Hello all,

I'm feeling so frustrated and need some input.

When I first went to a highly recommended bariatric surgeon. I was told by his insurance specialist that I needed to complete a 6 month supervised diet. As per my insurance BCBS Tennessee. I was not thrilled but figured it would give me time to complete all the steps necessary.

I checked with my insurance and was sent a letter stating I had to have a form filled out that included a 5 year history but nothing about a 6 month diet. The following month when I met with the nutritionist I showed her the letter and she took it out and showed it to the insurance specialist. I was told that yes, I had to have the 6 month supervised diet. So I continued going.

During the first five months I was busy with lots of tests:

Colonoscopy

sleep Study

Mammogram

ekg

My cardiologist appt and blood work were scheduled for the same day as my final nutritionist appt. I went to the Cardiologist group suggested by my surgeons office. I left in tears. The cardiologist doesn't believe in WLS. His comment was, "Do you have bread in your house?" I said, yes and he stated, "There you go, I do not." Then he proceeded to tell me I should learn to eat items like chickpeas. Never did he ask me if I already eat chickpeas. Basically, fat people are fat because they eat to much of the wrong thing. He was not rude just matter of fact. In the end he stated that I needed to have a stress test and Echo test done. The first appt. available for a stress test was 2 months away.

After speaking with my nutrionist about it I called the cardiologist office again and they are able to fit me in for a stress tomorrow. Apparently, my surgeons office called the cardio practice and let them know how unhappy they were with them. I asked the surgeons office if I could get on the schedule and they say not until I've been fully cleared by the cardiologist. They will not submit anything to my insurance until after they have all clearances. I was told that submitting to the insurance without clearances would cause my insurance to reject my claim. That incomplete authorizations submitted to an insurance company will put that patient on hold.

Oh, and I have the stress test one day and the echo on the following day. Because insurance won't pay for them if they are on the same day. Does all of this seem a bit crazy. Btw. I am going to a surgeon that is 1 hour 45 minutes away because he came so highly recommended. So, I've taken a half day off of work for each nutrition appt. and cardio appt.

The surgeons office has said they are booked through April at this point. Due to previous commitments at work I can not be off in June/July. So, I'm freaking out that It will have been an entire year from the start of this process.

Oh! Did I mention that the insurance specialist at my surgeons office was fired. From what I've gathered she came across like an expert but totally got things wrong. Like my 6 month supervised diet.

Sorry for the book. I'm at my wits end.

Sounds like they are driving you crazy and it's a short trip!

In my opinion, my pre-op ritual was more exasperating than the surgery and recovery. Hang in there.

Hi,

My insurance BCBS Anthem also required a six month wait period during which time I had to do all the tests you mentioned. My packet has now finally been completed and sent to the insurance company as of 3 weeks ago. I was told by my insurance specialist not to expect to hear from

Anthem for 4-6 weeks. (very disappointing). Others I've met in the support groups who

have BCBS NC don't have to wait for so long and do hear back faster.

I liked having the 6 months to prepare myself and my family for the surgery and all the changes

but now I'm ready to have the surgery.

I hope you mentioned your poor experience with the cardiologist with the Bariatric md. Maybe he should rethink using that Cardiologist.

Good luck and hang in there.

I understand your frustrations. I had my first surgeon appointment yesterday, and have to go for more testing on Monday (colonoscopy, and my second scope down the throat, I forget what that one is called) I've been jumping through their hoops for the last year, I had my first scope done last March. It's super frustrating, but the end goal or surgery is within sight for us both. Just keep your eye on the prize.

I don't have to go through the cardiologist portion of it (requirements are different here in Canada I guess) but I have read before on the forums that dealing with the cardiologists have cost, or almost cost other people their chance at surgery. I'm glad that your surgery team called them though to get things straightened out! Keep pushing, you're almost there. Good luck!

Sounds like they are driving you crazy and it's a short trip!

In my opinion, my pre-op ritual was more exasperating than the surgery and recovery. Hang in there.

Very short trip. Lol.

Edited March 10, 201610 yr by OBXhappy

I wouldn't have minded waiting the 6 months if it were truly required. Yes, the bariatric md is aware of what transpired at the cardiologist. It is a very large group of cardiologists. Apparently, they have never had this happen in the past. Just my luck.

Hi,

My insurance BCBS Anthem also required a six month wait period during which time I had to do all the tests you mentioned. My packet has now finally been completed and sent to the insurance company as of 3 weeks ago. I was told by my insurance specialist not to expect to hear from

Anthem for 4-6 weeks. (very disappointing). Others I've met in the support groups who

have BCBS NC don't have to wait for so long and do hear back faster.

I liked having the 6 months to prepare myself and my family for the surgery and all the changes

but now I'm ready to have the surgery.

I hope you mentioned your poor experience with the cardiologist with the Bariatric md. Maybe he should rethink using that Cardiologist.

Good luck and hang in there.

Edited March 10, 201610 yr by OBXhappy

I understand your frustrations. I had my first surgeon appointment yesterday, and have to go for more testing on Monday (colonoscopy, and my second scope down the throat, I forget what that one is called) I've been jumping through their hoops for the last year, I had my first scope done last March. It's super frustrating, but the end goal or surgery is within sight for us both. Just keep your eye on the prize.

I don't have to go through the cardiologist portion of it (requirements are different here in Canada I guess) but I have read before on the forums that dealing with the cardiologists have cost, or almost cost other people their chance at surgery. I'm glad that your surgery team called them though to get things straightened out! Keep pushing, you're almost there. Good luck!

Thank you, for the words of encouragement. I've been pretty positive the whole time. I think the past couple of weeks it has really gotten to me. For some reason I am freaked out over the stress test. Perhaps, it is the whole "Stress" thing. Hopefully, by Monday it can be submitted to insurance.

It is typical to run into problems during the process. All I can say is keep focused on the goal. It seems that is what you are doing. Also it might be worse. We had one individual in our Bariatric Surgery support group who had everything set. Surgery was in a couple weeks. He got a call to check into the hospital immediately. It turns out he was about to die of a heart attack. He had a quadruple bypass the next day. He lost a little weight from that operation, but he hung in there and a few months later after his body recovered, he went and underwent gastric bypass.

So anyways if you are meeting with a cardiologist and he is recommending a stress test and an Echo test, then there must be something either in your family history or your medical history, that might interfere with the success of the operation.

no doubt a frustrating process. I have BCBS (a different plan than yours) and have a 6 month medically supervised period. The day I had the ECG (which was normal) the cardiologist said he wanted me to have a stress test and echo. It was scheduled for the following week. A two month lead time seems utterly ridiculous! Plus it makes absolutely no sense to have to do the echo on a different day. Here's how my stress test/echo appt went (note I did the pharmacological stress test not a treadmill test)

Appt was for 10:00am, I arrived early and was called back at about 10:05am.

I answered a few history questions, they took my blood pressure and weight and explained in detail how the test would be done.

Then I got an IV line put in and they injected the dye used for contrast for the stress test. You have to wait 45 minutes for the dye to work it's way through before they take the baseline pictures.

So DURING that 45 minute wait, I got the echo done.

Then the baseline pictures.

Then they injected the more contrast dye and the drug to 'stress" my system. They monitored my blood pressure and heart rate for 5 minutes while the stress drug worked it's magic. Then I got to have some juice and a snack. about 20 minutes after injection, they took the final pictures.

I was completely done within 2.5hrs. I met with the cardiologist again 3 days later to go over the results (I could have opted to just receive the report and not meet with the cardiologist).

Note that the cardiologist recommending the stress test and echo does not necessarily mean there is anything of concern. Mine for instance, simply does it for ALL bariatric surgery patients to have a complete picture to make the risk assessment. He even told me there would have had to have been something majorly wrong for him to not recommend the surgery. He just wants to make sure the real risk level is known so that all parties (him, the surgeon and YOU) can make an informed decision.

All that being said, in the long run - yes this is frustrating, but the end game is worth all the pre-op frustration. Hang in there and keep jumping through all the hoops. You'll get there.

Had the stress test today. It was a treadmill test. The PA who administered the test was very kind. She had a RNY many years ago. The test was a breeze walked on the treadmill for a bit every 3 minutes the incline and speed were increased. After 15 minutes I was told the test was over. After I sat for a minute my blood pressure was taken again. All was fine. She wasn't surprised as I don't have a family history of heart disease, I've never smoked. Basically, in good health other than being obese.

I agree heidikat72 2 months was CRAZY. Especially, when you think this office has 32 locations around the Philly region. I go back for my Echo tomorrow. I called before going today to verify that there was no way I could have both tests done in one visit. I was told, "No" that insurance would not cover it.

That has been my frustration. Not the fact that I had to have any of the tests done. I'd rather be safe than have complications. Sometimes I wonder if reading the forums so much has caused part of the frustration. Although, I've learned a lot from them. I read about people that know their surgery date prior to having their final clearance. I read about people who have the stress and echo on the same day, etc. etc.

Obviously, each case is different . . . it just feels like a rollercoaster. Oh well, hopefully, in a few weeks I will have a date.

Thank you for the kind words.