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Tired of Jumping Through Hoops -Discouraged



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:mellow:

Yesterday I received a call from the surgeon's office. The secretary received my echo-cardigram and wanted to know if dh and I "were still considering surgery because we haven't heard from you." I emailed her back (I'm a teacher and can't take calls or really make calls) and told her we were doing the "6 months documented weight loss" like our BCBS insurance states. She told me our primary hasn't sent any notes over and that the surgeon should be reviewing these monthly. WHAT? Nobody ever told me that. I've been in contact with the head bariatric nurse monthly and she never mentioned it! The surgeon is the one that SUGGESTED we go to this new primary doctor! The secretary also said she never received any paperwork on our psych. evaluations, dh's sleep study, etc., etc. On all of that paperwork we wrote the surgeon's name...they are all under the same health system. AHHHHHHHHHHHHHHHHHHHHH! :thumbup:

I have been meticulous and trying my damndest. If I knew the primary was supposed to fax notes montly, he would have. The secreatary also said that we need to go to a few support group meetings to "beef up our insurance approval." I emailed back and asked if we could go prior to paying the $950 program fee (I don't want to pay this fee unless we are approved). I am so frustrated. I tried to get most of the apts. out of the way this summer before we both had to go back to teaching. Now I'm going to have to spend every free minute calling all of these doctors begging for my and dh's records to be sent over. I just feel like crying. I know I'm whinning and being a baby...but after a rough day to get this email back just put me over the edge! :-(:cool2:

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start with calling your primary and see if they are there. What I did was had everything sent to my primary and when my six months was up it was all at the same place. She then sent all paper work to my surgern and they sent it for approval.

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I know how frustrating this process can be too. My ins requires the same 6 month program and my surgeon's office wanted to review the documentation too. The only reason they wanted this info though, was because they wanted to make sure my DR was documenting all the necessary info for the best chance of approval. There are several PCP's that don't do much on the notes and have been denied for lack of info on the Dr's notes, so my surgeon's office wanted to make sure we were on the up and up. Hopefully this is the case for you too and it is just a matter of getting all the info to the surgeon's office for review. They should be able to get you a standard form letter for release of medical info that you can sign and mail/fax to the PCP, sleep test, etc; so you won't have to be calling all over...plus they will most likely want your signature on file authorizing them to release this info to the surgeon. Good luck!!

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It sounds like you are on the right track as far as your diet. It is the surgeon's preference not the insurance company to get it monthly so if you fax everything now it shouldn't be a big deal. I had to fill out the release form at each specialist's office then they faxed it all over. I am sure that as long as they get everything to submit at the end you will be fine.

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