My sad tale of woe...

[larrydoz 11]

Not really "woe" but a hurdle to clear.

I went through my 6 month weight loss program, got a sleep study, got a cardiac clearance, and generally jumped through all the hoops required of me.

On the very day I had my last weight loss appointment, I went to work after the appointment only to be told that my company would be switching providers in 30 days.

YIKES!

A quick look online showed that my new provider also covered gastric bypass.

After talking to my nurse navigator, we decided to wait the 30 days and then talk to new insurance company. my navigator hasn't been able to find out if I've met their requirements, so we just submitted a claim last week, figuring they'll let us know if we haven't met their criteria.

Keeping my fingers crossed. Hoping for the best but expecting I will have more hoops to jump through.

[Djmohr 6,965]

I will keep my fingers crossed for you. How frustrating! I hope everything works out for you with this provider and thank goodness they cover it!

Good luck!

[oweemytoe 43]

keeping my fingers crossed for you too!! Same thing happened to me and it took nearly 8 months from start to surgery .. but don't give up hope. The extra time really does help!

[AquariusDiva 15]

Something similar to mine. I have approval from my current insurance that came through last week after the six month diet, and a denial and appeal. but doc was off for the last two weeks of December and come January we will have a new insurance . So I will have to wait and see if the approval transfers.

[larrydoz 11]

we heard back from the new insurance company last week. They want me to do their 10 week telephone course, and we'll resubmit once that is complete. Disappointing, but at least I see a clear path forward again.

[larrydoz 11]

Okay, so after completing one telephone class for new insurance company - coopportunity - I go to work and boss tells me they just got word that coopportuity is bankrupt and our company will switch to United Healthcare on Feb 1.

I'm beginning to just enjoy the humor of all of this and have placed it all in God's hands.

[AquariusDiva 15]

Hey Larry, maybe it's not such a bad thing as long as the plan covers the surgery. With united you need a 5 year weight history, 6 months supervised diet, PCP letter .etc. so if you already had that completed, your coordinator can just submit it for approval come feb. 1st. Skipping the 9 weeks of phone calls...

[AquariusDiva 15]

Update: my new insurance thought the surgery doctor report, the nutritionist eval and the psychologist was too outdated for them. So I had to reschedule all of those (for today). I'm hoping that the 6 month supervised diet from last year won't be a problem now and resubmit everything (again).

Edited January 21, 2015 by AquariusDiva

[larrydoz 11]

Hi Aquarias,

That's what I'm hoping. What is a PCP letter?

Larry

[AquariusDiva 15]

Your regular doctor

[AquariusDiva 15]

UHC is the insurance I had last year, did everything, submitted and was denied. The doctors office appealed it and was approved. But bc of timing and new insurance, here I am a year layer - jumping through hoops. I will say that I have learned much from this site during that time.

[larrydoz 11]

So... after I FINALLY got my new insurance card, submitted. They told my nurse it could take up to 2 months for approval. seven days later....BAM! Approved! Surgeons visit on 3/17

[Djmohr 6,965]

I am so happy for you! I think I was holding my breath hoping not to hear a bad news update.

Congratulations and keep us posted on your progress!

[Kimberly Bouche-Perez 48]

congrats!!!!!!!!!!!!