Discussed - but not giving up

[thisislou 13]

This is my first posting… and I’m sure not my last.

I was going to wait until I was banded – but that has been put on hold.

My story…. I as many of you have, did a bunch or research and committed in my mind that this was what I needed. It was a very hard decision as I am really addicted to food, my diabetes is getting worst and weight going up. The first step was to find a doctor close by that was accepted by my BCBS. Found one that was the husband of my wife’s doctor who has been great for her. I went to his seminar and setup an appointment the next week. As I did my homework, I brought a bunch of stuff with me to this appointment including the requirements that BCBS insisted on and all my information on my recent 1 year on Weight Watchers. My first appointment really gave me a bad taste for this practice - I did most of the talking and tried twice to give this information to the "assistances" but told they did not need them because they worked with insurance all the time and had their own. I was never sat down and talked to - just given their requirements like make my own appointment with the nutritionist and they would setup one for the psychologist.

I completed both of these, got/gave them the required letter from my doctor along with over one inch thick copy of my doctor's file that dated back to 2002. I even went as far as compiling a cover sheet as I reviewed every page from the doctor notes of my weight, BP, AIC and cholesterol reading.

So at this point I thought it was a slam dunk - I am 60, weight 265 so BMI = 38 and insulin dependent diabetic.

Wrong - I called BCBS and was rejected after 2 weeks. Reason - the doctors office did not follow their requirements. Since my BMI was under 40 - I had to qualify by having 2 of 6 listed "comorbid conditions". Well I had 1 - Diabetes - but no mention or suggestion of any other. They also needed more information about my 1 year on WW.

When I called the doctor's office really discussed - they apologized for not doing the "required stuff" and would talk it over with the doctor and call me back. The next morning the office manager called me back and said that the doctor was dropping me and by the way - he found 3 "comorbid conditions" after reviewing my records (if he had found them before and did his job the way he should have - I would have a scheduled surgery date my now).

So I am very discussed - all that work, all that hope, all the time and money spent to get to my goal. As I said, I am 60 and want to live a long time. My daughter and her 2 sons (4 & 6) live with us now and I really want the health and energy to enjoy them and them to enjoy me...

I have not given up. I did a bit more research and found another doctor's office (the one that I meet with the nutritionist) and they are to call me back today.

Sorry for the long post - just had to get it out there...

Lou

[btrieger 21]

Lou,

I'm sorry to hear you are going through this crap. I had something similar but it was only one person in the doctor's office and she was fired when they found out.

Try to keep a positive attitude. This is only a small set back and life isn't a race.

There are plenty of competent surgeons in Florida and I'm sure you'll connect with one soon.

Good luck!!

Bob

[Jillobean 0]

Wow I can see why you are disappointed!! I wish you could have the experience I have had with my surgeon and his office staff! Execptional people and work!

I had a disappointing day also. I was denied for surgery today. I am 33 and 270lbs and 5'4. struggled all my life with weight issues. It was hard for me to make this life changing decision only to get denied. I guess they need additional info that I have seen a dietician. So I guess we will go from there and pray it works.

I hope you can find a new surgeon, one who cares about his patients so you can get on with your journey!!!

Good Luck!!

[Tracytma 19]

It sounds to me, like you are better off with this doctor. If they "dropped" you, (even though you really qualified for the program) then you should take this as a sign and run.... run quickly in the other direction and find someone who will treat you well and take good care of you! Good luck on your journey.

[Majj 0]

Hey Lou .... Thats really rotten luck ..I hope all go`s well with your new doctor and you can have the surgery ASAP...

I am 62 and have had NO Problems with having the surgery at all so don`t worry because of your age ..

Look forward to hearing good news from you very soon ..

Fingers crossed ..

Marion

[thisislou 13]

Thanks all for your support. I now have an appointment with a new office - one that seems a lot more organized. Talking to BCBS myself - I now know exactly what is needed to get my approval - all of which was already sent to them but not in away that summarizes and shows them on the cover letter why I should be approved. I go next Monday and hopefully will get thing moving again.

Just to put icing on the cake.... the previous doctor sent me a letter saying he was not my doctor anymore - and the office was so efficient they put a "blue card" on the letter to make it so I would have to sign for it but forgot to check to "signature required" box ...

Like some of you said - it was a blessing in disguise to find out before the procedure, the quality of service and expertise in the office.

I would wager to say that the doctor is probable ok - it is his office staff that messed thing up which he is probable not aware of...

Lou