Mayjah Aggravation! 4/16/10

I missed a call from Karen on 4/14. She called right before 5pm. She said she'd be in the office until noon the next day & to call so she could go over the insurance info w/ me.

Almost made me question whether I was hearing from the same lady I spoke with before...this one was kind of nice. ?? :w00t:

I missed her by a few minutes the next day so I left a message.

Didn't hear back from her so I called today and finally spoke with her.

Ugh.

The way she was talking at first was like this was the end of the road & I should just give up since I don't have the co-moribidities on the list of 5 or so that my insurance acknowledges.

I mentioned that they approved the endoscopy & whatnot and asked if I should go ahead with it. She tried to discourage me. Grrr!

I was about to cry... I told her that I *really* want this & my options are very limited as far as finances/physicians, so if there's any chance to make this work, I want to try.

Kind of sounds like they don't want to make any extra effort for me - or at least Karen doesn't.

I mentioned to her that a dear friend of mine had surgery with Dr. Oh in February.

My friend has the same insurance, is about 1/4" taller than me, started out within a couple of pounds of where I did, and didn't have any of the co-morbidities on the insurance's approved list. She has lots of "little" ones, as do I. They're legit co-morbidities! They're on the lists of every other bariatric surgeon I've looked up. (We both started out at the same BMI even though our insurance doesn't go by BMI...) We're both SAHM's with only children. Heck, the major difference between us is our hair color!

My friend was told that if a patient has enough "little" co-morbidities then surgeries tend to get approved through our insurance company just the same. It worked in her case.

Karen just said "I don't know... all of the requests and claims are handled the same way... Maybe your friend had diabetes." I told her that I knew for sure she did not have diabetes.

I made an appt to go back to my primary next Thursday morning. I don't know if she'll be able to tell me anything about my bloodwork that will help me for surgery.

I was prepared to fight the insurance company, but how can I and what difference is it going to make if the surgeon's office isn't going to help?