The Pre-Op "process"

[Kat Crowder 34]

It seems like there's a wide range of pre-op requirements and sequences of events that different practices are requiring. What seems most common? Should I be frustrated by ineptitude or just think it's par for the course?

I met with my surgeon for the first time in November, after talking to my PCP about getting surgery and being encouraged by her. After that meeting, they seemed well organized, set me up with appointments for my psych evaluation and starting my 6 month pre-op weight management program. In December, I ran across information that BCBS-IL was planning to remove their requirements for the 6 month program, and at a meeting in October they said the change would occur within about a month. I followed up with BCBS-IL, the surgeon's office, and the professional organization who had held the meeting with BCBS's parent company, and all said, "Hm, we'll follow up on that and let you know." So I went about my business attending my classes through March, when the surgeon's office called me and said "we've submitted you for insurance today because they dropped the 6 month requirement in early February." Thanks, everyone, for telling me!

So, up until yesterday we've been going through stupid insurance loops because I'm convinced that the insurance coordinator at my surgeon sucks, and she said that she was going to wait to "send me my 'next steps' sheet" until I was approved. My next steps involve setting up more tests that need to be completed before scheduling surgery, and then they will schedule more pre-op tests after surgery is scheduled, but they have to be completed at least 2 weeks before the surgery.

Today I tried to schedule the abdominal ultrasound and the "gastric sleeve dietary information class", which must be done before they schedule the surgery, and the earliest available dates were 5/15 and 6/23. WTF?!?!?!?!? So when I was meeting with the nutritionist for the past 4 months, how does that not meet the dietary information class? And regardless of any of this, why couldn't I get this scheduled and handled ages ago, and why does this need to be done before scheduling the surgery? And if I have to wait until the surgery is scheduled to do my upper GI, chest x-ray, EKG, and blood work, if this is how scheduling goes, how the heck am I going to be able to get in for the tests a whole 2 weeks before surgery?

With none of these things being parallel-pathed, it looks like the end of July at the earliest. So many other people are saying "my insurance is approved and my surgery is in a week!" - I just don't understand why this is so f'd up.

-Kat

[soontobe1/2ofmyself 13]

i completely agree there is a list of things that I have to do prior to submitting my paperwork to the insurance company to be approved. I am frustrated because I have done everything asked of me including paying for each visit and there is still a possibility that the insurance company may not approve it meaning i have just wasted 6 months and who knows how much money for nothing.

[suzcomptime 17]

Mine was a long wait too. My Dr. office will not send to insurance until x # of nutritionist visits and psych evaluation. The nutritionist appointments had to be at least 4 weeks apart. I sped things up a little by asking to be on a wait list for cancellations and managed to get earlier appointments than originally scheduled. Once insurance approval was received, I had to do 2 visits with the trainer before I could meet with the surgeon (2nd time) and schedule the surgery in that meeting. At that point he was 2 months out for surgery openings which gave me plenty of time to schedule the endoscopy. The chest xray, blood work and a bunch of other tests are walk in at my hospital no appointment necessary so no long wait needed for those. My preop was scheduled a week before surgery and who knows what other tests will be part of that. It was a long process and I didn't have the 6 month diet requirement so I can imagine how long it feels for you.