Depressed and ready to give up

tomorrowsdream · November 10, 2005

I've already begun this fight. The office manager from the dr's. office called today to tell me they have received my complaint and are considering doing the surgery, but they DON'T think Medicare will pay a cent. The office manager says she talked to the DIRECTOR for Medicare and they are not paying for the surgery. I have also talked directly with Medicare and I know they are paying and paying more than $800.00. It is Medicade that picks up only $800.00 and I don't have Medicade. Medicare will pay $10,000, but the dr. wants $20,000 for this "package deal" he has with the hospital. I told him let me deal with the hospital that I had worked there 38 years and they would give me a good deal on anything I owed them. The dr. doesn't like this idea. He wants me to pay him and I informed the office staff that they have to under the law submit my claim to Medicare before I'm paying them a dime. I truly believe with the help of my personal physician and a detailed letter she sent to Medicare and received an answer on that they WILL pay for this surgery.

The office manager let me know she doesn't like me already...ask me if I care? I'm betting she is a 20 year old blonde bimbo that weighs 110 lbs. She sounds absolutely disgusted discussing weight or weight issues, so I think we are going to have a go round in the future.

I am a person and I expect to be treated as such. I am no different than anyone else in this country and deserve the same treatment. What is it with people and their negative reaction to overweight people? Society on a whole sure looks at us differently for some reason. Personally, I've had enough and I'm taking a stand.

Now...did that impress you guys?

Thanks all. You have been great. Without you I might not have stood up to this woman as it wasn't characteristic of me to fight for anything.

Nykee · November 10, 2005

What I know of it.. medicare will pay 8000...and you can find banding in the states for 12,000 to 15,000 and they bill you for the rest.. this is what I WAS gonna do cuz I didnt care if I had a BILL for the rest.. plus there was a 2000$ co-pay.. so all I was gonna need upfront was 2000$.. this was over a year ago..

BUT I never got medicare like they all said I was gonna get when I got my SSI..

I am still on medicade. and I am shocked they even put 800$ to it.. I mean WHY even bother?

I say do it and figure it out as you go.. it will work out!

chichigirl · November 10, 2005

Good for you!!! I know that most of us don't like to be ugly and have to fight things, but this is your health and your life we are talking about here. It is so worth you standing up to them and I am proud of you for realizing that.

As for the bimbo in the doctor's office, kill her with kindness, it usually makes snotty people like her feel a little guilty even if they don't show it. If that doesn't change her attitude and it is bothersome to you, take the direct approach, ask her if you have offended her in some way. This usually catches people off guard, but it is far more effective than their passive-aggressive approach. It will at least put her on notice that you do not appreciated being treated this way and that you do recognize her for what she is.

It's sooooo good to here you got your fighting spirit kicked into high gear, sometimes that's what it takes. It shouldn't be this difficult, but when it is, you have to fight fire with fire. I know and so does everyone else here, that you are good, kind and caring individual and you deserve to do whatever is needed to take good care of yourself. This is your twin sis speatking, so listen;).

Good luck and keep us posted on your progress. Also, take Jack up on his offer, he is a doctor and knows how the sytem works, so I am sure he will have some good advice for you.

(((HUGS)))

Cindy

tomorrowsdream · November 10, 2005

The doctor's office called today and said they had my application and were reviewing it to see if I qualified (probably because of my heart surgery). I assured them I had medical clearance in writing from my heart surgeon, along with an EKG, a recent thallium nuclear scan and an echocardiogram (that should shut them up). I told them I was in the process of completing the sleep study and I only had blood work and the psych appt. to go. She wanted to talk a payment plan and told me Medicare won't pay a nickle. I said FINE, but you have to submit it to them and get denied or I could lose my coverage. She asked me well if it is denied can you self-pay. I told her yes, I could, that wasn't a problem (had to mortgage the house), but she had to submit it for me first. She didn't sound very happy about that, but that's the way the system works. She was supposed to get back to me this afternoon and I told her I was in the middle of getting my gums planed and crowns on my front teeth, and I was NOT in the mood to argue with her. I just said fine, call me back when the dr. reviews the application . He stood there in front of 100 people at the seminar and stated he took Medicare (probably because he thought they wouldn't pay) but I hear the first of the yr. Medicare will be paying quite a bit. If they don't I'll EAT (bad word) the cost. So, that is where I stand right now. I'm probably looking at the first of the yr. to see the dr. or the end of Dec., but I feel like I've made a little progress. If he decides not to see me, I'm going to want some answers.

Take care my adopted twin.

kimalicious · November 10, 2005

Wow, my band surgeon charged my insurance $24,000 and they paid every last bit. I only had to pay like $600 out of pocket. THey overcharged them so much it paid for everything else. THere is always a way. Keep trying and you will get your band. Don't give up.

tomorrowsdream · November 11, 2005

I have no intention of giving up, but there are only 2 dr's. here in all of Idaho that do this surgery and they won't do fills for anyone else...even the dr. that taught them this surgery in Portland, Oregon. She is still a very viable option for me. I'm putting a lot of thought into it. I would have to attend a seminar in Portland, then fly up for a dr's. visit, and then hopefully the surgery. I'm not a very good flyer and am sure to get lost in Portland, but if these dr's. here don't come around I know she accepts Medicare patients with no problem.

It's me-Debbydo · November 11, 2005

Hey, just a quick thought. Why can't you decline medicare since you have insurance all ready. If you are still working or DH I think that maybe an option?????