Still waiting for approval...

Aug 15, 2009

Well, I'm new to this site, but one thing I like already is that I have a place to really write/journal about my process and share my story with others.  Right now, I'm at the point in my journey where I'm still waiting for approval.  Here's a slightly short version of the last 18 months or so:

I had my initial consultation at the Barix Clinics in Ypsilanti, Michigan on January 21, 2008.  After that, I really didn't hear anything at all until I finally called Barix in March wondering what was going on.  They had sent me a letter, but it got lost in the mail or something..so they emailed me a copy of the letter which stated all the things I needed to do for approval.  On here listed things like Psych eval, Nutrition eval, cardio/pulmonary clearances, blood tests, etc.  I had a list of about 6 or 8 things that I needed to do and get in to Barix before they were able to submit to my insurance. 

I got right on that list as soon as I got the letter.  I made the appropriate phone calls, had my appointments for bloodwork and clearances, had letters written from both my primary care physician and my gynecologist (who was taking quite an interest in me getting this surgery), and got copies of all my medical charts turned in to show my weight history and whatnot.  The only thing at this point that was still holding me back was that I needed a current 6-month doctor supervised diet...and this was April before I found this out.  I was hoping to have the surgery that summer (I'm a teacher and that's where it fit best in my schedule...) but all thoughts of that were dashed with this new requirement.

So I started the diet right away and had my last appointment with my PCP in December of 2008.  All in all, I had lost about 30-35 pounds...not too shabby, but I still had a LONG way to go...over 100 pounds to lose to be in a healthy weight range.  Being a teacher and knowing that once I was approved I'd need to have the surgery in a certain amount of time, I held off turning in the new medical charts and paperwork.  I think I was scared...I rationalized it by saying the timing wasn't right with my profession, but truthfully I was really nervous.

Well, I finally prayed and prayed and prayed...and talked to people...and prayed some more, and got my paperwork from the diet turned in.  Now it was all there...a complete package.  My Barix insurance person was great and told me that everything was in order and that approval should come fairly quickly.  Also, I had lost my job, due to budget cuts in my school district, and now will be losing my insurance at the end of August.  I'll be taking out COBRA, which will keep my exact same insurance coverage with my school district, but this could prove tricky in the process.  So we were hoping to get the approval quickly and then push the scheduling department to make some room for me before August was over.

Well, here I am...about 2 1/2 weeks after turning in all the paperwork, and I still don't have approval.  I actually was denied by my insurance company because my psych eval was over a year old.  Barix called me, gave me a heads up on this, and I was able to get a new eval done last week.  The new paperwork was turned in to Barix, they faxed it to my insurance company...and now the waiting game continues.  I was hoping that since the only thing that needed fixing (psych eval) was now new and current that the rest would be easy.  Well, I got the actual letter today from my insurance company (the denial letter) and they also indicate that my 6-month diet was over a year old...which it isn't.  I just finished the thing in December!  I know my case is back in the review stage at Med Mutual of Ohio...but I'm still waiting.

Now I've just got to be patient; calm; and pray a lot to get this approval!  I'll give a call to Barix on Monday just to see what I need to do now...which they will probably just say to wait, which is the hardest thing to do!  I just feel like the closer I get to something, it's like the rug gets pulled out from under me and then they give me a bunch more hoops to jump through.  I'm almost afraid to call Barix on Monday for fear that they'll say my insurance company wants more documentation of something that they didn't want before...  The timing is so good for me to do this surgery now and I want it more than ever.  I want to be healthy and do this...I need this help.  I'm just praying that it will happen for me, which I know it will.

Sorry it's so long...thanks for reading it, for anyone that does.  I'm really just writing to put my feelings and frustrations out there.

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