Nightmare PA from Hell!

[BIZZYBIZZYBEE 1]

I have been waiting for this surgery now and it is finally (fingers crossed) going to happen this time.

I tried this 10 years ago, when I was 23, but was completely NOT NOT NOT emotionally ready psychologically to handle Bariatric Surgery.

A little under two years ago I had a great friend have the sleeve performed, and watched her through her success and decided to try again.

Since October I have be EXTREMELY Hypervigilant and OCD about doing it and doing it RIGHT.

Everything was great, all my tests and exams, evaluations, lab after lab, etc had come back and I was in the.schedule (after harassing the patient advocate/ billing specialist). I literally know that I could have done her job better than her under anesthesia and blindfolded!

She was thee biggest idiot I have ever met, and I did most if the leg work myself. I am on disability, and one of the reasons is extreme anxiety/ ADHD/ OCD, so I know a thing or two about double checking, asking questions, keeping track of all paperwork, so on and so fourth ( in my working days I had a high stress job, so it was all too familiar depending on only yourself to get things done).

I had all my pre op and post op food, done my final pre op appt with the nurse, surgeon, and dietician (whom asked me to personally come back and help newbies in support because I knew it like the back of my hand..it made me blush) meds, exercise plans, gone to all support groups, talked with friends who had this done, down to the outfit and hospital bag.

Fasted for two weeks, lost 28 lbs, and was geeked.

Less than 24 hours until I was to check in for surgery, the PA, called and said there was an insurance issue, and if I could not resolve it, my surgery would go on but I would have to sigh a finance waiver, stating that if the insurance company did not pick up the tab, that I would be responsible for the WHOLE $45k BEFORE I left the hospital?! I seriously asked her if she was kidding, and in her smug and condensing tone said nope.

This call was placed to me at 2:45 pm, and the insurance carrier was on the east coast!

I called they were closed and reopened at 5am AZ time. I made 17 phone calls all the way up until 15 minutes before I absolutely had to leave for check in at the hospital.

I was livid.

I come to find out two HUGE errors on my surgeons office's part.

Doctor was great, nurse was great, dietician was great, PA/ billing was a moron.

#1. No one informed me, and I asked COUNTLESS times that even though.I had Medicare,because my husband works and we have commerical insurance that HIS ,not mine, becomes Primary!

#2 They were no longer a center of excellence as of 2013 (lost it end of 2012) ,and had they kicked their asses into gear I would have been grandfathered in, but sadly no, and I was turned down again!

I cried for about and hour after I threw my binders (yes mulitple) across the room, picked myself up and got down to business again finding a new surgeon.

I have two local friends who had Bariatric Roux-en-Y, performed, by a great Dr, Dr. Hilario Juarez of St. Luke's Phoenix, and told me to start there.

Their staff Aisha Jones, Mary Banks, Ashley, the Doc, everyone has been Awesome and although they had few more requirements, have made this as flawless as possible, and Surgery is scheduled June 3rd, with last pre op check and testing this Thursday.

The only I am not looking forward to is the ABG test (I keep asking why as it has not been ordered by my Pulmonolgist), but if this is the last hurdle so be it!

I CANNOT wait! Fast is going great, just ready to be done, back home and ready to start this next chapter of healthy living!

[Flup 48]

I'm sorry that it's been such a struggle so far, but I'm happy to hear that there's a light at the end of the tunnel. We will be sleeved on the same day! It's so exciting, isn't it?!

[BIZZYBIZZYBEE 1]

Yes, thank God it is almost here!

I joked with my new Doc that even as they gas me, I will be like, " Is this covered," or "Is this really happening,".

They laugh!

Sleeve buddies!

Cannot wait to show progress! I have only told a select few, and most are not my family. I need no more stress right now.

I have been heavy my whole life, so this is about to be a total trip!

So geeked yet cautious!

[Flup 48]

Good luck to you, Buddy! I have been heavy on and off my whole life -- I was heavy in middle school, but slimmed down in high school, although at 135lbs I thought I was enormous. Then once I started having babies (5 in total!) I packed on the pounds steadily. But - enough is enough!! I'm so excited to be rid of the weight once and for all, and to have a new start in life!

[gia24 85]

I'm getting sleeved by Dr. Juarez on Aug 19. His office is very good, and been helpful through the whole process. I did all my requirements and got my approval in a week. Can't wait, excited but still nervous of the surgery and praying all goes well.

[Pastor Paula Jackson 91]

Im still waiting to have Psych done! Dr Juarez is Also my Surgeon. I lilt those ladies at Bridges! I call them like everyday. I'm going through an insurance nightmare as well! But at least you all have a date! I still have to wait for my insurance to ok it!

[gia24 85]

Hopefully you get your approval soon!

[gia24 85]

The psych eval was easy, the paperwork portion was longer than the interview, I used a Dr. on the list Dr. Juarez's office provided. He cleared me after our interview.

[Pastor Paula Jackson 91]

The psych eval was easy' date=' the paperwork portion was longer than the interview, I used a Dr. on the list Dr. Juarez's office provided. He cleared me after our interview.[/quote']

I'm not worried about clearance, I am just wondering how long after do they submit all documents to insurance and how quick do insurance give a approval so you can get a date? How much more time do I have from this point to get a date? I have United Health Care for Rail Roaders so my insurance is really quick no restrictions and 100% coverage!

[Pastor Paula Jackson 91]

How much longer do I have from this point? I need to pinpoint perfectly so I can send for my daughter so she can care for her little sisters and help me!

[gia24 85]

How much longer do I have from this point? I need to pinpoint perfectly so I can send for my daughter so she can care for her little sisters and help me!

[gia24 85]

Depends on your insurance, my stuff was submitted on 7/9 and I got an approval 7/16, I was told 14 business days, even my insurance company called earlier on 7/16 to go over my requirements and told me I would probably have a decision on 7/31. Mary called me later that afternoon to say I was approved. So I guess it depends on your history, and insurance co. I have United health care.

[Pastor Paula Jackson 91]

All Mary is waiting for is my Psych Eval. And that's next Wednesday 07/31/13, I know I'm approved because United Health have their own Bariatric department. I just use Bridges too because I started out with them before I knew my insurance had that department. I just want to know how long out is schedule date from approval date? Thank you Gia24

[gia24 85]

Well Mary told me Ashley would call me on Friday the 19, but I never heard from her, emailed Mary and on Tuesday the 23rd Adept Ashley called and apologized apparently the list they have messes up and my name was missing, but once I emailed Mary, they researched it and found me, I got my date right then, I chose a Monday since that's one if my days off, I check in at 11 surgery at 1, and it was all pretty easy, got my pre-op date too, which is the day I start my liquid diet 8/5 I can't have anything until after the testing, since you have to fast. Then they email a list of dates and info on your follow up appt and pre-op diet and what to expect.

[Pastor Paula Jackson 91]

Well Mary told me Ashley would call me on Friday the 19' date=' but I never heard from her, emailed Mary and on Tuesday the 23rd Adept Ashley called and apologized apparently the list they have messes up and my name was missing, but once I emailed Mary, they researched it and found me, I got my date right then, I chose a Monday since that's one if my days off, I check in at 11 surgery at 1, and it was all pretty easy, got my pre-op date too, which is the day I start my liquid diet 8/5 I can't have anything until after the testing, since you have to fast. Then they email a list of dates and info on your follow up appt and pre-op diet and what to expect.[/quote']

I just started on this Forum yesterday, so I don't know how it all works yet. But I will try to keep up with you and I want you to keep up with me too. Although I live out in Maricopa, I hope to meet you at the support group one day.. I will be praying for you girl, I wish you all the best and let me know how surgery goes and if you need help in any way.. I also want to thank you for all of your support and help... Paula