June 30th - What Happened???

I woke up the day of the surgery and tried dealing with the insurance company to get to where we needed to be before leaving for surgery.

To make a long story short, Mike's insurance would not cover as secondary if my insurance would not cover due to lack of paperwork. They would only cover as secondary to my insurance if my insurance did not cover the procedure or if my insurance was going to cover it. I had sent the requested paperwork to my insurance 3 times since January and for whatever reason, it was not sufficient and was grounds for denial. I had really just been too fed up to fight with them any more. So when Mike's insurance said yes, I figured everything would be fine.

So here I was, back and forth with both insurance companies, distraught and frustrated. At 10am the surgery was officially postponed. I felt as if someone had just snatched all hope from me.

I had gone through the fasting the day before with only clear liquids and did not eat until the next day. The week before the surgery I was focusing on simple foods like Slim Fast, bananas, cottage cheese, V8 Splash, etc. in order to get ready. In the process I had began shrinking my stomach. After gathering my thoughts I decided that I was not going to give up. I kept eating this way for three more weeks.

I was on the phone with everyone I could think of on the day they postponed. All the Doctors I had seen over the past two years were called and asked to re-submit my medical records to my insurance company. It took a full week (the 4Th of July weekend fell in between) before records started pouring in to them. I called twice a day to see what they had received and where things stood. I was told they had up to 30 days to review the material before they made a decision.

There was really no need to get angry over this. Everyone else who had been excited for my was mad enough. My mother couldn't understand why I seemed to be un-phased by the postponement. What else could I do? I was already having the records re-submitted and appealing the previous denial. Getting upset would have lessened my focus on what needed to be done. I put all of my efforts into this. I also felt that if I let myself succumb to the drama of it all that I could easily slip into a depression and make the situation much worse and gain weight back that I had worked hard to lose. The most difficult part was having to explain to everyone why I was back at work the day after what should have been my surgery.

I finally called Blue Cross Blue Shield of Alabama on the second Wednesday and explained my situation. I told them that I could not wait another 3 weeks for the decision to be made only to find out that they were requiring more information. Then I would have to submit and wait again. I needed to know what they were currently missing so that I could submit that immediately and move on with the process.

I had completed my requirements for this surgery according the the Weight Loss Center 7 months prior to this. I was ready to be submitted for a date but because they didn't have any openings available before January 1st, I needed to wait on my new insurance to kick in.

After being on hold for a few minutes the woman in Customer Service came back on the phone and informed me that I had met the criteria for surgery earlier in the morning and they were going to cover it.

I was shocked that it only took them a week and a half after receiving the information and naturally wondered why I wasn't approved back in February. I was totally beside myself, literally doing a happy dance in the isles at work.

I called the Surgeon's office and spoke with Jacqueline. She said that she had felt so badly about things falling through before that she had saved August 4Th for me and it was still open. She penciled me in and she went to work verifying both insurance companies and requesting paperwork.

I faxed the approval letter over to her last week and she made my pre-surgical testing appointment for July 29Th and stated we were on track with the 4Th as the surgery date.