pinksjo1

YEAH!!! Congrats! You are on your way...

I just got off the phone with Des Peres MyNewSelf and they haven't submitted my paperwork yet (they had everything on June 26). I switched over to Des Peres because of the lack of customer service I was receiving from St. Alexius. Now, I am getting the same run around. Little history - I stuck it out with St. Alexius until I got my approval from BCBSIL, which I did on June 14. Then I switched over to Des Peres because I was concerned about the aftercare. At first, they could not have been more customer service oriented. I had at least 3 people call me. But since I had my appointment with Dr. Scott (June 26), no one has called to tell me what's what. Although my insurance said they do not have to resubmit, they are saying they do. Which is fine, but DO IT! I hope they get their act together soon, this is soo not cool waiting... Also, Des Peres and St. Alexius are the only 2 hospitals that my insurance will cover, so I have to wait it out.

I went to my nephew's Norwex party on Friday. I was talking about my surgery to my sister and some of the guests were coming in. One lady heard me and asked me about the surgery...she turned to her friend and said "This is a sign" as she and her friend were discussing she may want to have the surgery...she was extremely supportive and asked if I could let her know step-by-step my journey. So, you just never know who's out there that may need your help!

I did the paperwork, submitted, got approved and then switched doctors/hospitals. According to my insurance as long as the new hospital uses the same code, nothing else is required. So I think there is a disconnect because the new hospital seems to think its a complete do-over. I have sent them an email I received from insurance saying its not necessary - just waiting to hear back. The waiting is the most difficult for me.

How long should you wait to take a hot shower?

Welcome!

Good Morning Joan, I received your medical records request and will be glad to send the records today. Would be it be okay with you if I send the records via email to Michelle Pearce at the My New Self office? Since our records are electronic we try to send via email to ensure everything makes it to its destination. I confirmed with them this morning they would accept via email and received Michelle’s email address but I noted on your release form you specifically asked for them to be faxed. Please, let me know if that is okay with you. Otherwise I will fax them. Thank you, April Ricca St. Alexius Specialty Services NEWSTART NEWSTEPS NEWREFLECTIONS

All - just need to vent regarding my experience with St. Alexius NewStart in St. Louis MO. I won't go on and on about how they provided me absolutely no customer service. I also won't go on and on about how I basically had to call the different hospitals myself to gain my records or how I had to get my PCP to do the medically necessary letter. I also won't go on about how they never answer my phone calls, or gave me any status reports. I also won't go on about how their NUT was out for 3 weeks and I wasn't told. No, I won't go on about that...but I will tell you this story: I decided as soon as I am approved I am going to another hospital. I figured with the lack of care I received before surgery...who knows what I would get after surgery when I really need the support. So, for peace of mind, I decided I had to make the move. So, I called the insurance and they said "no problem" as I am going to Des Peres which is covered by BCBSIL. Des Peres called me right away, sent me the release form to have St. Alexius release my records to them, set up my appointment with my new surgeon, Dr. Scott. and I felt very good. Until today... St. Alexius called me and basically refuses to release my records. Oh, they will send Des Peres the records on the notes from the NUT and the surgeon's notes, but they REFUSE to send all the other documents in my file as they said its agains HIPPA. To quote Rachelle "third party records". Of course I just got off the phone and called the insurance company. It took about 45 minutes but that agent, William, must love a challenge because he did a lot of research and found that I have EVERY right to request my records and St. Alexius cannot refuse to send them along. He said that if St. Alexius stonewalls the process, I am to contact the Missouri State Medical Board and the US Department of Health and Human Services. He also said to make sure St. Alexius knows that I am going to do this if they give me trouble. So I sent a quick email to Rachelle at St. Alexius and we'll see what happens... I'll update once I have some information. Thanks for letting me vent!!

Thanks everyone! I would say the lesson I learned was to get a copy of EVERYTHING that goes in your file. I had no clue I was going to switch hospitals and it be such a pain, but I will get everything together and resubmit. Luckily, I have most of the necessary items that the insurance company needs, so I should be able to resubmit soon.

Mizzou Girl - I am also having Dr. Scott as my surgeon at Des Peres My New Self. Let me know what you think of him. I have my appointment for June 26.

Called the original hospital today to let them know that I was going to the other hospital. Called the new hospital to let them know (they requested all my records be sent to them). Called the insurance company, they approved the switch (just wanted the new hospital to use the same approval code - to make things easier). So not difficult to do, just a few phone calls. So if you are having second thoughts about your current hospital, you can change.

I am having second thoughts about going to the hospital I have chosen. I have everything done, am approved. Its that the customer service I have received through this process is lacking to say the least. My insurance only supports two hospitals in my area (St. Alexius - who I have now, and Des Peres). So I was wondering if anyone else has ever switched in the 12th hour. I left a message for St. Alexius telling them I am uneasy with them as the customer service was so poor, and I am very afraid it may stay the same of even get worse - and after surgery I would need their support more than ever. I also sent a message to Des Peres asking if this was a possible switch. Anyone else experience this? Thanks! Joan

Excellent - I will give my insurance a call. Thanks for the feedback!

Good luck!

My paperwork has been at BCBSIL for 6 business days today. I sent them an email yesterday, but haven't heard back from them yet. I like using the email as it is given a tracking number so it has to be addressed. I didn't want to call just in case one of my co-workers heard me (I am keeping this to myself). I'll let you know what I hear back, wish me luck!!

I just got off the phone - I AM APPROVED!!! They are sending the letter out today!!! I am on my way!

I just got off the phone - I AM APPROVED!!! They are sending the letter out today!!! I am on my way!

I actually had someone ask me what I was going to do with "all that extra skin". Without hesitation I said "donate it to burn victims".

Same here, I can use up to 12 weeks FMLA. The first week I have to put down as PTO, but I get it back when I return to work.

Fingers crossed!! I am on the same time period as you as my documents were submitted to insurance today also. The PA said to call on June 17 if I haven't heard back. She said the insurance companies have been responding fairly quickly lately...so let's hope that is correct!

UPDATE!!! From St. Alexius this morning: "I just spoke to Starr, the insurance specialist, and she stated that she has everything that we need and that she is submitting your predetermination letter right now. By law insurance companies have 30 business days, not counting weekends and holidays, to respond to the letter. However we are optimistic that we will get a response within the next two weeks (insurance companies have been very quick with their responses the last few months). I would contact Starr after 7 days (so by Monday, June 17) if you do not hear from us or your insurance company."

I thought I could wait this out, but I am getting too many mixed messages from St. Alexius NewStart. First I was told that RK was my patient advocate so I was corresponding with her. Then I was told that JP is my patient advocate and I should be talking with her. I was called last week 5/28 that my file was being reviewed and should be sent to the insurance that afternoon. A nurse (don't remember the name) called me, not my PA. The nurse said don't call the insurance company for at least 30 days (yeah, whatever). Then yesterday a Sara calls me saying she is my NUT and that I may need to do a 6 month diet before submitting...WTF? I know that my insurance does not require this, but she didn't...doesn't anyone take the time to look through the file? That should be noted somewhere, wouldn't you think? I did contact the insurance company and they said NOTHING has been submitted in my case. I kinda figured that yesterday when the NUT called as I did know that was a pending item, but thought well maybe they will submit and see if the insurance catches it...who knows. The closer this gets the more nervous I am becoming and I don't like it!! I left a message for the PA and am waiting to hear back. So, how is your day going???

You go girl!

Congrats and good luck! I hope to hear something soon, submitted 1 week ago!

Hi Everyone! I have been lurking for a few weeks as I found this site right at the time I started my journey to have WLS. I have learned so so much! Currently, I have 2 outstanding items before submitting to BCBSIL. My PCP's letter and my visit with the NUT. I have everything else. I just got about the best news today, my firm will pay for Short Term Disability 12 weeks at 100%. I can't imagine I will need 12 weeks, but nice to know its covered. I am in St. Louis, MO and am going throught St. Alexius Hospital New Start which was 1 of the BCBSIL recommended hospitals of excellence. Just wanted to come out of hiding as I am at the home stretch now... Good luck to everyone and I'll try to post again once I get the BIG NEWS!!! Thanks, Joan