Less of Jess

Waiting has been tough!
    
I first decided to start this journey Jan 2014 when I found out the new insurance my work started carrying would cover WLS.  I needed to get a referral from my PCP first, but first I needed an in-plan PCP! Took three months to get into an in-plan PCP, then the insurance required a 6 month "i can change" program, which consisted of talking to a life-couch once a month for 6 months.  I started that program 4/2014.  My first appt with a surgeon was 7/2014.  At that point the surgeon's office required psych and nut consults before submitting for insurance approval, then the rest of the pre-op testing; sleep, ecg, upper gi, bloodwork.  I completed my Nut consult and began psych consults in 9/2014, as well as my first sleep study. 
 
 I completed the i can change program in 10/2014.  Once I submitted the proof of program completion and Nut and psych consults to the surgeon's office I asked them to call me if they needed anything further to complete my pre-approval.  I didn't hear anything for a few weeks, so I called the surgeon's office and asked if they'd heard back from my insurance, they said that they hadn't heard back yet.  So I contacted my insurance to see what the hold up was, the hold up was that nothing had been submitted!  So I called the surgeon's office and was told someone would call me back.  Nothing...  Called again a few days later, again told someone would call me back...  Since I'd heard that before I demanded to know why my pre-approval wasn't submitted yet.  Grumpily the receptionist grabbed my file and said they were waiting to get my final OK from psych (which was completed and sent to them 1 month prior!).  So I called psych and asked them to resubmit it.  They did and a week later, now the end of November, I get a call from the surgeon's office that my claim had been denied as the insurance required all the pre-op's to be done before pre-approval... So they were sending me info on the rest of the pre-ops.
 
I was able to complete all the sleep studies, ended up with a BiPAP in January 2015.  My ECG and Upper GI were done right before Christmas and bloods were drawn right before New Year's.  But by this point I was fed up with the lies and delays of the surgeon's office that I started researching other surgeon's in the area.  I was able to bypass the seminar requirement at Dr. Pohl's office and get an appt with him Jan 21st.  Since all the pre-op's done previously looked good and I had my BiPAP, all he required in addition was an abdominal ultrasound.  But unfortunately in that time my insurance had changed their requirements, and now no longer needed the i can change program, but now just needed 3 consecutive months with a nutritionist... I only had one appt! So I got a new Nut, and had the ultrasound which showed gallstones.
 
Now after 2 additional Nut appts I finally got pre-approval and a date of May 13th, 2015, 17 months after I started this whole process, and 10 months after my first surgery consult.  Though all of this has been beyond annoying, I have learned quite a bit about the process, and am glad that I have the surgeon I do now! I have come to terms with the prospect of loosing most of my stomach, and as a bonus, my gallbladder!  Had I now taken all this time and effort I may have ended up with a lap band, which to my un-educated self was my first choice.  I now know that that surgery was not the best for me. Especially since a co-worker of mine was able to get the lap-band done, through a different insurance, in only 3 months, and now wishes she had gotten the sleeve!  Also, had I stayed with the first surgeon, I wouldn't know about the gallstones, and would likely be looking at additional emergency gallbladder removal in the near future.
 
In the end, this is my journey, but it was the right journey for me! Everything will be fine!