital, Olympic Anesthesia, and Pacific Surgical. Also sent all the consent forms, etc.   Heard from Michelle after she got the paperwork & she set me up for 7/27.   Got a call from the anesthesia folks for a pre-op appointment. Set it up for 7/21.   My husband started work at his new command in June. I think he was a little skeered to tell me that his new boss said "no" to the 27th. Thanks.   (All of this was originally mapped out/planned with the notion that my husband would be getting home from deployment mid-July & have some vacay before starting at his new command in August. Love how the military seeps into and infects every aspect of a family's life. .....And people have the nerve to say I have nothing to do with the military - only my husband does.)   Aaaaanyway...   So we decided he'd talk to his boss the next day & I'd call Michelle. Dr. Neal only does surgery in Silverdale on the 2nd & 4th Tuesdays of the month. So I was looking at pushing it to August. Just ducky.   The next morning Michelle called me before I had a chance to ring her. She had great news! They had a special going on - if I were to move my surgery from Silverdale to the South Sound Surgical Center in Olympia & schedule during July...I'd get $3K back! Woo-hoo!   Had to wait a couple of days to hear back from my husband's boss before I could call Pac Surgical back. One of the dates Michelle mentioned was the 30th & the boss said that was ok. Whew!   Michelle was on vacation when I called back. Peggy was filling in for her. She was super nice! She helped me get everything squared away & said she'd mail me a final checklist & info on what amounts need to be paid to which people in Olympia.   Wish I'd double checked about refunds & what needed to be done for the Silverdale cancelation. Still haven't received refunds from Harrison Hospital or Olympia Anesthesia yet. Plus my Silverdale anesthesia pre-op appt wasn't canceled (I got a reminder call the day before & the lady asked if I was sure it was canceled...)   Got the checklist & payment instructions in the mail a few days later. Also had a prescription so I could get it filled ahead of time.   Called the new anesthesia peeps & paid with a CC over the phone. Pac Surgical was going to take my refund & forward it to the Surgical Center. I had a small balance left w/ them so I mailed that off the next day.   My son & I were actually going out of town for a few days to see my family, grandparents, aunts, etc. My husband couldn't go because of...the military. The location was 5 1/2 hours away, but because it was out of state he'd have to get special permission. This command is so much more restrictive on travel rules than any other we've been to.   So, I filled my mom in on everything. I bounced the idea off her of whether I should call about a different prescription. She thought I should.   The one I received was for Lortab & Zofran. Well, Zofran does absolutely nothin' for me. I've never taken Lortab, but after I looked it up I saw that it's part of the hydrocodone family, just like Vicodin. I can't take Vicodin.   I listed that on my new patient paperwork & took it to my consultation back in April. I remember Dr. Neal commenting on it - right after I listed the "no-no's" I wrote "I prefer to use Percocet & Phenergan in their places".   Always nervous that I'll come across sounding like a drug-seeker, but it's not that at all. I've had 6 other surgeries, been pregnant w/ nausea that put me in the hospital, have had gallbladder issues with nausea that put me in the hospital, and have thrown my back out umpteen times, etc. so I know what works & what doesn't.   I still remember Dr. Neal saying "ok we can do that!" in the consultation - about the substitutions.   So, I got brave & called Michelle to ask about a different prescription. She said that she'd run it by the dr in the morning since he had already left for the day.   The next day though... I got a call from Heather on my cell phone. She said that the dr would just give me a new prescription the day of surgery. "Ok, sounds good! Thank you!"   This got me all suspicious-like See, I hadn't heard from Heather before, and the ladies I had heard from always called my home number. Got me wondering if they thought I was a drug-seeker so they had a different person call, and call to my cell phone maybe hoping to just leave a message in case I was going to be argumentative. Oy.   The straight-A/goodie two-shoes girl inside me didn't want people thinking that I was a druggie or something gross like that :eek: So I decided to send the original prescription back. I had no need for it.   Honestly though, I didn't know (still don't) if it's ok to just shred an un-needed prescription or if it needed to be accounted for since part of what it's written for is a narcotic.   Then today (7/28) I got a call from Karen. She sounded kind of stressed (maybe a little frantic too??) She said she needed the last page of my consent form. I said that I mailed everything in last month with my payment. (Said that like 2 or 3 times *cough, cough*) She said that Dr. Neal had the surgical files & the stuff may very well be in there, but she needed the last page for her stuff, for my protection, can't do surgery without it, etc.   Had to rush out of the house & go to town so I could fax it over. I offered to e-mail scanned copies of the documents. (I always keep copies of everything.) She really wanted it faxed.   Made it to Staples & faxed it just before 4:30. I can't remember if Pac Surgical's office hours are until 4:30 or 5pm; either way I made it in time.   Oy!   So, right now I've really got to (get off the computer!) hurry up & do all of my last-minute cleaning, organize all of my 1st week post-op food so my husband will be able to find everything easily, and do about a zillion other things.   This last week my sheer delight has started to turn to delight/worry. Even though I've had 6 surgeries before (4 of 'em were laps), I'm a little nervous about going through it again. Also nervous about being able to do everything right.   Plus there's a little anxiety because I know that the following weekend we'll most-likely have to see my in-laws for their anniversary. Get-togethers with them always revolve around food, and these are the primary people I'm NOT telling about my surgery. I'm going to be hitting the ground running, eh?   The weekend after that is my son's birthday. Usually my family comes from out of state to our house & my husband's family comes from their place about an hour away. I don't think I can handle that.   My husband of course doesn't think it will be that tough. Riiiight... All the regular pre-company cleaning/organizing, plus birthday stuff, while being still early out from surgery, and having to hide all that from half of the guests. No thanks!   I hope we can break it into two celebrations. Might need to anyway, because my mom might have to work that weekend. We'd need to go to their house if we want to see them then. My husband's family won't do anything if it's remotely inconvenient or anything that doesn't directly benefit them personally... I would think time spent at a grandchild's b-day party would benefit a grandparent, but...   So, I s'pose I should wrap this up and get my rear in gear. So much stuff to do before Friday morning!
desperate4aband

desperate4aband

0
 

Visit to My PCM 3/18/10

I thought I could skip a visit to my Primary & charge straight ahead to my LAP-BAND consultation.   At the last minute, I panicked. I called to squeeze in an appointment with my Primary & had to move my LAP-BAND consultation for the week after that.   I want things in this process to go as smoothly as possible & I knew that Dr. Hirai's office requires a thumbs up from your Primary.   I've got "issues" with visiting the doctor so I try to put it off unless necessary...   Despite the fact that I was lucky to find a civilian who takes my insurance, too much abuse from military doctors over the years has turned me into a seriously nervous Nellie whenever there's an appointment on the calendar!   Plus, I knew I'd need to see someone new at the clinic I'd been going to as the Primary I'd been seeing quit working there. Add another thing to the "nerve-wracking column"!   Anyway, I had been experiencing widespread joint & muscle pain for quite some time so I made an appointment for that and to talk about WLS.   Thank Heaven that my new Primary is a lovely woman who acutally listened to me AND believed me!?! Go figure! It's been years since I've had that!   She suspects that I may have fibromyalgia so she sent me for bloodwork to rule out other schtuff. She was very supportive when I brought up WLS.   Whew!
desperate4aband

desperate4aband

1
 

Ugh. Her Again?! 4/26/10

Last Wednesday (the 21st) I called St. Francis & spoke with Karen. I asked her to cancel my endoscopy that was scheduled for 4/28 and the follow-up a week later.   She said she'd do that.   I didn't get a warm fuzzy feeling that it would be taken care of though. That feeling kept nagging at me so by the time Sunday rolled around I decided to call & leave a message to confirm the cancellations.   I said "I'm calling to confirm that two of my appointments have been canceled. My name is... My phone number is... I spoke with Karen on April 21st about canceling my endoscopy on 4/28 and the follow-up on 5/5. I haven't had the best results when speaking with her so I wanted to double check to make sure the cancellation was made."   I'm passive-aggressive like that :w00t:   Bright & early at 9:30 this mornin' Karen called to say that she did cancel my appointments.   Hmmm...   So, as I was on my way to a consultation with my new surgeon today, I got a call. I normally don't talk while driving, but considering the phone prefix I thought it was probably something about one of my many appointments.   Sho'nuff. It was a lady from St. Francis Patient Registration who wanted to get me squared away for an endoscopy appt on Wednesday. Huh? I told her that I'd spoken with Karen at the weight loss center & she was supposed to have canceled the appts. The lady was nice, but I sure felt like a dummy. Thanks Karen!   I turned off my phone when I was at my consultation.   I checked my phone when I got home...someone from Patient Registration called & left a message while it was off! That was about two hours after the first call.   I had barely come inside the house & taken off my shoes when I got ANOTHER call from Patient Registration! I told this lady the same thing as I said before - that I spoke with Karen *twice* about canceling my appointments. She was really nice about it. She apologized & said she'd note it in the file so they don't keep calling.   Oy vey! :biggrin:
desperate4aband

desperate4aband

1
 

Insurance Approval?! 4/1/10

I think I might be approved! I sure hope it's not an April Fool's Day joke   I've been checking on triwest.com to keep tabs on my claims & pre-approvals. The claim for my consultation showed up on 3/29 and as of today, still says "in-process".   Today listings for "office consultation", "esophagus endoscopy", and "office/outpatient visit x3" popped up in the authorization & referral status area of the site. All three things were marked "approved".   Could it be true? Man, I hope so!
desperate4aband

desperate4aband

1
 

Getting the Ball Rolling! 3/3/10

I attended a seminar with Dr. Hirai on March 3, 2010.   Pretty much the same info that I received at the seminar I attended with Dr. Neal at Pacific Surgical back in 2006. Insurance wouldn't cover a band back then, Pac Surgical doesn't accept my insurance, and I couldn't pay out of pocket at the time, so I couldn't go any further...   At the end of the seminar I ran up to the front to put my name on the list for a consultation appointment!   I hope everything will go smoothly & things will fall into place with the timeline I'm up against.   It will be tricky, being a homeschooling mom with a DH who is about to leave for a partial deployment. Ugh.
desperate4aband

desperate4aband

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Consultation 3/24/10

Today I had my much anticipated Lap Band consultation at Dr. Oh/Dr. Hirai's office in Federal Way. Oy vey! I forgot to double check to see where I actually needed to go! There were several phone numbers and addresses listed on the paperwork from the seminar. I tried to call before I left the house, but it was during the lunch hour - they don't answer the phone between 12pm & 1pm... I decided I'd go to the address for a clinic that's a few blocks from the main hospital. I thought I'd be early enough that I could run to the correct place if need be. I live around an hour's drive away from their office. I was really nervous so I ended up getting there nearly 30 minutes early. The parking was very limited. Walking through the older office building is almost like a maze. I'm sure I'll be able to find it all in my sleep by the time this is all done, but it was a little confusing for a first-timer. Once I made it to the right office, I found that the receptionist was super nice! She handed me about 10-12 pages of paperwork to fill out. I was done with them long before my appointment time. Since it was in the afternoon, they were running behind schedule. I was called back to be weighed, etc. a little after 3pm (my appt was for 2:40pm). Apparently I'm 5' 5 3/4" tall. Huh? I've been going around for years thinking that I'm 5' 8". Oh well, it works in my favor for WLS! I waited in the exam room for around an hour. It was so quiet out in the hall that I almost started to think that everyone went home for the day. :eek: It was after 4pm when Dr. Oh came to see me. A friend of mine who has gone through the process with them, told me that Dr’s Oh and Hirai often switch & cover for each other. Honestly, I was a little scared when he walked through the door. I made my appt to see Dr. Hirai. I guess they really do switch/swap/cover each other’s appointments! I’d heard some less-than-glowing reviews of Dr. Oh’s bedside manner, so I was quite nervous. I’m happy to say that my experience with him thus far was positive! He was very nice. He had me sit in the chair next to his desk and asked me questions from a form, rapid fire. “Do you hurt here? Do you have this? Does your family have that? What surgeries have you had? What medications do you take?” and so on. He pulled out the ol’ stethoscope and listened to me breathe. He checked my belly button. He said he wanted me to stop at the front desk on the way out & schedule an upper GI endoscopy and follow-up. I asked him about pre-op weight loss – my friend told me Dr. Oh requires a 10% loss. He confirmed that & said he’d send everything to my insurance for approval, and we were out the door. Since I homeschool and my DH is in the military, I needed to bring my son with me. I was nervous about that – afraid they’d kick me out the door when I tried to check in. Luckily it didn’t happen. I’ve had chats with my DS about the lap band, all the appointments I’d need, etc. in age-appropriate terms. He has done really well sitting still and being quiet. Part of it might be the heavy bribery I did, :w00t: but either way I’m so thankful that he’s been a perfect gentleman and that the people at the doctor’s office have been ok with him being there! However, I’m not thrilled about the endoscopy appointment. The earliest I could get in is five weeks from my consultation. I also am required to have a driver. Huh? Nothing like making it simple for a homeschooling mom with a DH in the military and no family in the state. Sheesh! I hope I can find someone to go with me.
desperate4aband

desperate4aband

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