jammerz
Hi All!!
Currently, I feel as if I am in the last leg of the race - only 1/4 of a mile to go and I cross the finish line! Like many of you.... I am just waiting for "the call" from the surgeon's office with a surgery date. I met with Dr. Quilici and his staff on 1/15/07 - ironically enough - Civil Right's Day (MLK). I went back on 1/17 for my psycho-social eval - it was interesting in itself, but I know beyond a shadow of a doubt, that I will be cleared for surgery (all of my paperwork is in and should be in place, just waiting on the final OK from Dr. Perry) and will be called pronto upon insurance clearance!
It's been a long road, a long race and many, many hoops had to be jumped through to get where I am today!
Originally, I started the process over 2 years ago. The first time, I was denied by my insurance carrier after some lame excuse about my knee surgery was too new and I needed time to see if it was going to heal well enough for me to start extensive excersiing again. I appealed and lost and at that time, gave up hope.
About a year or so ago, I decided to start the process again. And of course, anything I had done or accomplished before hand did not count towards my current trip down the surgical weight loss trail. So... I waited over 4 months to get into my medical group's mandatory 6 month education program. I started it, finally in July of 2006. All was going well... I had friend, family and my fiance come with me to the edcation classes to help educate everyone - it all seemed to be working very well. Everyone was on board and I was excited.
About the mid/end of September, my insurance carrier AGAIN decides to change eligiblity requirements. Since I was not the only person hit with this reality (yet another set back) we ganged up and revolted against the insurance company. I will say our medical group was AWESOME and had our back - they aided in fostering a "grand-father" clause in and my co-classmates and myself could continue with the medical groups education program and then also start the insurance carriers new mandated third party administrator and weekly coaching calls. It's all been very overwhelming to say the least. It feels like I've had double duty - and have learned a lot of the information if not twice, three or four times. At times, I think... I could teach an education class at this point, LOL.
Anyhoooooo, I graduated both education programs on 1/8/07 and as you see in my first paragraph, got my referral ASAP and have expedited the process to this point. Anyway I could speed the process, I did. Took the next available appointments at all times and hand held some of my paperwork to the surgeons office. I would recommend be proactive and not reactive in this process! I am sure you will appreciate the end result.
So, now I sit and wait - fingers crossed, toes and eyes as well...that the insurance carrier doesn't decide to deny me for something ridiculous again and or change something from an eligiblity standpoint. Until I have a surgery date... I am not holding my breath. But you know.... I've come farther than I have before and that in itself is positive and exciting to me.
Stay tuned, for more!
2/2/07
My surgery is scheduled for 2/15/07. So exciting!
