Need some Advice....

tiffany26 · October 10, 2006

Hi everyone.

I went to my surgeon's office today and after having my psych evaluation, getting a physical, bloodwork, EKG, going to the nutritionist, having a letter from my PCP stating that she recommends the surgery, going to the nurse at the surgeon....the coordinator at my surgeon's office said that without a letter from my PCP stating that I've been on a medically-supervised program for the last 6 months, they will cancel my appointment with the surgeon, as my insurance company (Horizon BC/BS) requires the letter.

Problem is, I've only been with my doctor for 2 months. I can't get the letter. I even asked my PCP if she would write it for me anyway (I know, bad), to which she rightly said, "I can't...sorry."

I thought that the letter was recommended but not mandatory. The thought of waiting another 6 months is devastating. I'm ready! I have high blood pressure and sleep apnea....and a BMI of 44. I've been battling weight my whole life and have the receipts to prove it (WW, JC, NutriSystem, ZoneChefs, you name it)... I've done everything! I have my appt set with my surgeon for the 20th and I was going to get my surgery date set then...

Any advice? I guess I need to call the surgeon's office tomorrow and tell them. They'll cancel my appointment. I'm so bummed, I can't even tell you...

:think

DouglasP13 · October 17, 2006

Tiffany, I'm right there with you. My insurance has denied me, now I have to appeal. It is very discouraging. If feels like everyone is against you, and you have no where to go. I feel your pain. *hug*

tiffany26 · October 17, 2006

Thank you for your supportive responses.

They didn't cancel my appt with my surgeon (so far). At least I'll get to see her (on the 27th). I have to wait about 4 months...it sucks, but I'll get over it. I waited this long!

I just hope I don't have to appeal after all of this...

Scribby · October 17, 2006

Keep your head up...I fought the insurance company for a year before approval. I too had to do the 6 months with a pcp. I just kept in perspective that 6 more months of being fat was nothign compared to the LIFETIME of fat I had been so it was worth the wait! I also didnt have the money to self pay so that wasnt an option for me.

Good luck!

Ariel · October 17, 2006

Could your old PCP write the letter for you? Good Luck!!

5jacks · October 18, 2006

Totally feel your pain. Found out today that I was denied because I hadn't proven I was overweight long enough! Good luck and don't give up. If it's meant to be it will be, just may take a little longer that we had hoped!