The saga continues...but with HAPPY NEWS!

Insurance issues continued: Here is how things have gone the last 24 hours! As you know, yesterday I called Humana to see if insurance had been filed. They told me "NO" (which was incorrect.) They then told me that bariatric surgery was NOT covered. I knew they were wrong because I had already spoken to the author of our company's certificate back in March; plus a few nurses I know of have had it done. So "E" from Humana says she will have their supervisor check into it and call me back. "B" from Humana (the supervisor) has someone call me back last night and still says it is not a covered benefit. At this point I still plan to fight it once it gets submitted and denied. Apparently @ 8:30 this AM Kristine had called me @ home. Our phones were messed up, so she left a message on my cell phone. Before calling her back, I called our insurance person, "H.D." We chatted; she confirmed it was covered, said she would call Humana and they would call me back. Then I call Sonnanstine's office. I talk to Taryn AND Kristine. Turns out I AM ALREADY APPROVED. Sooo........ #1. I OWE KRISTINE A BIG HUGE APOLOGY for my venting out my frustration & thinking it had never been filed; Kristine has been working her butt off with the exasperating insurance people....and #2. Humana reps are really scaring me because ......... At 13:00PM I get ANOTHER call from "A" at Humana again telling me that "B" has confirmed that bariatric surgery is NOT a covered benefit under my plan. I told her that I already had been approved, had an approval #, and had spoken to the author of TriHealth's insurance plans who said it is covered. She just said "oh, ok". WTH? (Seriously though, I could not do Kristine's job; I would go postal...... ) So I am finished talking to the front-end workers @ Humana and just waiting to get a copy of the approval letter from Taryn or Kristine so I can ... ask off of work !!! WHEW!!!!! Melanie g.

Good for you!!!!!!Like I said the other day. Kristine has to wear alot of hats with what she does. I wouldn't want to do her job. Couldn't pay enough. I use to work for a large group of doctors. I chased money with the insurance companies. I fought and filed appeals all day. Loved my job. I liked the challenge. But after 23years had twins at 38 and when the girls were 4 decided to be a stay at home mom. When they were in second grade I had my WLS. I am now a new mom and wife. I am so thankful to dr tom and his staff. I feel we are given so much knowledge and that makes the followup easier. I hope you get a date soon. Keep us informed. Good luck jane

woooowhooo melanie,,, congrats!!!! I am so glad you wrote this note, I talk to people all the time that state their insurance company does not cover WLS...each time I tell them to go through a center before they take no for an answer, it's amazing what the docs office can find out and do that we cannot... We get very intense when trying to work through the hoops, I remember it well..we gotta take the stress out on someone. Unfortunately the docs and office folks get the blunt end of it. so did you get a date yet??

Congradulations Melanie ! Kudos for hangin in there just go's to show you should never give up . Good luck, Pam

All right!! We told you it would happen. You just needed to be patient. It's easy for us post ops to say that as we don't have to wait any longer. But it hasn't been that long that I haven't forgotten the anxiety that goes with the wait.