What would you do?

[1000words 0]

I have a tendancy to overreact a bit... I am also not a patient person. So, I am hoping that a few of you might be able to give me advice on how to handle this situation.

Basically I have been working towards getting the lap band for a few months. I was going through a local hospital's obesity center and everything was going great. The lady that handles the clinic was very attentive and quick to answer questions and phone calls. I like her a lot.

But, things have seemed to change there and I am not sure what the problem is.

I had my evaluation appointment two and a half weeks ago. I made sure she had all the paperwork from my other physicians she needed and my primary had ordered the bloodwork. Unfortunately the day after my appointment, the lady that takes care of submitting items to the insurance company went on vacation for a week. She said she was going to try to have everything ready for her assistant to send to the insurance company while she was gone, but she didn't finish the cover letter. So, my file set on he desk for the week she was gone.

She got back over a week ago, but when I called her she told me that I was number 5 on her list of people to finish and she probably wouldn't get to me until last Monday. Nothing was submitted last week... after I left several messages she emailed me a one line answer saying she should submit it on Thursday. I called her office on Friday and spoke to her assistant who told me she was out of the office and would call me on Saturday. The assistant told me she was unsure whether or not my file had been submitted. Of course, no calls came on Saturday.

Since I am tricare, she told me that we would probably get an answer the same day. I spoke with Tricare on Friday and they said that nothing is even pending in the system yet.

She also told me at my appointment that I should expect to have my surgery in two weeks... now we are on our third week.

I am not mad at the office, I am just confused. I am clueless how my file went from getting done in the day before she left to sitting on her desk for more than a week after she gets back. And if she ever called me and explained what the hold up was or that she was really busy, I would understand more... but the silent treatment is killing me.

To make matters worse I have remicade infusions and I have to schedule the surgery when I am due for the infusion which is right now. If I get my infusion now I have to wait for another 6 weeks.

Should I just sit and wait and not say anything else? Should I go by her office? The person that I am waiting to submit the approval is also the same person that does the fills.

Okay, that was another long vent. Thanks for your replies.

Edited May 12, 2008 by 1000words

[cindy730 0]

This sounds very familiar, are you in Indianapolis?

[MerryHearted 20]

I'd probably call one last time, explaining that I just needed to know whether to go ahead with this current infusion or hold off.

My guess is that you are going to need to go ahead with your infusion and plan to be banded 6 weeks out by the time she finishes & submits your paperwork, gets approval, and gets you scheduled for an actual surgery date.

How frustrating! Hope you hear good news on Monday if you call.

[HF2008 0]

Tricare is pretty quick with approvals...You can check the website for updates 24/7....If I were you ... I would go to the office and explain your delimna and I would hope they would do it ... right then! My gosh I know that sucks...Does your surgeon require a pre op diet? If not then if they would finally go ahead and submit it....you won't have long to go considering you have done everything else. Good luck!

[MissCT234 0]

WOW things happen quick where you are. The process here in Maine takes 9-14 months! MONTHS...you must first see the social worker..then the nutritionist...then attend a seminar..meet the surgeon...have all other tests (I had to have an endoscopy, colonoscopy, and stress test)...attend a support group meeting....complete a nutrition quiz..THEN they send your stuff over to the surgeons office....

Then you wait (It took almost two months) for office to process through insurance and find a date..which is usually a month away. And they will not process until you give them a $500 deposit (Even though I don't have to pay that much with my insurance.)

I was lucky because I knew a lady at the obesity clinic and she gave me cancellation appointments so I started in August and was operated on in May...And that was the FAST TRACK.

trust me, you will survive the wait. I think.

Cindi

[1000words 0]

Thanks for all your replies.

Yes. Luckily Tricare and the doctor does not require a lot of extra crap to get the band. And, it is not that I could not wait for a few months... I would struggle through any hoops that I needed to jump through. My problem is that two and a half weeks ago I was told to expect to have the surgery in two weeks... and that time has passed and my file had not been sent to the insurance company... and no one has offered me an explanation.

I am a worry wart and I am running through several scenerios in my mind... including that the doctor or the hospital has decided not to take my insurance for the procedure... since I know that topic was being discussed and they decided to take me as a patient and see what they pay before they decided to take more.

And, I have been on the pre-op diet since my appointment.. no big deal just sugar busters. I am doing well and have lost at least 10 pounds.

I agree that I might have to go ahead and get my Remicade and wait out another six weeks... I am just aggravated that I didn't go ahead and get it two weeks ago because I was told I would have my surgery by now.

[amsderb 1]

Well, my approval got delayed too...but it will work out just be kind and persistant! Stress will not help you right now...I have waited since my approval for about 8 weeks so it does go by fast....

Good Luck! All good things happen to those who wait!

[pennyt 14]

Why do you take Remicade? I get infusions also, but they were OK with me having my infusions on 5/6/08, and then on 6/3/08, and surgery on 5/21/08.

I have Crohn's Disease (and rheumitoid arthritis), and maybe it's different for you because you get the Remicade for another reason.

[1000words 0]

I am taking Remicade for Rheumatoid Arthritis and Remicade causes a delay in healing. I was always told that you should wait to get any dental work or surgeries until you are due for Remicade and then wait for at least two weeks after the surgery to get another infusion.

I know every doctor is different, but personally I wouldn't want to take remicade so close to the surgery. Even after I had a c-section three years ago my rheumatologist wouldn't let me have an infusion until the wounds healed.