Frustrated with Pre-Op process surprises

[IAMREADY! 16]

Hi, I'm new here and this pre-op process is starting to get a extremely frustrating so I thought I'd see if anyone else was having the same sort of issues I am having. Insurance covers my sleeve with a 3 month nutrition program if I use a center of excellence. I chose Johns Hopkins. My first appointment was 12/1/15. After my appointment with my surgeon (who was amazing by the way) I was sent to my surgery coordinator who gave me a folder filled with information and a LONG list of things I would need in order to get my surgery approved. She was polite, she said she new it was a lot but it was a very streamlined process since this is what they do and she'd be there to help me every step of the way. I spent hours scheduling appointments, driving to different cities, paying hundreds in co-pays, missed 30+ hours of work for the required appointments, calling doctors to get results to send back to my coordinator because she couldn't sit on hold. Then repeating some steps because the coordinator never reviewed some of the paperwork I sent in and over a month later tells me they require additional information. Towards the end of my "streamlined" process I was hit with another list from the nutritionist that will be required so then I had to double to doctors I had already been to in order to get those tests. Finally on 3/15/16 I had done everything they required including making my 5% weight goal! I contacted my coordinator several times and when she did call me back she asks about sleep study results. I told her that I had a sleep study 4 years ago and gave her the doctors info to get the results. I also told her I told the surgeon or CRNP about the study at my initial visit. She said ok and that my paperwork would go to the nurse for review then off to insurance for approval! I was so excited. On 3/29/16 the CRNP called to tell me they would require a sleep study and that I was told at my initial visit (she was very curt). I told her that I was asked and answered about my old one, and that I wasn't told about needing a new one (I definitely would have remembered because the first one I had felt like torture), it wasn't on the long list of requirements that I had methodically taken care of over the last 3+ months, and I hadn't even been given an order or referral for a sleep study. She told me she would mail it to me and I needed to make the arrangements and get the results before she could send for approval or get a surgery date. After receiving the order from my coordinator I spent another hour or so making calls (they sent the order to the wrong clinic for my insurance) and waiting for the order to be approved I made the first available appoint for 4/23 with the results follow-up for 5/18. I am so heartbroken. My 3 month process is now looking like 6 month and it is because they have added another unexpected step (sleep study) with a long scheduling lead time. Now I'm worried because several of the tests and appointments that were in my initial list were noted with time frames like must happen no more than 60 days prior to surgery and now those items will be outside of that time window since this was just sprung on me. I am really feeling down. I feel like I have ran a marathon and then they moved the finish line on me after I started celebrating. Why would they not tell me about this sooner? Why am I having to do so much coordination for this "streamlined" process on top of focusing on my new way of eating and living? Why would I even need a sleep study since 4 years ago I didn't have apnea and was basically the same weight I am now (not to mention I don't have any of the symptoms besides weight)? I would think I would be well monitored during and after surgery regardless of if I had apnea. I know both my coordinator and CRNP know I am frustrated with them and the way my case has been handled...should I look for a new surgeon or just tough this out? Anyone else out there going through similar hurdles? Thanks for reading.

[oceangirlpc 68]

i'm sorry, I am with you on this process. I was told mine would be a 6 month wait through my insurance and now with the weight loss center it is now their requirements that I have to complete. I am on 9th month of procedures and extra stuff to do. I have sleep Apnea and currently have a machine. My list of to do's included that but now not necessary since I currently have Sleep Apnea. Truthfully they don't care about your being tested 4 years ago. They want everything current. It is exhausting and frusterating. I am hoping to look at June for my surgery if all goes well. That will be 11 month into my process. Good Luck and hang in there our time will come.

[IAMREADY! 16]

Thanks, I hope you're right. I can understand the need for current testing, but not why I was told about the study AFTER I completed everything else. Plus I don't know why I would need the test, I don't need a comorbidity since my BMI is well over 40. I feel they could have at least admitted they let this slip through the cracks and explain why I need the test. I'm just a Debbie downer today I guess. I will keep fingers crossed for a June surgery date for you...11 months is a long time. Good luck!

[Christinamo7 4,042]

please get the name of the office manager and speak to that person about what you are going through. I work at a doctors office and sometimes the manager can review things and make sure what is being asked is truly needed and if so help you move the process along sooner.

my path to surgery hit a medical snag that tied me up for a year, and made me jump through several hoops. I was heartbroken several times, but I finally had surgery in February. Hopefully you will be posting here this year with a success story too. I know how hard it is.

[IAMREADY! 16]

Thank you Christinamo7. I was unable to find an office manager or program manager's contact info online so I just sent an email to my coordinator asking for information. Congrats on finally getting your surgery and good luck on making all your goals!!

[ava32 48]

Jeez. My insurance requires 6 months. I almost halfway through. My appointments are very expensive, luckily insurance covers some of it. I looked at a bill for one of my visits and was charged $400+. All the physician assistant asked if I'm having problems with my diet or if I needed help with meal ideas. Total visit was about 8 minutes and I got charged $400. I just can't wait until I'm done.

[Momwith3minions 52]

I started Oct 2015. My sleep study was end of Nov 2015. My pre-op NUT visits were Jan, Feb, March 2016. I got the insurance approval last week. My surgery is next Thursday, April 7. That makes 6 months total from start to finish.

I am so sorry about the sleep study error. That was the longest process for me. Hang in there! You have every right to be upset. I wonder if there is a sooner if possible list the sleep study place can put you on.

Edited April 1, 2016 by Momwith3minions

[Falecha 50]

Hi, I'm new here and this pre-op process is starting to get a extremely frustrating so I thought I'd see if anyone else was having the same sort of issues I am having. Insurance covers my sleeve with a 3 month nutrition program if I use a center of excellence. I chose Johns Hopkins. My first appointment was 12/1/15. After my appointment with my surgeon (who was amazing by the way) I was sent to my surgery coordinator who gave me a folder filled with information and a LONG list of things I would need in order to get my surgery approved. She was polite, she said she new it was a lot but it was a very streamlined process since this is what they do and she'd be there to help me every step of the way. I spent hours scheduling appointments, driving to different cities, paying hundreds in co-pays, missed 30+ hours of work for the required appointments, calling doctors to get results to send back to my coordinator because she couldn't sit on hold. Then repeating some steps because the coordinator never reviewed some of the paperwork I sent in and over a month later tells me they require additional information. Towards the end of my "streamlined" process I was hit with another list from the nutritionist that will be required so then I had to double to doctors I had already been to in order to get those tests. Finally on 3/15/16 I had done everything they required including making my 5% weight goal! I contacted my coordinator several times and when she did call me back she asks about sleep study results. I told her that I had a sleep study 4 years ago and gave her the doctors info to get the results. I also told her I told the surgeon or CRNP about the study at my initial visit. She said ok and that my paperwork would go to the nurse for review then off to insurance for approval! I was so excited. On 3/29/16 the CRNP called to tell me they would require a sleep study and that I was told at my initial visit (she was very curt). I told her that I was asked and answered about my old one, and that I wasn't told about needing a new one (I definitely would have remembered because the first one I had felt like torture), it wasn't on the long list of requirements that I had methodically taken care of over the last 3+ months, and I hadn't even been given an order or referral for a sleep study. She told me she would mail it to me and I needed to make the arrangements and get the results before she could send for approval or get a surgery date. After receiving the order from my coordinator I spent another hour or so making calls (they sent the order to the wrong clinic for my insurance) and waiting for the order to be approved I made the first available appoint for 4/23 with the results follow-up for 5/18. I am so heartbroken. My 3 month process is now looking like 6 month and it is because they have added another unexpected step (sleep study) with a long scheduling lead time. Now I'm worried because several of the tests and appointments that were in my initial list were noted with time frames like must happen no more than 60 days prior to surgery and now those items will be outside of that time window since this was just sprung on me. I am really feeling down. I feel like I have ran a marathon and then they moved the finish line on me after I started celebrating. Why would they not tell me about this sooner? Why am I having to do so much coordination for this "streamlined" process on top of focusing on my new way of eating and living? Why would I even need a sleep study since 4 years ago I didn't have apnea and was basically the same weight I am now (not to mention I don't have any of the symptoms besides weight)? I would think I would be well monitored during and after surgery regardless of if I had apnea. I know both my coordinator and CRNP know I am frustrated with them and the way my case has been handled...should I look for a new surgeon or just tough this out? Anyone else out there going through similar hurdles? Thanks for reading.

I'm so sorry for ur problem its like u want something so bad and its almost in the palm of ur hand and its taken away from u my heart goes out to u I would look for another surgeon but that's just my opinion??

Falecha

[kmorri 1,689]

wow! I'm sorry you're having such a rough time. You've been through so much at this point I would be afraid to change surgeons as it may end up starting the whole process over again.....someone else suggested the office manager ....that's probably your best bet. I can't believe they have you making all the appointments and stuff....what is the coordinators job? My surgery coordinator has done everything for me. She scheduled all my appointments and emailed it all to me to put on my calendar.....

I hope it all works out for you very soon.

Kathy

[Loudy227 96]

I was able to be put on a wait list for my sleep study and I ended up getting it done almost a month earlier. Maybe you can, too.

[Tssiemer1 549]

sleep study was definitely the longest part of my pre op process.

[missvee 28]

Hi, I'm new here and this pre-op process is starting to get a extremely frustrating so I thought I'd see if anyone else was having the same sort of issues I am having. Insurance covers my sleeve with a 3 month nutrition program if I use a center of excellence. I chose Johns Hopkins. My first appointment was 12/1/15. After my appointment with my surgeon (who was amazing by the way) I was sent to my surgery coordinator who gave me a folder filled with information and a LONG list of things I would need in order to get my surgery approved. She was polite, she said she new it was a lot but it was a very streamlined process since this is what they do and she'd be there to help me every step of the way. I spent hours scheduling appointments, driving to different cities, paying hundreds in co-pays, missed 30+ hours of work for the required appointments, calling doctors to get results to send back to my coordinator because she couldn't sit on hold. Then repeating some steps because the coordinator never reviewed some of the paperwork I sent in and over a month later tells me they require additional information. Towards the end of my "streamlined" process I was hit with another list from the nutritionist that will be required so then I had to double to doctors I had already been to in order to get those tests. Finally on 3/15/16 I had done everything they required including making my 5% weight goal! I contacted my coordinator several times and when she did call me back she asks about sleep study results. I told her that I had a sleep study 4 years ago and gave her the doctors info to get the results. I also told her I told the surgeon or CRNP about the study at my initial visit. She said ok and that my paperwork would go to the nurse for review then off to insurance for approval! I was so excited. On 3/29/16 the CRNP called to tell me they would require a sleep study and that I was told at my initial visit (she was very curt). I told her that I was asked and answered about my old one, and that I wasn't told about needing a new one (I definitely would have remembered because the first one I had felt like torture), it wasn't on the long list of requirements that I had methodically taken care of over the last 3+ months, and I hadn't even been given an order or referral for a sleep study. She told me she would mail it to me and I needed to make the arrangements and get the results before she could send for approval or get a surgery date. After receiving the order from my coordinator I spent another hour or so making calls (they sent the order to the wrong clinic for my insurance) and waiting for the order to be approved I made the first available appoint for 4/23 with the results follow-up for 5/18. I am so heartbroken. My 3 month process is now looking like 6 month and it is because they have added another unexpected step (sleep study) with a long scheduling lead time. Now I'm worried because several of the tests and appointments that were in my initial list were noted with time frames like must happen no more than 60 days prior to surgery and now those items will be outside of that time window since this was just sprung on me. I am really feeling down. I feel like I have ran a marathon and then they moved the finish line on me after I started celebrating. Why would they not tell me about this sooner? Why am I having to do so much coordination for this "streamlined" process on top of focusing on my new way of eating and living? Why would I even need a sleep study since 4 years ago I didn't have apnea and was basically the same weight I am now (not to mention I don't have any of the symptoms besides weight)? I would think I would be well monitored during and after surgery regardless of if I had apnea. I know both my coordinator and CRNP know I am frustrated with them and the way my case has been handled...should I look for a new surgeon or just tough this out? Anyone else out there going through similar hurdles? Thanks for reading.

I originally started my process at AAMC last August and was very uncomfortable and felt they were giving me the run around. Needless to say after the 3rd visit I didn't schedule my next because they wanted me to do tests I didn't need and would ultimately make me come out of pocket much more than I had planned. I expressed my concerns and it was like I was a bother to them.

Started again at GBMC in February and since the first visit with my surgeon I've felt nothing but confidence and actual help from the staff.

If it doesn't feel right go somewhere else. However, consider the cons does your insurance require consecutive visits? Will the next program use the prior visits to submit for you or only want to use their own?

Go with what feels right for you

Sent from my iPhone using the BariatricPal App

[mmell 22]

Hi guys....I just want to say I feel your pain, but you must stay focused, and patient. I met with my surgeon the first time at the end of Oct. 2014...that's right Oct. 2014. I am finally getting my sleeve on 4/18...yahoo!!!!! My surgeon didn't think I was making the appropriate progress. He is very strict, (which I like), and the extra time, although frustrating, was necessary to get my HEAD ready. It's not a race, it's a lifetime commitment. You"ll all succeed at differing rates, so take the time to really analyze your eating habits, and pinpoint your strengths and weaknesses. By the time I'm sleeved, I will have lost 90 lbs. on my own. I have about 175 to go after that. I wish you all, the best and healthiest journey, on your way to your final goal. And if you get frustrated, think of my 536 day journey.. Good luck!!!

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[IAMREADY! 16]

Thanks for all the support. I took the advice and contacted the program manager and and she was helpful. Although The surgeon is still requiring the sleep study 4/23/16 , She spoke with the nurse and coordinator and they agreed to at least put in the request to my insurance company (Aetna) on April 6th. I got a call that I was approved and my surgery is scheduled for June 15!! Thanks again for the advice and support!!

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[Inner Surfer Girl 12,015]

Thanks for all the support. I took the advice and contacted the program manager and and she was helpful. Although The surgeon is still requiring the sleep study 4/23/16 , She spoke with the nurse and coordinator and they agreed to at least put in the request to my insurance company (Aetna) on April 6th. I got a call that I was approved and my surgery is scheduled for June 15!! Thanks again for the advice and support!!

Sent from my iPhone using the BariatricPal App

I am so glad you got approval. The whole pre-op process requires a great deal of patience, polite persistence, and perseverance. It will be worth it in the end to have a safe surgery.