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Disappointed doesn't even begin to describe what I currently feel...

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I posted this awhile back and later felt that the issue had resolved itself and wasn't what I thought it to be. Looks like I may have been wrong.

So here goes..

I've received conflicting answers from UHC regarding my requirements. There are the typical; BMI, 6 month supervised diet and psych eval. All of which I have completed and my file is in the process of being submitted. I'm this close!!! And boom....I hit a big @ss brick wall that has knocked me off my feet this afternoon.

I called insurance to see if they'd received my file. While on the phone we discussed my requirements, etc. The rep then mentioned receiving authorization 6 months PRIOR to surgery. Curious of his answer, I asked him to convey his perception of that statement. Which he did, and I did not like. I then asked him that IF I were to be approved, let's say next Wednesday, does that mean I have to wait an ADDITIONAL 6 months before I can actually have surgery? So, like...August??? His response was yes. This whole scenario makes absolutely no sense to me. Why? Why make a patient bust their rump for 6 months to prove that they CAN follow guidelines set by their provider/nut but receive little to no result? Why have a patient see a psychiatrist, get the go ahead and then wait an additional 6 months? I'm not saying it will, but there is a lot that can happen in a 6 month period. I can honestly say that when my father passed away in 2012, I would not have been emotionally stable if you will, to follow protocol after surgery.

Up until today, I have been under the impression/hopes of having surgery in early March. I have put in my time and done what has been asked of me. And this news has rocked my world. No it's not the worst case scenario. Yes, I can put on my big girl panties and wait the required time. Yes I am even lucky for the fact that my insurance actually covers this. But I simply do not want to. And that is okay. Please do not ridicule me for being upset over this. I guarantee most of you would be just as disappointed if you were almost there and had the carpet ripped right out from under you.

And yes- when I first started this process I did inform my benefits coordinator at the office of what I was told. She said it did not sound correct and she thought the rep had misunderstood what they were reading to me. I spoke with another rep a couple of months later, and she told me that I did NOT have to wait 6 months. However, I will be calling my coordinator tomorrow to request that she call UHC and discuss this with them. When she initially called to verify my benefits, they never mentioned this to her either.

I'm just having a pity party, okay? :( And in an effort to avoid a bad habit I have almost broken...I am trying not to resort to emotional eating. I just want a big friggin donut right now!!!!!! Maybe a cupcake too..

Edited by sassyfrass23

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My file was sent to UHC on Friday. I called tonight just for kicks and giggles, but it wasn't showing in the system yet. So I shall try again at a later date!!

Yes definitely try again! My insurance company told me they work over the weekend on these approvals so maybe yours does too! <3

I'm really hoping you hear something soon sassy!

In the meantime, I have two more appointments left before going in for final approval from insurance; one is schedule for this coming Friday and the last is early next week. Why do I feel like time has gone into slow motion suddenly? Usually time flies by, except now I feel like I'm never going to get done with these appointments!!!

Ugh. Hopefully once it goes to insurance it won't take them forever to approve. Fingers crossed for both you sassy and me!!!!

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Ladiessss! I have officially been approved! I'm still in total shock but so glad it's FOR SURE this time! My file was submitted last Friday so I was approved in 2 business days which totally surprised me! I am so stinkin excited.

@@RNYDawn isn't your date soon??? Please keep us posted on your progress. I'm tickled pink for you and @@Nurse_Lenora !

@@Renkoss thank you so much! And yes- I believe the time at the end seemed to slow down drastically for me as well. Your appointments will be here and gone before you know it! Our surgery dates may be fairly close :) I will definitely be sending prayers your way as you await the decision from insurance! Let me know how it all goes for you :)

Yessssssss girl!!!! All that stress and worry and finally it's relieved!!! My surgery is on Wednesday! Thank you!

  • Author

Yessssssss girl!!!! All that stress and worry and finally it's relieved!!! My surgery is on Wednesday! Thank you!

I can't even explain the relief I feel. I knew I was stressing..but didn't realize just how much :blink:

Yessssssss girl!!!! All that stress and worry and finally it's relieved!!! My surgery is on Wednesday! Thank you!

I can't even explain the relief I feel. I knew I was stressing..but didn't realize just how much :blink:
So happy for you!!! I've been lurking reading your story! How exciting!
  • Author

Thank you, @@MsB7 ! Hopefully I will be updating next week with a March (fingers crossed) surgery date!!

And thank you as well, @@shrinkingkimber !! It's been an eventful/entertaining story nonetheless. One I'm glad to see coming to a sweet, sweet end!

Where are you in the process? Pre or post op??

Ladiessss! I have officially been approved! I'm still in total shock but so glad it's FOR SURE this time! My file was submitted last Friday so I was approved in 2 business days which totally surprised me! I am so stinkin excited.

@@RNYDawn isn't your date soon??? Please keep us posted on your progress. I'm tickled pink for you and @@Nurse_Lenora !

@@Renkoss thank you so much! And yes- I believe the time at the end seemed to slow down drastically for me as well. Your appointments will be here and gone before you know it! Our surgery dates may be fairly close :) I will definitely be sending prayers your way as you await the decision from insurance! Let me know how it all goes for you :)

im so excited for you!!!! Let us know when your surgery is scheduled!!! You have been through so much!!! Congrats!!!????????????????????
  • Author

Awwww thank you, @@jantra12 ! I honestly believe I appreciate it even more now after all I've gone through. I just hope my story inspires others to keep fighting and not quit just yet :)

@@RNYDawn - I hope you see this before you go to the hospital:

Good luck! And I'm sending prayers your way! Please stay in touch when you feel up to it and let us know how life on the loser's bench is! I picture rainbows, unicorns and glitter EVERYWHERE!! :)

Thank you, @@MsB7 ! Hopefully I will be updating next week with a March (fingers crossed) surgery date!!

And thank you as well, @@shrinkingkimber !! It's been an eventful/entertaining story nonetheless. One I'm glad to see coming to a sweet, sweet end!

Where are you in the process? Pre or post op??

Sassy, I am pre-op! I just finished up month 3 of the 6 month insurance requirement! I expect my surgery to be in May or early June at the latest!

Edited by shrinkingkimber

  • Author

How exciting @@shrinkingkimber! It'll be here before you know it! Which procedure are you having done??

How exciting @@shrinkingkimber! It'll be here before you know it! Which procedure are you having done??

Gastric sleeve! I have inflammatory bowel disease so it's basically my only option since it doesn't involve the bowel. For my BMI a gastric bypass would be ideal but my GI Doctor and surgeon think it could be dangerous since I already have malabsorption issues when my disease is flared.

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