Feeling frustrated

[baileyj908 37]

Feeling frustrated. Last Thursday was my last weight management class. My nurse assured me I had everything and the case manager should submit all my info to my insurance on Friday of last week. I called Tuesday to check that everything was submitted. The caseworker did not know I finished my 6 classes. She then went through and said that I didn't have my psych clearance letter and asked if I had it done. I told her yes back at the end of August - using the person in their office. She said she would get it and then call be to confirm everything was submitted. I called today again to check and was told she had the day off. I'm a teacher and am planning on having the surgery done over winter break. I'm worried that if for some reason it is not approved at first that it will take too long to appeal and I may not be able to have it done over break and will have to wait. I really wish it had been submitted last week - if it had I should of had a decision by next week.

[2goldengirl 2,076]

Call and ask to speak to the Office Manager and explain your concerns. Be polite, but be clear that you have a narrow window to plan for your surgery and recovery. If you have the dates and names of people you spoke to, so much the better.

[fluffytofit 25]

I'm going through the same thing right now. Everything was submitted on 10/29, except the psych eval. I have called insurance everyday to see if they've gotten it. I'm really anxious to get an approval as I need to put in for my time I need off. My insurance company has been so helpful with calling the office to try and light the fire under their butts.

[Ellenomore 25]

Going for my last dietitian visit today. I hope I do not run into these problems with the clinical coordinator. Typically if everything is submitted how long does it take for your insurance to get back to you with a response?

[ar1kah12 3]

I'm in the exact same boat! I have been so upset and wanting to quit bc I've been working on this since July14th and had my psyc eval July 27th and was told I was passed. Then I finally finished nutrition portion last month and was told I'm clear to make my pre-op appt with the surgeon. Then a week after waiting on the bariatric nurse to call me back with my appt she tells me that psyc has not entered anything yet via notes on my records. So I have been trying to get in touch with psyc she was off so I had the secretary send an email, I have called her direct line for a week!!! After she finally signs off on it officially, I still have to make appt with the surgeon so he can schedule my EGD. Then make anther appt to look at my EGD, to make another appt for the actual surgery. I'm scared that it won't get done in time for me to be able to recover over Christmas break. If this happens I will probably have to wait until spring break in April. The problem doesn't lie with how many more appts I have, the issue is waiting on a phone call after multiple messages and emails!! I am upset that after months of appts hard work that they forgot to put it in the computer or they take a week to actually make an appt that is probably another few weeks out

Edited November 6, 2015 by ar1kah12

[Inner Surfer Girl 12,015]

This is a very busy time of year with many people in the same situation as you trying to get surgery approved and scheduled before the end of the year because of insurance, scheduling, holidays, etc.

I suggest you be patient, polite, proactive, and very persistent in following up and staying on top of the process. Try not to treat the staff (who are slammed and probably a bit overwhelmed right now) as adversaries but allies.

Have faith but do what you can to help get everything completed.

[baileyj908 37]

I'm feeling a little better today. I spoke with the case worker today and she assured me that she got it and sent everything over to my insurance. So now I'm just waiting for my insurance to approve but they scheduled me for December 18th. I plan on calling my insurance on Monday to double check that they got everything.

Edited November 6, 2015 by baileyj908