Friday, January 22, 2010

Taking my ball and going!

Thursday, I committed to another bariatrics office and surgeon.

So, here's the deal. Throughout my months of visiting the dietitian and getting all the tests, the bariatrics office had two surgeons, both of which maintain private practices. Recently, the surgeon I committed with left and went to a larger hospital in larger town about an hour away.

I wanted to go with him then, but I denied myself that because of a battle I have been grappling with. There is only one major provider is in this area that pretty much runs the show. I grew up in South Florida, Miami to the south, Fort Lauderdale to the north. A world's difference in just about every facet of life. When there is more than one provider, competition for my business drives better service. In this neck of the woods - not so much. This region is filled with pocket towns that have one gas station, one diner, one Chinese restaurant, you get the idea. Maybe it is because I didn’t grow up here and don't understand the mindset, but I always seem to feel as though I am bothering the gas station attendant when he has to get up from his stool to run my credit card. The expression "Have a nice day" is rarely said.

So, when I first arrived here I turned my nose up to this area. But I found myself getting too negative. I mean, who the hell am I to tell people to "be nice?" If I am going to be happy here, the round peg and square hole routine is going to have to stop. This mindset is precisely the reason why I did not follow my instinct and go with the first surgeon, who about a month ago left my area hospital to go to the larger hospital about an hour away. I considered staying with him at the smaller, much smaller, hospital, therapeutic to my assimilation effort.

What is the expression about first instincts?

Last Tuesday morning was the last I spoke with the bariatric center where I started, and it was me that called. I can only be told, "We'll call you when we know something" so many times. I mean, wouldn’t it occur to someone that after my surgery has been postponed twice, I might be a bit anxious. I don't want to seem high maintenance, but at least patronize me with a phone call every afternoon and say "The surgeon couldn't call you insurance company yet but he will very soon. Gosh, I know you must be a bundle of nerves."

Already, I see the difference at the larger facility. I called yesterday morning, Thursday. It seems as though the doctor’s files traveled with him. They said they would call me back before Friday afternoon. Maybe I was too negative after my first experiences, but I thought "Sure, I'll call you Monday afternoon and you'll say that you were going to call me last week but you really had not found anything out yet."

Before lunch on the same day, the office manager called me herself. She said that her main responsibility is pre-authorization and the only thing not in my file from the move was my insurance info. So I gave it to her. An hour later, she called again. Mind you, the first office has not called me in four days. the second location, where at this point I had not even committed to yet, has called me twice. Sunshine is starting seep through the clouds.

The good news is, the office manager, not the surgeon, was able to get concrete answers from my insurance company. The bad news is that, yes, my insurance company requires that I attend two post operative support meetings and get a clearance with a cardiologist. The office manager, like the lady at the first location, said that this is the first insurer they knew of to have such a requirement. Then, I had to ask it.

"Had I have initially came to you, is the support meeting requirement something you would have found out ahead of time? The office I have been working through only filed for pre-authorization about 72 hours before my surgery and 10 days into my liquid diet."

Answer- "More than likely we would have caught it, but I can't say for sure. See, we file for pre-authorization before you start your liquid diet, and if your insurance is one that we are not very familiar with, we call them before your first appointment and get a checklist of everything and then review it with you while you are here."

Proactive and transparent. Two qualities I admire. Yes, I am sold.

Now that this post has taken way too long, I'll cut to the chase. I will attend support meetings the first weeks of February and March and then we have a pre-op appointment, two weeks on liquids (again) and then under the knife I go.


  1. I am sure it is frustrating to have to wait until March, but it sounds like you've finally gotten some good news.

    I had a huge insurance/surgeon battle myself and it ended up taking 6 months before I finally had surgery. In a lot of ways it was the longest 6 months of my life but in other ways it gave me enough time to really get my mind right about the choice I was making.

    I hope the next two months pass quickly for you!!

  2. I'm really glad the new location is being proactive and getting all the requirements up front. Congratulations on finally getting some answers and someone who will contact your insurance company.

  3. Hi, I just found your blog through TracyZ, & thought I would pop on over & say hello!! I will be Following you if you don't mind.


  4. Finally, some results! So happy to hear that there is sunshine through your clouds. The waiting will definitely kill you more than the surgery will, believe me. The surgery was cake after the waiting to get it done was over with.

    Really, so happy to hear about this!


  5. I'm so glad you got some answers. I can't wait til I have a more specific time frame. Thanks for sharing and thanks for reading my blog and for your funny comment. Hang in there.

  6. How frustrating but I'm glad you're finally getting some answers. Even though your surgery is delayed, it sounds like you're moving in the right direction for approval and that this new facility will be much more accommodating. Good luck!

  7. I am so sorry that you have had so much trouble with this. My surgery was pushed back two weeks, I was actually in the OR waiting area with an IV hooked up when they told me! When I found out it would be two weeks, I was so upset. I can't even begin to imagine how frustrated you are.

    However, it sounds like you might be on your way, finally!