SCREAMING in FRUSTRATION

[Mvpo8961 1]

I hear ya Nanahanna. Sometimes a gal has got to do what she has got to do. Time is a wasting. M:biggrin1:

[Mvpo8961 1]

:update:

Well thought I would give everyone the 411. Called ins co every morning this week to see if surgeon's office had sent the requested info to them. NOTHING YET! Called surgeon's office and they were going to call ins co and talk to them. Office manager told me UHC was down system wide one day two weeks ago and last week. With loss of incoming data. So this afternoon I called to see if ins co had been contacted by surgeon's office. Was told that something had been received yesterday but had not been logged into the computer yet. I am hoping this was the fax surgeon's office sent for the additional information.

Guess what!!!!! Went to my mailbox today and there is a letter from UHC stating what info needed to be sent in. The letter was dated March 20 but wasn't mailed until March 27. I told my husband it was probably sitting around in the mail room and I guess I was right.

So I am still waiting for info to be received by insurance co. My thirty days are up next Wednesday. So maybe I will know something by then. But the letter sent to the surgeon also requests his name and address! What's up with that? Did they just pick a name out of thin air to mail the letter to? M:phanvan

[nanahanna 1]

Oh my God! Sounds like a bunch of incompetents! Well, I went to the seminar in Shreveport Tuesday afternoon. Dr. Merriman is really cute. I read a patient's testimonial on Obesity Help about him....said he looked like Richard Gere. He does...sort of...only he is cuter than Richard Gere! Great personality and he knows his stuff too. I was impressed. I am sticking with him come heck or high Water. I hate to say it but I am leaning towards a RNY...just because it seems easier...you don't have to go back and forth for fills etc. But I am not sure yet. I will make up my mind by the time the Louisiana review committe meets on 5/2/06 fer sure! His insurance coordinator has had the band. She let me feel of her port. Didn't feel bad at all. She has lost 72 pounds in 15 months. She looked great. There was also a 71 y/o lady there who had had the RNY and she said it was a piece of cake. She has lost 90 pounds in 1 1/2 years. I am rootin' for you MVPO!:clap2: :clap2: :clap2:

[Mvpo8961 1]

Hi Nanahanna and everyone else. I think I am going to be a May bandit after all. I talked to the insurance co twice today and once to the surgeon's office.:faint: The information the insurance company needs has to be sent by mail and the surgeon's office sent it out today. It will take at least till Monday to get to Atlanta from Dallas. Then it takes a week to get the info into their computer system. Then it will have to be reviewed and an answer typed and mailed. Once the letter is typed they have about seven days typically before it goes out in the actual mail. Once I receive the letter I have to make a preop appt again. I have already signed forms and such when I went in early January. But I have to touch base with the doc again and then start my preop diet for 7-10 days. :confused: So I just don't think there will be time for all that in April. But I do think I can get it done by early May. Wouldn't you know it. Our town's Garden Club will be having their FIRST garden tour this year and we have been asked to be one of the show gardens. Darn't it I will probably laid up in the recliner then. :violin: Thats why I was hoping to get this done in April. Oh well I'll take it when I can get it. M:peace:

[nanahanna 1]

Alright! Way to go! I am pulling for you to get it done very, very soon!

[Suz 1]

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[Mvpo8961 1]

:omg: OMG I just talked to the ins co and the rep wanted to know why we had sent in a letter of pred since my plan says it is a covered benefit and I meet the criteria!!!! Was told my surgeon's office needed to call them for the verbal approval and that was all. Well I sat here and thought about and called back and asked to speak to a supervisor. Was told there was not one available but the rep would help if I liked. So I told the lady the whole sordid tale of how my stuff had been mailed, received, lost remailed, letter for more info received, info sent to them but not arrived yet even though it has been almost two weeks. The lady said she didn't know what that rep earlier today was talking about but that was incorrect info and the yes I did need a letter of pred. Okay all they want at this time is the NAME OF THE FACILITY to be used and I am approved once they get that. I ask her could I mail it to them. She said yes or I could FAX it. The surgeon's office told me it had to be mailed only they would not accept a FAX. So I think I am going to do BOTH. That should cover all the bases right? If I can get a copy for the surgeon's office of the info that needs to be sent.

I think I am ready to go POSTAL!!!!!!!!!!!!!

M

[DrHekier 0]

I have heard through the grapevine that in the next few weeks there may be a lawsuit filed against BC/BS of TX to challenge the legality of the 12 month supervised diet requirement.

Perhaps they got wind of that and are becoming more lenient.

Disclaimer: This is only hearsay on my part, and I am not alleging any wrongdoing by any party.

[nanahanna 1]

MVPO....:clap2: :clap2: :clap2: :clap2: . I have all my medical records except one I am waiting on and my referral letter from my PCP, and then I can make an appointment with the surgeon. I may be able to get this done this summer sometime! Hopefully before then, but according to how busy he is and how busy the nutritionist and psychologist are...I have to have my first appointment with the surgeon, appt with nutritionist and psychologist and then the doctor decides what other tests he wants....so I am hoping and praying to be done with this at the very latest by fall (except for all the followup and support group meetings.)

:clap2: :clap2: :clap2: :clap2:

[3loves 0]

Mvpo8961 ~ Yup, sounds like my insurance company....NGS American....they need to work on some training issues. Isn't is amazing the things they can come up with from day to day? I was told today the lapband is not covered by my insurance. :censored: That info is incorrect, but still, why do some of these insurance companies have a hard time keeping their story straight?

You are soooo close!! Hang in there and keep us posted.....I'll do the same. You too nanahanna!!

Fight Bulldogs Fight :fencing:

[Mags 0]

:help: When it comes to insurance -- I feel everybody's pain!! Iwas just turned down today by Blue Cross Blue Shield of Illinois. According to my surgeon's office, BC/BS said I didn't have enough appointments with my doctor during the required 12-months period of medical supervision. Although I went through the 12 months I only had 10 appointments and they claim I should have had one every month. I can't believe this!!! Other than this I qualify under every other point - high blood pressure, high bmi, osteoarthritis, sleep apnea, psych consult, nutritional counseling, etc. etc.

I am now in the process of trying to find out what I can do to remedy the situation. I don't give up easily but I'm really disappointed and losing hope. I was hoping to have surgery in May. Has anyone else out there had this particular experience?

Mags

[Mvpo8961 1]

:peace: Well talked to the insurance company today and ALL MY INFORMATION has arrived. I have a verbal approval pending the verification that the hospital is an HCA facility. Of course it is but I understand they have to do their thing in checking. So now I am twiddling my thumbs and waiting AGAIN. But that's okay what's a few more days in the grand scheme of things.

Ya want to hear a funny. Yesterday I called to check to see if the info had arrived. The guy that answered my call tells me Oh you don't need a letter of pred. Lapband is a covered benefit in your plan book. All you need to do is have the surgeon call us. I am thinking man your crazy I have been going through this for months and this is the first someone has told me this. So I call later and talk to another customer rep and told the the guy from that morning was incorrect and yes we did need a letter blah blah blah.

Called today and HE answered the phone again and says I talked to you yesterday and you don't need a pred. I tell him I think he gave me incorrect info but whatever. Called LATER and talked to somebody different and finally got the information that I needed which was all information for my file is in now.

Talk about the blind leading the blind.

[3loves 0]

Yippee!!:dance:Sounds like your just a letter away....verbal approval...:wow2: Glad to hear that!! :clap2: I find it interesting that we can become so educated on the procedures of a company in a short period of time and help train their employees in the process. We should get paid for training, don't you think?

My psychologist wrote the letter I needed. I will call to make sure they get the fax and I dare them to come up with a new excuse. :Banane04: Since Friday is Good Friday, I don't look for an answer until next week.

We will be doing the happy dance soon!! :dance:

[Mvpo8961 1]

:update: Well just talked to the insurance company and was told I was definitely approved and they would be mailing my approval letter today. Woot Woot!!!!!!!!!!!!!:wow2:

[3loves 0]

Yeah...FINALLY!! Congratulations!! You must be elated to have this phase behind you. It's the biggest hurdle if you ask me. I hope to join you soon.

Nothing can stop you now girl!!

:cheer2::banana :eek: :dance: :peace: :clap2: