Talking in circles...grrrr

Jul 16, 2009

So I had my consult appt. with the surgeon on the 25th of June...it went great.  She told me I was a candidate for either the RNY or DS.  After much research I've decided to go forward with the DS for several reasons.  One being the need for NSAIDs due to arthritis and fribromyalgia.  The surgeon's office told me that as soon as they received all my paperwork after my last appt. with my PCP on 7/20 and my psych eval, then they will send off to the insurance.  I had my psych eval done on the 8th of June...but he hasn't sent the letter yet because he was waiting for insurance to pay.

So then on Wed. July 1st I get a letter from the insurance company that the psych eval payment was denied because I didn't complete a specific weight loss program, which I wasn't even doing.  Instead my PCP is following me, which is an approved option.  So then the insurance tries to tell me that they don't have anything from my PCP that says I've been doing a weight loss program...PCP has faxed it repeatedly...even met with the referral committee....then I get told that they are waiting for my mental health records...WTF...and the woman says but you probably don't want them to get a hold of your mental health records...I said um why...she says because it could have an affect on your future insurance benefits...I said WHAT...lady there is nothing in there that is bad!!!!!!!!!!  Pissed me off!!!!

Then they proceed to tell me that I have to go through a month of psych visits...a minimum of 3 and that there is no testing that needs done...uh that isn't what the criteria that was sent to the psychiatrist or the surgeon said...and my dr's office told me they are full of it...that they are trying to get me to give up.

So I called today again and I get told by the insurance that I can't get approved for the psych eval and testing(which wasn't necessary the last time i talked to them) unless I'm approved for surgery...but can't get approved for surgery unless I get the psych eval....so now it looks like I'm going to have to pay $800 for my dang psych eval out of pocket...

My doctor's office said they are talking circles and not making any sense...well yeah...so now what...I'm getting a bit freaked out that they are going to be a PITA when it comes to approving the surgery...and I feel like beating my head into the wall...

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