Update On Pre-Op Issues Grrrrrrrrrrr.......

[BladeFox 235]

If anyone has been reading my post about my frustration with my nutritionist you will know that I have gone from mad to frustrated to do something about it, to ok...NOW, I'M HOT AGAIN!!!

So I emailed my PA to request that they submit my paperwork for approval since I am in the pre-op diet phase. I received an email from the nurse coordinator telling me that I had to complete 4 more things before submission. Two of the four things have been completed, which clearly tells me that they are not paying attention to my file or that they have poor record keeping. The only thing left to do is lose the weight by December 18 and visit with the DR. Ok, so maybe they don't want to submit the paperwork to insurance until I have done the two, but don't tell me that I have to do the other two when it is already done! That is straight up incompetence at play right here!!!!

So, I emailed them back an ubber professional reply about my concerns - I had to go in management mode like I would with my direct reports and let them have it regarding my records and their processes. Nothing I said would hurt you, just cut and sting a bit to jar them into reality that they are not dealing with a helpless and incompetent person. I requested that they contact me basically with better news.

Please tell me if anyone else has gone through this before? I don't want to be alone in this one. Help me to help them.....

[beansmomma 11]

My surgeon's office uses a 'team review' process. After the team 'accepted' me into the program, I got a letter detailing everything I had to do before the team review process, instructing me to do it all asap.

I called, very confused. Evidently the 'new person' at the office had used the wrong template letter to send to everyone who had been approved at that team review. It's easy to make mistakes, and difficult to keep patients separate. I'm not saying what your office did was awesome, or even okay, but it is the end of the year, and I'm sure they're packed with patients trying to get done before January 1st.

Trust me when I say, killing someone with sweetness is much better than being stinging or biting. I do what they do for a living. I've been there!

[woo woo 872]

No offense to the OP, but quite frankly that sort of attitude is a turn-off in just about ANY situation .... including those "direct reports" of yours for that matter... It's just really not helpful IMO

Just my opinion, but why not try a polite and respectful approach? Can't hurt and will probably help.

Good luck

[BladeFox 235]

No offense to the OP, but quite frankly that sort of attitude is a turn-off in just about ANY situation .... including those "direct reports" of yours for that matter... It's just really not helpful IMO

Just my opinion, but why not try a polite and respectful approach? Can't hurt and will probably help.

Good luck

I respect your opinion wow woo, but here's where you and I differ. See, I have been respectful and allowed the process to just happen, to the point that they have dropped the ball a few times and I had to inquire about it. I have been polite, for as mentioned, going on 5 visits, being given the pre-op because they dropped the ball once before. As a manager, you help your team along and coach them in hopes that they eventually get it right, so I am now at the place of, what else can I do. However, I entrust that my medical team will be on top of it because we hold them in high regard. I am an outsider hoping that this "top-notched" medical division of the hospital will be accountable to each patient. At this point in it, I'm sad to say that my hope is waining. I'm also beginning to wonder if it's just not for me because my pre-op journey is nothing like what I've read on this board, and also wondering if I should get off the board because it makes one anticipate in wait.

You, woo woo, can't tell me that you have never held someone accountable in your entire life. I have no other option because they are not my direct reports, but what they are is my highly regarded medical team providing a service that requires surgery and and it is my obligation to hold them accountable and ask questions.

[BladeFox 235]

My surgeon's office uses a 'team review' process. After the team 'accepted' me into the program, I got a letter detailing everything I had to do before the team review process, instructing me to do it all asap.

I called, very confused. Evidently the 'new person' at the office had used the wrong template letter to send to everyone who had been approved at that team review. It's easy to make mistakes, and difficult to keep patients separate. I'm not saying what your office did was awesome, or even okay, but it is the end of the year, and I'm sure they're packed with patients trying to get done before January 1st.

Trust me when I say, killing someone with sweetness is much better than being stinging or biting. I do what they do for a living. I've been there!

Ok, I get where you're coming from. The part that "...and difficult to keep patients separate....but it is the end of the year..." is scary, YIKES! However, it gives me a new perspective on the situation with the end of the year. Read my reply to woo woo and you will see why I seem stingy. I bet you are learning how to be a better nurse/pa/doctor from this thread.

[woo woo 872]

Well... I mean by your own admission you have two items left to be completed before your case can be submitted to insurance for approval.

I guess I don't really get what the big issue is here. So... they had you down for 4 reqs left rather than 2? OK, fine. I am very sure that you set them straight on that issue. Check. So what's the big deal now?

It seems like maybe you are just mad in general and don't like them. Which is fine, but what can you really do about it? Switch to another surgeon/practice or just deal with it.

I really just doubt that long emails from you are really going to "help" them "improve their process" as much as you seem to think it might....

Just my opinion. Please don't hit me.

[BladeFox 235]

Well... I mean by your own admission you have two items left to be completed before your case can be submitted to insurance for approval.

I guess I don't really get what the big issue is here. So... they had you down for 4 reqs left rather than 2? OK, fine. I am very sure that you set them straight on that issue. Check. So what's the big deal now?

It seems like maybe you are just mad in general and don't like them. Which is fine, but what can you really do about it? Switch to another surgeon/practice or just deal with it.

I really just doubt that long emails from you are really going to "help" them "improve their process" as much as you seem to think it might....

Just my opinion. Please don't hit me.

Not hitting just don't think that you really think objectively or thoroughly read that's all. You are entitled to your opinions however. What I can do is what I said above. READ and open your mind to offer positive feedback. Actually this feedback was much better than before. :ph34r:

[BladeFox 235]

Well... I mean by your own admission you have two items left to be completed before your case can be submitted to insurance for approval.

I guess I don't really get what the big issue is here. So... they had you down for 4 reqs left rather than 2? OK, fine. I am very sure that you set them straight on that issue. Check. So what's the big deal now?

It seems like maybe you are just mad in general and don't like them. Which is fine, but what can you really do about it? Switch to another surgeon/practice or just deal with it.

I really just doubt that long emails from you are really going to "help" them "improve their process" as much as you seem to think it might....

Just my opinion. Please don't hit me.

Oh and the big issue here is the one request that has been completed is "you must participate in monthly calls from your insurance company for 5 months" which would put me out for 10 months total. If I hadn't inquired, I would be on that roller-coaster. That's the BIG ISSUE.

[QueenCityGal 76]

I kind of feel the OP on this. My situation was a little similar. When I started the whole process I was given a list of things I had to complete before insurance submittal. I did them. When I was done, I was told it would be time to submit.... only to get another letter stating i needed to complete two more requirements before submittal because "insurance requirements have changed". Total BS because there were no changes to my policy nor was it after a policy renewal. Thank goodness I was able to complete these last required tasks in a timely manner... nonetheless I was pissed because my surgery center should have known this to begin with (or they just goofed and sent me the wrong requirement letter template). I eventually called my insurance company inquiring about these "requirements" and they told me their rules and requirements have not changed in years.

There is cause for concern here because there is zero tolerance for errors when it comes to medical stuff. Whether it be paperwork, procedures, diagnosis, surgery, whatever.

I've spent the last two years dealing with the medical disaster of a family member, and I totally get the frustration. The only way to sometimes force these professionals to do their job right is to be assertive and not take any crap and let them know you're on top of them.

I would have probably changed my surgery center based on the above, but I already came too far and my surgeon is tops in the area so I'm sticking it out. Fingers crossed there are no more issues or confusion post-op!

[BladeFox 235]

Yes, I did the same thing. Called the insurance company and they said that they didn't even have a set nutrition visit. The only thing that they required is having surgery with an approved dr, attend the info session, get the letter from my primary care for surgery, and meet with the psychologist. Again, not being nasty here, just staying on top of the situation.

I kind of feel the OP on this. My situation was a little similar. When I started the whole process I was given a list of things I had to complete before insurance submittal. I did them. When I was done, I was told it would be time to submit.... only to get another letter stating i needed to complete two more requirements before submittal because "insurance requirements have changed". Total BS because there were no changes to my policy nor was it after a policy renewal. Thank goodness I was able to complete these last required tasks in a timely manner... nonetheless I was pissed because my surgery center should have known this to begin with (or they just goofed and sent me the wrong requirement letter template). I eventually called my insurance company inquiring about these "requirements" and they told me their rules and requirements have not changed in years.

There is cause for concern here because there is zero tolerance for errors when it comes to medical stuff. Whether it be paperwork, procedures, diagnosis, surgery, whatever.

I've spent the last two years dealing with the medical disaster of a family member, and I totally get the frustration. The only way to sometimes force these professionals to do their job right is to be assertive and not take any crap and let them know you're on top of them.

I would have probably changed my surgery center based on the above, but I already came too far and my surgeon is tops in the area so I'm sticking it out. Fingers crossed there are no more issues or confusion post-op!

[Lilrosie 34]

Sorry to hear that you have to go through ANY of this at this point in the journey.

I am getting my "surgery date" on Dec 3 which is also the day they are submitting to my insurance for approval. My insurance had a check list and my Bariatric Team had a check list of items for me to complete including NUT classes and multiple doctor visits and tests.

I've completed every single thing and all of the clearances are done so I'm hoping for a smooth ride.

Sounds like nothing is a "sure thing" though, is it?

Hope it all works out for you!