Grrrrrrr - ThinnerTimes

VickiLyn · 05-14-2008, 01:55 AM

Well..... What I thought may be a easy process, more than likely just got harder. A couple weeks ago, I talked to the Nurse Practioner where I work and she seemed like she was gung hole about helping me get the papers I needed to submit to the Insurance company. Well, yesterday finally received my medical file from them which isn't very big since I'm just not a go to the doctor kind of person. She would not write the letter that they asked for at the seminar, nor fill any kind of additional papers out like weight loss etc. Also, we had a dietician come in once a week last year for what they call lunch time learning, theres no documentation that I attended and she won't write up a sheet on that either. So, I am a little bit dishearted and afraid that this may hurt me in the insurance approval department. I've been so excited, but now afraid all that excitement just set me up for a big fall.

Discouraged

SDeRossett · 05-14-2008, 02:18 AM

Often times some have to jump through a lot of hoops to get there, but you will if you keep fighting for it. Just keep plugging away and see if there is anything else you can do to satisfy the insurance companies documentation requirements. Perhaps you can start by setting up an appointment with a doctor for a physical and then also bring in the weight loss surgery and past attempts to lose weight, that would be a start on some documentation. Wishing you luck.

Sharon

Native2u · 05-14-2008, 08:00 AM

Quote:

Originally Posted by VickiLyn

Also, we had a dietician come in once a week last year for what they call lunch time learning, theres no documentation that I attended and she won't write up a sheet on that either.

If I were you, I'd write a "personal letter" to you insurance company and in the letter of your life's history....include that you have attended "lunch time learning seminars" at your workplace for __ years/months.....and that the dietitian's name is _______________ and her address is ______________(give full address).

Here is another thought. If you have to see a dietitian for your insurance company, offer to pay her fee.....and ask her include the fact that you have been in these classes for __yrs/months.

Godsblessedme · 05-14-2008, 09:07 AM

I'm living proof that you can do this! just keep fighting! it took me 1 1/2 years to get approval and now i'm 4 months out. You just have to stay at it and let them know your NOT quitting

Angel~in~KY · 05-14-2008, 10:20 PM

Vicki, it's not unusual for this process to be drawn out but that doesn't mean you should give up at the first sign that it won't be easy. Just keep your eyes on the prize and do what needs to be done. Don't give up, you can make this happen! Every time you think it's more hassle than it's worth just think about where you want to be five years from now, and if you're like me, there aren't many options for getting there.

VickiLyn · 05-20-2008, 04:56 PM

Update:

Two weeks ago, I sent a letter to my Primary Doctor to release my Medical Records to Dr Dyer so I can start the insurance process. I know I know, I should of went there to get this done, but I'm working 10-12 hours a day right now and on Saturday, and I just can't afford to take off. (We have a point system at work, and what points I have; I save in case the baby gets sick). So, anyways today I called to see what the hold up is and was told they never received the letter (I find that hard to believe), but I said okay and got the fax number and faxed the release form right then. I asked when she would be able to get these sent and was told the medical records department was way behind and she couldn't give me a time. Grrrrr, the sooner I can get these the sooner the process continues. I politely thanked her though (knows how it is to be behind) and said I would appreciate it as soon as possible. So hoping my niceness wins over and I have them by the end of the week cause they don't want to see my bad side...lol...

Heres to hoping she hurries..........

~Vicki~

Godsblessedme · 05-20-2008, 05:00 PM

God girl i would be mad too. Keep it up it really will pay off in the end

Angel~in~KY · 05-21-2008, 01:34 AM

I hope she hurries for you... but keep in mind, you did say you wanted me to go first (and I don't have a date yet).

I had a complication with records too which I'm hoping is resolved now, gonna give a call to the office today to find out the status.

So after records what the next thing you have to push for?

VickiLyn · 05-21-2008, 06:15 PM

After I get my medical records in, its a waiting game I think until insurance approves. One lady at work it took, 2 weeks. Another lady (same insurance) took almost 3 months. After the insurance approves I can most likely get a surgery date within a month, month half. I have to have a Psych evaluation,and see the nutritionist but was told I should be able to do it all in one day, so thats a plus since its a little bit of a drive to Nashville.

I hope you get your date soon Angel, I want you to go ahead of me but not by a whole lot.

~Vicki~

Angel~in~KY · 05-22-2008, 04:04 AM

I called yesterday to find out the 'status' of my stuff and the insurance coordinator at WLS doc's office said she had just sent in my stuff that morning. She had already submitted my info once but the insurance company requested more (I don't think they outright denied me the first time).

She seems really convinced that with my diagnosis of Pseudotumor Cerebri that they would make an exception for me even if I didn't qualify... but I do qualify. She also said that UHC is fairly fast with the approvals when all the criteria are met. So I'm still optimistic that my date will be mid-June. You better get to pushing so you can be my little WLS sister