I'm so pissed

My last visit to the Dr. was 10/17 . I was told then that they were going to submit everything to BCBC and it would take two months for insurance approval. I called them before Thanksgiving and asked if they heard from the insurance co. yet . They told me they didn't and they would call me as soon as they did. Well, I just got off the phone with the DR.s office and they told me they didn't even submit the paperwork yet that they were waiting for me to get my 5 year weight history from my primary DR. before they could submit any paperwork to BCBS.WHAT!!! I've been waiting for approval for over two months and they were never in touch with me to tell me that they needed my weight history? I told the woman at the Dr.s office that this was the first time I heard of the 5 year history thing. She insisted that I was told all about it . I felt like she was calling me a liar . As a matter of fact that was exactly what she was doing .Bitch!!!! I've been working on getting this surgery since Jan. I did EVERYTHING they told me to do when they told me to do it so why would I intentionally leave out an important piece of the plan? At least admit they made a mistake .And why didn't they call me two months ago and ask about it . I'm sitting here crying I feel like they wasted a year of my life.Can I still trust them ?

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i know exactly how you felt i went throught the same thing. i was referred to my surgeon from my pcp so i went to my surgeon for my 6 month of weight checks. then when everything was submitted my insurance company said they needed weight checks from my pcp and then a letter of recommendation from my doctor and i was like but i did the weight checks at my surgeons office. i was irritated by then thinking all this work and then to do another 6 months with my pcp for weight checks. thank god they just accepted from the surgeons and i faxed them a letter of recommendation. i started my journey in january by the time the insurance co approved me and was able to get a surgery date it was december 12,2007 even though i shoulda had it sooner it was well worth the weight.

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rochelle crissman
new lapbander
12/12/07 date banded
initial wt.294
current weight 209
MERRY LOSERS
url=http://www.TickerFactory.com/weight-loss/w2H2huB/]

[/url]

When I started my weight loss journey in August I figured out right away that my hospitals staff were not the brightest bulbs on the Christmas tree.

In September to the dietitian which was the last person I needed to see for approval, says "every thing looks fine I'll send all the paper work in tomorrow". So I go Off to Las Vegas for two weeks naively thinking that when I get back I'll be setting up a date for surgery. She calls me on the last day of my trip and say she just needs to get my weight because she wrote it down wrong during our visit. After being completely dumb founded for a few seconds I asked why she was just now calling me and her answer was of course " I've been busy." Even now she doesn't return calls.

Which Is why I love this site. There's always someone who can give an answer to even the silliest sounding question.

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Iowa
10cc Band November 1 st, 2007
Rebanded November 27 (Cracked tubing)
1st fill 3cc Dec. 13 2nd fill 1cc Dec. 27 3rd fill 1cc Jan. 10 4th fill 1cc Jan 31 5cc's total. Very tight and very happy.

I had a similar situation: After the surgeon's office sent in my info I got a denial letter from my insurance co saying I hadn't met all the requirements. I was crushed, and had a second or two where I considered giving up. But I really thought I HAD done everything I was supposed to. I called the surgeon's office and they said I didn't send them everything that was required (which made me wonder then WHY they sent anything??) But I contacted my family Dr (who was very supportive) and she called my ins co, then faxed over the info they wanted - and I got an acceptance letter the next week! So I would say don't give up, take a deep breath and send the surgeon's office what they want, OR maybe see if your pcp can step in and contact your ins co directly. These things happen - the people at the surgeon's office have many, many people to handle, and tons of paperwork. I know it doesn't make the waiting any easier though!!!

Good Luck!!!!!

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Forestcat






30 lbs lost pre-op
Band Date: Nov 1, 2007
Cleveland, Ohio

Is there another doctor in your area? If so, walk into your surgeons office and tell them you want copies of everything in your file. Once you get the copies, tell them that if they want to keep patients, maybe they ought to you with the respect of doing their jobs properly.

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Mini goals: [250 REACHED] [230 (50 lbs lost) REACHED] [210 (half way) REACHED]
{195 REACHED WOOO!!!} Current Mini Goal 180 (100 lbs lost)
165 (the weight I remember most form jr. high)
140 (FINAL GOAL)

5 year weight history is what BCBS used to deny me. I said F that, went ahead as a self-pay, then submitted anyway and have been paid for everything except the hospital stay. So out of a $23k bill, I've ended up paying about $13k.
Don't lose hope!!

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Banded 9/27/07

Ford Ironman 70.3 Orlando, FL May, 2009
NJ State Triathlon July, 2009

Thread Starter

If I knew for sure I wouldn't have to go through the whole process all over again I would go to a different Dr. We have at less three or four in the surounding area . This one was suppose to be the best . It wouldn't be so bad if they would admit that they made a mistake instead of blaming me for their mistakes . Just say we're sorry we thought we told you that we needed your weight history .and then why wait over two months to call me to get . After they put the package together and saw it was missing call and ask for it don't wait two months and tell me that I called in Nov.they didn't tell me that it was submitted and they were waiting approval. I know what they told me .

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Thread Starter

I got my weight history and mailed it to the Dr. office they said they received it and submitted everything to the insurance co. on the 1/9. Now my two month waiting period starts all over again. I hope it goes by fast .

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Does the doctor know what happened to you? I would certainly make sure he/she does. They need to know how front office is treating their customers.

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Artsy
Banded 12/19/07

Thread Starter

When I mailed them my paperwork I also inclosed a letter to the Dr. about what happened and how I felt about it . I haven't heard anything from him . When I called the Dr.s office to see if they received my history they didn't say anything about it and when I started to say something I was told that it was in the past and we have to move forward now . No apology , She just brushed it aside like it never happened. Like I said before if I didn't have to start all over again I would go to another Dr.

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I strongly suspect the doctor never saw that letter. You're back on track now, though! Good luck.

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Artsy
Banded 12/19/07

Thread Starter

Thanks I need all the good luck I can get and I think you're right about the Dr. not seeing the letter.

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I have BCBS and they covered me 100%, but I had to submit a 5 yr history and get the surgeon to write the reccomendation to BCBS. I called my insurance company myself before even seeing a dr about it though. I just called and asked if it were covered and what the exceptions were....sorry you are having bad luck with yours. I hear BCBS of Texas is the WORST !

Thread Starter

Approved at last ! I got a letter from BCBS yesterday that said I was approved. I call the Dr's and they didn't hear anything yet so they are going to call BCBS to confirm it on Tuesday then call me to set the date for surgery. I'm so excited!

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Congratulations on finally getting through all the red tape. Let us know your date.

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