oliveeue
Have been overweight since the birth of my second child. Never seemed to be able to loose the weight.
I have been to the gym over and over and over, I get going and then something stumps me. As time has gone on I have had to have several knee and back surgeries in which now I have terrible arthritis and affects my ability to walk and move easy.
I have wanted this surgery for a long time but never really looked into it. Finally this past spring (2009) I met someone who had had gastric bypass surgery and it got me thinking that maybe , just maybe, It was covered under my insurance. It was, So I started my journey.
October 5, 2009 - Met with doctor, love him
October 22, 2009 - Attended the mandatory pre-op class
October 27, 2009 - Hand delivered my doctors notes to surgeons office
October 28, 2009 - Surgeons Office refuses to submit paperwork. They insist that I need 6 months of Diet and Exercise notes. Humana doesn't require.
October 28, 2009 - Received letter from Humana that no 6 month diet and exercise notes required.
October 29, 2009 - Called Doctors office AGAIN, they advised that they will NOT submit paperwork, they do not care what Humana wants.
11/2/2009 - Spoke with Humana directly, ironically, Medicare doesn't even require a 6 month diet and exercise plan. They forwarded a copy to doctors office on 10/28 and today. Found out from Humana that I cannot use another physician because I cannot travel outside the area where I live. So I am stuck with this doctors office!
11/4/2009 - Still have heard nothing from the doctors office.
11/4/2009 - Called and left a message for the office manager to call me back
11/5/2009 - Office Manager still has not called me back. Left another message for her to call me back.
11/5/2009 - Called Physicians other office and was able to talk to a reasonable person. However, she about made me drop my jaw... she told me that I have lousy insurance (medicare replacement policy) and that the doctor probably will not break even so the office wont work hard on my claim because there is no money in it. I just couldn't believe my own ears... I'm still pretty speechless...
Friday, November 6, 2009 – Spoke with office manager and she again advised that I was wrong and that Medicare ALSO gave me the wrong information. I finally caved in and agreed to give them what they want.
Friday, November 20, 2009 – Emailed Humana requesting for them to provide me a link for official Medicare criteria. http://www.cms.hhs.gov/Transmittals/downloads/R54NCD.pdf
Saturday, November 28, 2009 – Sent letter to physician's Office to the attention of the office manager and CC to physician.
Monday, November 30, 2009 – Physician called and asked for an update on my issues.
I filled him in and asked if he had received my letter and stated “No”. I advised him that I DID want my clinicals sent to insurance company. He requested that I send the office manager an email. The practice is afraid that if they deny them I will blame them and I advised that I was aware of all that.
December 7, 2009 - I just received an email from the office manager that all my information was submitted to the insurance company. Hallelujah
WOW what a week!
December 13 at 1:30 am I was admitted into the hospital in Plano, Texas. I was in EXCRUTIATING PAIN, I have never had such bad pain but it was BAD. The ambulance took me to the hospital and they advised me that I had gallstones blocking my liver and pancreas ducts. Since Sunday Morning, I have had two surgeries and am home recouperating, and received a phone call today that I was approved for surgery for WLS, I laughed, how ironic! BUT am happy, it looks like I may have to wait now about 6 weeks before I have my WLS surgery.
THE GOOD THING... I was right about my requirements for surgery!
Surgery has to be postponed due to Gallbladder surgery. Surgery is scheduled for 1/26/2010
1/18/2010 - Pre Op Appointment - All ready for sugery!
1/26/2010 Surgery - Please read blogs for updates!
4/15/2010 Called to reschedule my appt and was told there were no appts available. I am only three months out and still throwing up daily, but Dr. Castro's office staff trump him.
4/15/2010 I did get the office manager to call me back and they did accomadate me. HOWEVER, when I arrived for my appt, I was scolded for the write up I put on www.obesityhelp.com.
DO NOT USE this WLS Clinic
New Beginnings Surgical Group
Dallas Office
http://nbsurgical.com/content/index.php?option=com_contact&task=view&contact_id=4&Itemid=46
