Frustrated

[EJamiFan 7]

Once I make up my mind I am all about getting things done. I am beyond irritated with the process of getting approved for surgery. I have completed my psych eval and met with the nutritionist. Dr wants a sleep study before surgery. As far as I can tell it is the Dr requesting and not an insurance issue. I was fine having it done until my insurance denied it, saying I don't meet the required criteria. Honestly I think the nurse of my primary care Dr didn't know what she was doing when she tried to get the precertification. She called me last week asking why I needed it, I explained the issue and she misunderstood and thought I wanted to do the sleep study it just to have the test. I told her I have had sleep apnea symptoms for years and that is why the surgeon wants the test ran but I think she still mucked the process up. Sorry to be so negative, but I am upset about it. I emailed the surgery center to let them know that my insurance will only cover an at home pulse ox monitor test, hopefully that will be good enough.

I am stressed about qualifying for surgery. I have BCBS, which is good, but my BMI is in the 38-39 range. I have HBP, takes meds for it and borderline diabetes. I know with comorbidities I could qualify with less than 40, but I'm not sure if they would consider the borderline diabetes or not.

My consult is next Thursday, I guess I will find out soon, just stressed about it all and am worried I won't qualify. I have spent the better part of 20 years obese. Diets worked to bring my weight down, but I never seemed to have enough willpower to stay on them once I lost the initial 50 lbs or so.

Thanks for "listening" to me vent.

[LaceSleeve 76]

I know how you feel. Took me 2 years to get approved, worried the whole time I wouldn't qualify. But eventually I did, and it was all worth it. Keep your head up and don't give up, you won't regret it, I never have regretted the struggle to get approved good luck with your journey.

[EJamiFan 7]

Thanks, I read what others have been through and I feel bad complaining.

[LaceSleeve 76]

Don't feel bad, stories are different but they can be just as frustrating it helps to vent none the less.

[Lisa's Hope 421]

Don't feel bad. Just keep on trying to get approved no matter how long it takes. My insurance denied it out right and said it was one of their exclusions. I had no choice but to borrow the money and self pay for the surgery myself. I meant I was going to do this no matter what. I'm still making payments but don't regret it at all. So, keep trying. Don't give up. I think you will get approved. Even with me being self pay, I still had to jump through a lot of hoops to get the surgery. It is just a process and sometimes a looonnng process. Good Luck!

[vlb4vols 16]

EJamiFan .... The exact same thing happened to me! After I didn't qualify for a sleep study (only the home study) my Sleep Dr. wanted me to stay over night to be "titrated" for my sleep Apnea machine ... I waited till 2 weeks for my apt. and they called me and said my insurance would only approve me to have a self pap from a company to take home myself .... I called my Dr.s office after my home study was read and they went ahead and sent my information in for approval based on the diagnosis of Apnea ... I have a BMI of 40.7 anyway. Maybe your Dr. will do the same...it only took 3 days for my home study to be read.

[vlb4vols 16]

I go Friday to pick up my Cpap machine but already heard back from my Insurance with approval for a surgery date of April 25th

[EJamiFan 7]

Thanks for the info! I am sure I am stressing too much about it. Kind of had a crappy day and I have been down about the possibility of it not happening, or not as soon as I would like it to.

[EJamiFan 7]

That is awesome! Congrats!!!

[vlb4vols 16]

II was so frustrated I cried about it ... I felt like if I had just kept my mouth shut about maybe having sleep Apnea I would have been approved a month ago but it all worked out ... Be sure to ask if they will go ahead and submit your Approval when your home study gets read

[EJamiFan 7]

Oh wow, I have thought the same thing about writing down apnea symptoms on my paperwork.

[vlb4vols 16]

Good luck ... Hope everything goes super fast for you!

[EJamiFan 7]

Thanks! Good luck with surgery. Look forward to hearing how it went.

[EJamiFan 7]

OMG!!!! So excited! Got my insurance approval! Now just waiting for surgery center to get me scheduled!

Home sleep study went well, PCP said I passed. Very glad I won't have to do the in lab one.

Can't believe I could be having surgery soon!!! Pinch me!