I've been lurking on this site since August of 2007, but have never posted. However, I needed to share what happened to me today.

I've done EVERYTHING the doctor has wanted. I sat through 2 of the orientations because my husband couldn't come to the first one. I called my insurance company twice to verify the surgery was covered. I was told both times I would have to be pre-certified (evidence of medical necessity from the surgeon's office - I have a BMI of 43 & 2 comorbidities), but that my insurance would cover it. I even got copies of ALL my medical records incase they needed weight records. I went all the way back to 1994! I could come up with 13 years of weight history!! I was told that I had to lose 5% of my body weight, I lost close to 10% in 6 weeks. I have been ready for this surgery ever since August.

My husband cleared his schedule (which is difficult for him to do) for the week of the 7th (My surgery was scheduled for April 7th). And, at 5pm Friday night when I was at work, I was called by my surgeon's secretary to tell me that she had to cancel my surgery. My insurance denied my surgery not because it wasn't medically necessary, but because they said they never got the surgeon's paperwork for the surgery. The secretary faxed all 25 pages back in March, received a fax confirmation sheet that the papers went through, but she didn't follow up with a phone call until the last business day before my surgery on Monday. My insurance company claims that they never received her fax.

I didn't follow up with the insurance company because I couldn't control the paperwork submission - and I figured that I would receive notice if they denied me. I NEVER thought that the doctor's office wouldn't follow up with my insurance company if they didn't receive ANY word from them. So, my surgery is now cancelled.

I do feel badly for the secretary though, the surgeon is pissed off at her. He told her that she is to get on the phone with my insurance company on Monday - get authorization - and put me in the next available OR spot. He only does surgeries on Mondays, but is going to do my surgery the next available day, Monday through Friday. We'll just have to see though, I'm not making the mistake getting my hopes up again until I'm being wheeled into the OR.

Sorry about the long first post,

Marlene

I am so sorry...I know that you must be really upset. I will keep my fingers crossed that you will be in for surgery next week! It will happen!!!

Wow I am so sorry... Truly i am. That's why I call like hello It's Stalker Katrina... im just calling to see if there are any updates.. did u receive my paperwork yet.. I know u said that u would call me but i'm a eagar beaver and I had a few minutes so im just checking with u... and she is like not yetttt.. Don't care if u get on her nerve.. she needs to everything in her power to get you approval a.s.a.p. because she should have followed up to ensure that everything was a go... How Sad....

ooh my gosh - I am SOOO sorry. I wish I had the money to self-pay for you!!!

I am sorry for your wait, when the time comes your ready. Hope you get it done soon.

I can't believe you have had to go through that! I hope you are rescheduled soon, and as for the nurse. I think she should be looking for a new job!! Good luck to you!

how very very frustrating! I am so upset for you, I hope they can get it all figured out quickly and your husband is able to clear his schedule. :sneaky:

Well, the good news is that you know you're insurance will cover it... so be thankful for that, you're just gonna have to wait a few more days/weeks... But trust me, I know the feeling. They had to re-sechdule my sugery as well due to an emergency with the doctor *ugh*.... I would had been banded on the 15th of March, now I have to wait till 4/2... *Wahhhhhhhh* lol but at least I know that I have two more weeks and I'll be banded! woot!

Keep us updated :tongue_smilie:

Best,

Chris

I am SO sorry this happened to you! This is why I double check everyone and everything in my life on a daily basis. I don't even know what my existence would be like if I didn't check this or ask this..UGH, makes me crazy! Sadly, as evidenced by this person, not everyone does what they are suppose to do. Not every price is what it is suppose to be (the checkers at the store HATE when I ask them to wait until I have everything on the belt before they begin checking )

Here's to hoping you have a swift reschedule and the secretary learns that not doing 100% can have a HUGE impact on people's lives. Live and learn I guess..I'd still look a little something like this---> :ohmy:

this is from 08 folks

So sorry about your cancellation, that kind of stuff can make you crazy.

I saw your VA Tech logo, do you live in that area. I'm from Roanoke VA.

Hope you have a quick reschedule.

I just got my surgery date of 4/27 this morning and my emotions are all over the place

Keep us updated

Darlene

Sorry guys, I am not trying to be a smart a** or anything, but the replys coming in on this post act as if it is recent. The original post was April of 2008----last year.