This roller coaster of "Yes you're approved" and "no you're not" is too much... I need to throw up and i'm still not sleeved.

[Flutterby 98]

Here I am so EXCITED and positive and renewed and hopeful...

NOW a phone call from the financial counselor - Just got shot down from my cloud by the bariatric clinic saying my surgery has to be converted to self-pay (which I can't afford in four days) or wait several months to be covered. They just don't trust that the "pre-approval" from my insurance is good enough. They think it won't be covered. How dare they!!!

NOT FAIR...NOT FAIR...AND JUST TOTALLY MEAN!!!

We went back and forth with this place for weeks, had numerous conference calls with the insurance company to get everything taken care of and everyone happy and made SURE it was covered and all going to be fine.

The clinic called and told me it was APPROVED, then called and scheduled my surgery for June 4th.

My husband had to get vacation time approved. I had to get vacation time approved. Told my family and got all my stuff in order. Ready to start my pre-op diet Sunday.

So, I'm shot down and on the ground ~~ but I'll get back up. I'll go forward because I CANNOT GIVE UP!

This is a fight and I'm worth it. All this opposition will not knock me down forever.

I may not be posting much on this forum for a few days.. (well, at least a little while as I lick my wounds)... but I'll be back.

So to all those I joined with to be "June sleeve siblings" and the posts I've made about my surgery being soon... well, never mind. It'll happen, but not likely as soon as I was told and hoping. I'm so sad at the moment.

[smjuroska 60]

I am so sorry for you! I haven't been shot down this way (yet) but I been through alot of red tape with the clinic and insurance. I have been doing their jobs for them for a year! I can somewhat relate to your frustration and disappointment! Hang in there take the time you need and when you are ready to come back we will all be here supporting you! You are worth it! Have a good rest of the week and enjoy the long holiday weekend!

[NeverBeTheSameAgain 241]

I am so sorry to read this, I also went thru so many chnges trying to get an approval. I have cried, screamed, been happy, been mad and ready to go blow up some offices...lol I dont kno how religious u are but this weight is a form of bondage and God does not want us to remain in bondage, so therefore if you trust him he will fix this in your favor...he gives us the desires of our hearts and if ur heart is like mine being here for my sons without limitations on their life is ALLLLL I could ever hope for. So hang in there, if its urs cant NOBDY take it...not that clinic or the insurance company.

[No game 14,437]

I'm so sorry to hear this! I don't get it what does the clinic want? Have you talked to your insurance company to find out when they might "fully" approve it?

[Flutterby 98]

I'm so sorry to hear this! I don't get it what does the clinic want? Have you talked to your insurance company to find out when they might "fully" approve it?

Thank you Laura.

I somewhat understand the clinic's side of this. Even though I want to be so mad at them, I can't. We have just tried so hard to cover all bases and make sure it was approved.

While we've spoken to several insurance reps both in HR at my husband's job and directly with BCBS who have assured us over and over it's approved, the clinic is under the assumption it's going to be "unpaid" eventually because we have a "pre-existing" clause on our policy. They'll cover it in October (a year into our insurance coverage).

The financial counselor told me today that it's a way for insurance companies to get out of paying, even after they've "pre-approved" a claim. If I've been weighed in at ANY doctor's office in the past and they wrote anywhere in my medical history that I'm overweight...then it can be used as a pre-exisiting.

So they won't go through our insurance because of the possibility of not being reimbursed even though the insurance rep told them OVER and OVER that being overweight doesn't fall into the "pre-existing" exclusions of our policy. I've never been seen for WLS before EVER.

We haven't decided if we'll try to get it financed and self-pay before then, or just wait. Even more assurances from the insurance company won't make the clinic change their policy. If there is any hint of a "pre-existing condition" policy on anyone's coverage, their decision will be to refuse to go through insurance because they think it won't pay. I guess they've been burned by insurance companies in the past that have "pre-approved".

Sucks so bad. But I know that insurance companies deny claims a lot. I want to trust our insurance reps and believe it would be covered. But I don't blame the clinic for having the policy they do.

[Nicolanz 1,484]

My coworker's husband is a bariatric surgeon and she said BCBS is notorious for not paying. I have BCBS and knew I couldn't handle the heartbreak so I went to MX. I'm so sorry you're going through this! Can you go to another clinic? I'm not sure how all that works.

[No game 14,437]

Ok....ummm.... I have the same insurance and was "pre approved" too when I had my surgery,

Have you thought of a different bariatric doctor?

[Flutterby 98]

My coworker's husband is a bariatric surgeon and she said BCBS is notorious for not paying. I have BCBS and knew I couldn't handle the heartbreak so I went to MX. I'm so sorry you're going through this! Can you go to another clinic? I'm not sure how all that works.

I'm definitely looking at other clinics and other options now. I know dealing with insurance companies must be horrendous. Our country's problems with health care makes that obvious. It sure has hit home with me today.

I may just try to get financed and go self-pay. I just have to do it fast if I want to keep my surgery date of June 4th. Fingers crossed we can do it!!!

That voice in my head that wants me to give up keeps bombarding my thoughts. It makes me feel more able to shush it with all this support!! Thank you everyone!!!

[No game 14,437]

Yes look into a different surgeon! My surgeon had his own insurance coordinator working for me to get the pre approval she was a shark and knew the ins and outs of all insurances.

She got the job done I had nothing to do with it..

After all they want you to get this surgery so they can get the money!

[Nicolanz 1,484]

I agree. If I were you I'd be calling other clinics today! If insurance will pay for it, that'd be nice! Good luck, Flutterby. I'm keeping my fingers crossed for you!

[Flutterby 98]

I got an appointment with a new clinic for next Tuesday. Big sigh... restarting. There's a reason... maybe I needed to be even more determined. It worked.

[No game 14,437]