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So close....

Amyly2n

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Amyly2n    34

Amyly2n
Posted (edited)

I had my last weigh in this morning and got copies of what I thought were the last 4 missing pieces needed for insurance approval. I scanned and emailed them to my patient advocate and she called and said she is still missing one of my monthly weigh in reports and will need that before they can submit to insurance.

I have left a message for the doctor's office to send that one sheet of paper to my surgeon ASAP so hopefully that will get done today. My patient advocate said that she would go ahead and get the surgeon to review everything else so that as soon as they get that missing piece they can submit to insurance.

I am so close to this hoop jumping being over that I just want it to be over with and get my approval and surgery date!

She did say they will submit in the next day or so and that is should take about a week for approval. Hopefully it will all be over with before I know it!

Update: I just found my copy of that one missing paper and have just scanned it and sent it to the patient advocate! Fingers crossed I get submitted today!

Edited by Amyly2n

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finediva    979

finediva
Posted

You are almost there. Don't let the hoops deter you. As they put them up, jump through. Keep jumping until you are in the recovery room. Your new journey to o better health awaits you. All the very best.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
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