tashalpn2006

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Surgery Date 10/8/10 

I'm so happy to finally be approved and get things started!!!!

so the insurance company (Tricare) has had my paperwork since Aug 19th, on the 23rd i had to send MORE info to them and on the 30th my PCM had to renew my referral for the surgeon so now i'm just waiting and it's "in process" sigh...just want to hear YOU ARE APPROVED! come out of someones mouth!

Well tricare has had my paperwork since 8/19 and i'm currently "pending approval"  they called the surgeons office and needed a little bit more info about my weight, my medical conditions (which i really have none) and how WLS will really benifit me...ummm HELLO that was all written in the  medical necessity letter did they even bother to read that...sigh...so anyway my PCM has THREE days to get the info into them or else i'm automatically denied!  UGGGHHH i soo do not want to be denied right now!  Tomorrow i'm going to call the PCM to see that they got the letter through fax and see if she has filled it out and sent it back yet...if not i'm just gong to sit there the entire day til it's taken care of!  I don't know what else to do, it's been a nightmare getting all this info turned in, in the time frame they wanted it and NOW THIS...i just want my approval!  Hopefully if i get my approval by next week i'll still be on the Sept schedule for surgery, if not i wont be able to schedule til October! Either way i don't care as long as i can GET SCHEDULED!  Fingers and Toes crossed that i get approvedl!

Well the 6th was my Nut and Psych visit, and the 12th i picked up my clearance  papers from the Pulmo...and here we are on the 20th and the surgeons office has been SITTING on my paperwork for the past week...UUGGGHHHH! They said the "thought" they had submitted it, then called me back and said "woops" it was in the sent pile but they obviously didn't send it to tricare and would be submitted first thing Monday morning...blah...thankfully tricare usually doesn't take that long to come back with an approval so hopefully by the end of next week i'll have my date!  Time to get things in order for the sugery!

Well all of my pre-op appointments are finished as of today!  I mailed the rest of my records and my Pulmo clearance to the surgeons office today and they should have everything prepared to submit by monday or tuesday of next week.  Should take about a week to get my approval back and then go ahead and schedule my surgery!!! YEAH!  I'm still eligible for a september surgery date so fingers crossed that everything goes as planned! Now it's just a waiting game....

Well the surgeon recieved all my info and set me up for my psych and nut appt on aug 6th!  That's it!!!  All i have left to do is the Pulmo clearance on the 12th and i'll be able to submit for approval.  They said it should only take a few days to get my approval and then i'll get my surgery date...yeah

Wow all i have left to do is pick up my clearance paperwork from the pulmo on aug 12, send those to my surgeon and then i can make my Psych & Nut appts.  Once that is done they will submit for approval and she said she usually gets an answer from them within 5day!  HOLY CRAP the time is almost HERE!  I'm soooo thrilled!  She (lady at my surgeons office that does all the insurance submissions) said that ALL my paperwork looks REALLY good and she doesn't think there will be ANY issue with getting approved!  I can't believe it...i'm really on tract to have this surgery by Sept/Oct time frame and that's JUST around the corner!  AMAZING!


Clearance from Pulmonologist -Aug 12 2010
Nutritionist TBA-Aug
Psych Evaul TBA- Aug
Submit for approval TBA prob end of Aug 2010
Tentative Surgery Month- Mid Sept or October 2010

This thursday is my 6mo supervised diet visit...the last in the final series of things!!  I'm so excited but a little nervous too that they may deny me anyway!  I've GAINED 10lbs not on purpose either!!!!  So here is what is left for me to do...

Supervised Diet appt #6 -July 22 2010
Clearance from Pulmonologist -Aug 12 2010
(can't make the following appts until after all medical records/labs/medical necessity letter are turned into surgeon)
Nutritionist TBA-Aug
Psych Evaul TBA- Aug
Submit for approval TBA prob end of Aug 2010
Tentative Surgery Month- Mid Sept or October 2010

I really can't believe that the end is finally drawing closer!  Not much else to tell so i will keep ya'll updated as i go!  Wish me luck and a FAST approval time!

Tasha

Well supervised diet visit #5 is done and over with...whew...but it's just a frustrating process!  I've gone twice to get my medical records (they don't have my copy nor have they forwarded the copies to my surgeons office) and it's been three weeks.  I'm going back in on the 15th when i have more time, and i swear i'm gonna sit in the waiting room until they have them ready for me!  That's what is really holding up this whole process because i can not make my PSYCH or NUT visit until they have the last two years worth of medical records to review, i FINALLY today got my medical neccessity letter, however, it's so generic a 5th grader could have written it.  I just hope that doesn't screw me out of being approved!  I still have quite a few things to do before August, but hopefully it will all get taken care of and I'll get my date for September.  I guess i need to look at the bright side of things, i truely only have 5 more appts to go to before we submit for approval!  That's a good thing. 

ABG & Chest Xray- June 15 2010
Supervised Diet appt #6 -July 12 2010
Clearance from Pulmonologist -July 12 2010
(can't make the following appts until after all medical records/labs/medical necessity letter are turned into surgeon)
Nutritionist TBA-July/Aug
Psych Evaul TBA- July/Aug
Submit for approval TBA- probably Early to Mid Aug 2010
Tentative Surgery Month- Late Aug/Early Sept 2010

that will push my surgery back to Late Aug or September...sigh.  I was upset but now i'm trying to see the positive of all of this.  I'm preparing to quit my job in July in order to go to school full time, my two oldest kids start Kindergarten and Pre-K mid Aug, my youngest is 2 and will be home with me all day, so if the boys are in school at least in Sept if i have it, then i won't have to be so stressed caring for three kids at once i'll have a "little" bit of a break during the day with those two at school.  AND the other upside is that the later i have it done in the year and the closer to December (XMAS) then i wont have to stress about trying to buy new clothes in different sizes, ill just ask for gift cards for gifts so i can buy new SMALLER clothing as i'm ready for it!  =)  Just stay positive right???

These are the remainder of the appts I need to have done in order to submit and get my approval (which i've been assured pretty frequently that i will be approved)

Supervised Diet appt #5 -June 3 2010
ABG & Chest Xray- June 2 2010
Supervised Diet appt #6 -July 2010
Clearance from Pulmonologist -July 12 2010
Nutritionist TBA-July/Aug
Psych Evaul TBA- July/Aug
Submit for approval TBA- probably Early to Mid Aug 2010
Tentative Surgery Month- Late Aug/Early Sept 2010