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Waiting For Insurance Blessing

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Ssilian

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I have been a member of the Verticalsleevetalk.com forum since December 2011. I log on almost every day to see if there is new information to learn -- and there always is. In April of 2011 I learned that my insurance company (Anthem Covacare) paid for the VSG, but I would have to complete a 12 month counseling process. At that time, I really didn't know if I was going to have surgery. I found a WLS doctor near my home and made an appointment to visit and find out more information. I talked to his surgical coordinator and to the doctor in person. When I met him, I did not get a good feeling but I ignored my initial feelings and thought I was just overwhelmed with information.

 

I talked to my assigned counselor twice a month. There was a 4 week period where I dialed in to a group conference on the telephone. It wasn't until September or October that I really got serious about surgery. In December I found this forum and became a "peeper" and read for a while until I had questions and then joined.

 

I found out that a friend of mine was having the gastric bypass in December. I couldn't get a hold of her until late January and she told me about her journey. She wanted the bypass because she wanted the dumping effect. She said that she needed the reminder of what not to eat. Anyway, she told me about the doctor she went to and I had not hear much about him. Turns out he used to be partners with the doctor I had chosen -- even showed my doctor how to do the surgery lapriscopically!

 

Then in March I contacted my doctors office and asked them what else I could do to get ready for May 2, when the insurance company would be making their decision. The nurse scheduler told me to get a psyc eval and that I had to pay the $1000 to the doctor that was required before surgery. I hit the roof because I was not told this. She said the money was to pay for his fitness gym and additional appointments. They gym is not big at all. I kind of freaked on her and she scheduled me for another appointment with him since it had been a year since I had talked to him. I hung up and immediately contact my friend who had surgery in December and got the number of her doctor. I called and even the front desk girl was so helpful!!! I cancelled the appointment with the first doctor. I had my psyc eval sent to this new doctor - Dr. T. and was told to attend an orientation. Dr. T's PA did the orientation and I learned nothing new but had to go through the process. Next, I had to get an endoscopy which went very smoothly and 4 days later I met with Dr. T. I was blown away by his down-to-earth style. I was immediately drawn in by his charisma and his willingness to answer all my questions -- and believe me, I had a ton! His physician's assistant was just as informative. You could tell these guys knew each other well and have worked together for a long time!

 

Last week I finished another group session that lasted 3 Mondays. I talked to my counselor for the last time last week and on Wednesday, 5/2 she will send through my paperwork to the insurance company. The Drs. office will put through their paperwork on that day as well. I should know something by Friday, 5/4 or Monday, 5/7. I'm really scared, excited, scared, hopeful, scared, nervous!

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Good luck to you. Sounds like you were put through a huge process. I hope you hear by the 7th.

I'm hoping they will schedule surgery before the end of May. Swimming is my treat. If I had a choice of cake or swimming, I would always chose swimming. I was told I won't be able to swim from 4 - 6 weeks after surgery and I really wanted to be able to swim by 4th of July.

Like you though, I'm scared, excited, nervous and yes, scared again.

It looks like we'll be doing this very close together and that's a good thing, we can be scared together!

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Good luck to you! I'm glad that you found a surgeon that you feel comfortable with, as it's really important! The moment that I met my surgeon I knew that he was on his 'A game'. I felt absolutely no hesitation in letting him do the surgery. The time will pass quickly and before you know it you'll be on the Loser's Bench with all of us!

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