somebody is a lier!

[meanmom04 0]

Ok I have been dealing with this for over a year I am getting so tried of the bs..... over 2 weeks ago i was told by my surgerons office that everything was submitted and going good. but they did send a letter back to the surgery office asking for a list of all the diets i have tried over the last 10 years. Well I did that. well this weekend i got of waiting so i called my insurance company to find out if they need any more information... guess what they told me....Insurance company said that my doctor has not sent them anything and there was no record of them asking for any information on my weight.. that they had no record of my trying to get my pre-determ for the lapband surgery.. really feel like i am getting jerked around!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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[mattie7632 24]

Sometimes it takes several days for insurance companies to show documentation in their system, so your doctor's office may have sent it.

[Phranp 46]

I totally get that you feel like you are being jerked around. And, maybe you are ... but maybe ... not so much. Here's the thing, if your docs office does primarily WLS, perhaps they haven't sent your paperwork because it is there practice to gather absolutely everything BEFORE submitting. But, here's the thing, while I truly understand your anger and frustration, that's not what will get you your lap band. So, my suggestion is this ... just like you called your insurance company and rreceived the info that led you to the the conclusion that your docs office is lying to you, you should call your docs off and get all the prerequisites that theyrequire for lapband. You can usually find it on your insurance company's website and your insurance company can help you find exactly where that is. Once you have the information make a check list of all the things you have given to your doctor's office. IF you find that you have submitted everything required, make an appointment with your doc and bring the prerequsites supplied by your insurance and your check list. Calmly discuss it with your doctor. If you do no like his/her answer, send a request - in writing- for your medical records and find another doc.

Now, if when you get the prerequisites from your insurance you find that you do not have everything you need, complete the remainder before your doc even asks for it. Submit it and THEN make the appointment with you check list, etc.

The bottom line is that more and more our medical health (as well as other areas of our life) is completely our responsibility. I know there was a time when professionals cared about "doing the right thing" and doctors were truly "caregivers", but that time is just about gone. WE have to take our medical care in our own hands and do the research necessary to get what we need. I know it's not always easy, and from you name "meanmom" you have kids and THAT in itself makes everything more challenging because you are not only responsible for yourself but your entire family -- including hubby. LOL But, just take a deep breath, and after the kids are asleep sit down with pen and paper and make a list of things you need to do to get to where you want to be -- in the surgery room getting your lap band.

Many of us bandsters have had challenges on the way to getting our bands (myself included), and some of us have had challenges AFTER getting our bands, be it insurance or the doc. Trust me, I know you are anxious, I was too. It's good to have a place to vent and this forum is definitely the right place because so many of us understand your frustrations.

You WILL have your surgery, patience was never one of my virtues - still isn't - but I'm afraid you, like myself, will need it to reach our goals (be it getting the surgery or getting the weight off after the surgery). Good luck and God bless.

~Fran

[Russian_BANDit_inNY 4]

I know how you feel!

My doc's surgery coordinator took her sweet time to NOT send my docs to insurance.

She told me I need 6 month supervised diet - NOT TRUE;

She told me repeatedly that she send papers - SHE DID NOT.

Insurance requiered ONE two page form, during my appointment I asked and doctor completed it in front of me, I made sure the *(&^(% 'surgery coordinator' knows that form was the ONLY required form to fax - SHE DID NOT.

I opened the case with the insurance myself and established good relationship with my insurance rep.

After weeks of weighting I insited of NOT going through that one person from my docs office. And office manager faxed everything the same day.

Got approval from insurance in 30 min!!!!

If you feel something is not working, the papers are not moving - speak up. I did but after weeks of frustration.

[54Shirley 105]

I agree with all of this... The bottom line is make contact with the Ins. Company, get a name and extension to the person your dealing with, and ask if you get all the paperwork that she needs for the surgery, can you go threw her. Because it might be getting lost in Transit.

Now get a file and make 2 of everything you have. If you have to have proof from your PCP, ask for the printouts of your visits. The same goes for the specialists. Any and all paperwork, you make copies of.

If you choose to go threw the Ins., and they will help you. You will have the paperwork, and copies in case they say we lost something. NOT A PROBLEM for you, because you have a file on yourself.

[meanmom04 0]

I have done a year of the diet with my main doctor, i got 10 years of medical history, i did the phys evel, I wrote the letter stating why and what all i have done to lose weight. i got the letter from the doctor saying it is medical ness. Surgery office said they sent them over 3 weeks ago...insurance co still saying they dont have them.. so going today to get copies of EVERYTHING and sending them to the insurance co myself.....

[Phranp 46]

I have done a year of the diet with my main doctor, i got 10 years of medical history, i did the phys evel, I wrote the letter stating why and what all i have done to lose weight. i got the letter from the doctor saying it is medical ness. Surgery office said they sent them over 3 weeks ago...insurance co still saying they dont have them.. so going today to get copies of EVERYTHING and sending them to the insurance co myself.....

Sounds like a good plan. Skip the middle man!

[54Shirley 105]

Sounds like a plan to me !