getting frustrated and fussy!!!

[dontgoggilme 0]

ok... so i had my consultation on jan. 25 and the doc said my surgery would probably be scheduled for the last week in feb. i was like "yay! great!". when i spoke with the insurance lady at my doc's office she said it might take a week for her to submit the paperwork to get the referral for the procedure (i'm tricare prime) but that after it was submitted tricare gives an answer (approved or denied) in three days or less and went on about how it's a pretty quick thing with tricare when someone meets all the criteria like i do. so i was sooo excited. well, i been checking my tricare referral status everday since that appt on jan. 25 and the doc's office still has not even submitted the referral for review. i'm like wtf? it's been 9 days!!! she said a week at most. 7 days! the longer it takes to get the ball rolling the further out the surgery date will have to be as i have to have the pre ops done and do a two week liquid diet. a friend of mine who was banded a year ago by the same doc (she is also tricare prime) says to be patient and that they are busier now than when she got hers which is why it's taking longer for me than it did for her, but i'm sooo ready to get banded and get the ball rolling on the before surgery stuff. i find myself getting angry with the doc's office for not turning the stuff in fast enough. has anyone else had this problem? i was thinking of waiting til friday to see if they have done it by then and if not then i'll prolly be fuming by then and wanna call and gripe them out. but i know i can't do the latter but still. has anyone else had similar issues or similar frustrations?

[serenity55 15]

I know exactly what you're going through. I was denied several times before I actually got my approval, and the time could have passed more quickly if the woman in my primary care doc's office had sent the paperwork to my insurance company. To add to my frustration, the idiot submitted a request for gastric bypass, which is not what I wanted! I wanted to strangle her!

And then the insurance company took forever. I had to keep calling them. People told me that I had to be persistent, which isn't easy for me. So yeah, I was definitely frustrated and fussy!

Be sure to let us know what happens. Once everything got settled, things moved pretty quickly for me, too. Hang in there!

Debbie!!

[mrsdivine 0]

I know you are frustrated, but once it is submitted it is approve really fast. I am Tricare Prime as well and my paperwork was submitted on 2-4-10 and it was approved the next day.

[Vivinthewoods 0]

Can I join in and just vent about my surgeon's office staff. Although my doctor is very experienced, he employs a staff of former patients, but I do wonder how qualified they are.

When I called for an initial consultation it was scheduled at the wrong office, (he has 3) 100's of miles from where I live. Luckily one of his staff caught this mistake before the appointment date.

I was asked to bring my psych evaluation on a certain day to the office. The doc did not have enough appointments that day, so did not open the office, Unfortunately no one let me know, I turned up and waited an hour for someone to arrive - not fun on a Aug afternoon in Texas!

On my pre-op visit I was suppose to get a 'bag of goodies', but the staff forgot to bring it. I don't know if there would have been anything in there that I would find helpful.

Before surgery I called the office to ask if I should take the steroid med I am on the day of surgery - as it has to be taken with a full glass of Water. I heard the girl on the phone call my question out across the office, to other members of staff. I was told not to take it. At my pre-op testing at the hospital the nurse said I must take that med before surgery, but with just a sip of Water (not only must this med be taken every day, but it should also be taken at the same time of day). Shouldn't my doc have someone on staff that knew this????

And now for the latest kicker! I had assumed that because I was asked to pay for my first fill that they had checked with my insurance and fills were not covered, but for some reason I decided to checked on this myself - and yes my fills are covered! They would have gone on charging me and I would have gone on paying for fills if I had not persisted in getting this info.

There have also been many phone calls, from me, which were never returned - I would have to call them back. Because of this any info I did give to the staff over the phone I backed up by sending that info to them by mail also - this way there was a paper trail.

I hope by posting this it may help others with questions to ask of their surgeon.

Edited February 6, 2010 by Vivinthewoods

[chrisdirects 0]

Man, I am so glad that others are having this journey!!

I have CareFirst BCBS...they pay for the procedure, but required a 6 month waiting period. That's OK, I figured with all of the preop studies my surgeon requires it would take me about that long to get it all done anyway

So, now all of that is taken care of, and here I am cooling my heels, waiting to get the final authorization. I went on the preop Medifast diet recommended by the surgeon (must be on this for at least 2 weeks before the operation), thinking I'd be good to go for this coming week. I called the surgeon's office on Thursday, only to be told that 1) No, they haven't heard from the insurance company yet, and I was not to call, less I torque them off and make things even worse, and 2) they are SOOO backed up right now, since they've had to reschedule so many people due to the weather conditions here, that the best they could offer would be the 2nd week in MARCH. Yipes!!! :woot:

I decided to stay on the Medifast, so that I could be ready for cancellations should one happen. In the meantime, I am going stark raving looney-toons. Patience was never my strong suit, that's for sure!