A Bit Bummed :(

**WARNING** this post is a pitty party for myself. I'm just whining because I need an outlet.

One of my very best friends in the entire world wants to write me off because of an argument we got in over work related issues :( It shouldn't have effected our friendship at all, but she basically told me (after I apologized even though I have nothing really to be sorry for-I'm passive aggressive) that she's done with me. Maybe this work issue is just what broke the camel's back. Maybe she's been ready to be done with me for a while...that's the only thing that makes sense, otherwise this tiny stupid insignificant work issue would not have been enough to end an entire friendship.

She was supposed to go to the hospital with me for my surgery :( And now I'm sure she won't be. I'm so bummed. I really needed her for support and just to have her there with me. I support her in everything and now she's abandoned me all because she got her panties in a twist over something stupid :( I guess our friendship wasn't that strong.

And now I'm just frustrated because I was counting on her in the first place. Maybe I shouldn't count on anyone because they all have the ability to let me down. Or maybe this is one of those life lessons where I'll learn to count on myself and only myself.

In all reality I won't be by myself, I do have other people who love me and would not abandon me over such stupid little arguments, and one in particular who will be by my side the entire time. But again, this is a pitty party and I wanted to be dramatic and negative.

To those of you who are still with me and haven't given up on me, I so appreciate you!! Your constant support and encouragement is what keeps me going!

It's about time!!

Thank you SO much for those of you who still check this! I finally have some good news to share!

Insurance has FINALLY approved me!!!

It has been such a long time coming and it was NOT easy, as you all know given my last posts. Basically what's going to happen is I am going to self pay the band removal portion of my surgery only, and the insurance will pay for the rest. It's not ideal, but it's better than being a complete self pay and wasting more and more time fighting the insurance company on this. I'm not getting any younger or thinner here people!!

I am having my surgery with Dr. Husted here in Arizona. For those of you on OH who know of the Dr. Husted controversies- please, I am respectfully asking you to not put me down for my decision. I am not about to get into a surgeon war with anyone and I have made an educated decision that I am comfortable with. I only ask for your support in my surgery and surgery related questions/concerns, not my decision in my surgeon.

Anyway-- it's not 100% official yet, more like 98%, but my big day is supposed to be August 1st!! Six weeks!! AHHH!!

I cannot begin to tell you how excited I am, but nervous at the same time. It is FINALLY my time to re-join you all on the losers bench...so scootch over!

(ps- the pic is just 'cause I felt like photo whoring a good angled shot)

Ok, maybe it's not so bad...

Perhaps I over-reacted a tad yesterday, as it seems that the reason for the decline isn't all that bad. The insurance company denied the surgery because I didn't have an updated psychological review. The one that my surgeon's office sent was from my lap band surgery approval in 2009, so yeah, they'd want something more recent. So I have an appointment tomorrow with my same behavior modification therapist, Dr. Garcia. It'll take about 3 hours and 500 pages of questions plus the verbal part, but then I should be good to go! She'll write up her evaluation and then fax that to my surgeon's office and then they'll re-submit my request. I'm hoping for a week or so to hear back, but up to two weeks, and then it should be approved. I've gone over the requirements and I meet all of them so there really should be no reason for them to deny me again.

SO KEEP YOUR FINGERS CROSSED!

WHY?!

I do NOT understand why it was SO easy for me to get this crap-band put in, but now that I'm trying to revise to a surgery that will actually work for me, it's become the biggest nightmare of my life!! I can't get my insurance company to approve a revision. They said that it's not medically necessary. Despite the fact that my port is disconnected so I can't get filled OR un-filled without going in for a fluoroscope every single time, despite the fact that my band is FULL and I still don't have restriction 100% of the time, but then other times I take 1 bite and I throw up, despite the fact that it's making me sick all the time. So I re-submitted for approval for the surgery only instead of the revision, and I would pay to get the band taken out myself, and I just called and they have denied me again!! I am so livid, I don't know why they denied me, they couldn't even tell me. The crappy part of all of this, is that I'm going through a divorce and my insurance is through my husband's work, so the longer this goes out the riskier it is that I'll get kicked off of his insurance before the insurance company finally agrees. I'm waiting to hear back right now as to WHY it was declined, so that I can appeal immediately. I qualify for the surgery part itself, there is NO reason why I should be denied! I'm going to go cry.

Just one thing after another

I hope everyone had a great Christmas!!

Ok so here's what's been happening:

* I didn't have my revision because 3 days BEFORE my scheduled surgery, the insurance denied my appealed request for coverage stating that it's not medically necessary. They didn't feel that we presented them with any new information.

*My insurance wants me to write out a new letter with why I feel that the surgery should be covered and why I feel that my claim is medically necessary. I'll be getting the original letters and information sent to them from my surgeon so that I can see exactly what my surgeon's office said.

As I'm sure you all can guess, I am so extremely frustrated. I have until the end of January to write my personal appeal, so for now I'm just trying to recover from the holidays before I start stressing about that.

If anyone has any good pointers or tips on what to put in my appeals letter, PLEASE let me know.

Happy New Year!!

UPDATE!

Thank you for patiently waiting for this update. Let me start by saying "ugh."

Ok so I went in for my appointment with Dr. Blackstone (the surgeon) and she was very excited about my decision to revise to the DS from the lap-band. She re-assured me over and over that this is not going to be very risky and that she is not at all concerned about my health in regards to potential surgical complications. She really made me feel better about my concerns with being her first DS surgery.

I feel like the ball got dropped once it was out of Dr. B's hands because it seemed to take forever to get my insurance submitted. Only after numerous calls did something finally get submitted with just barely a month until my proposed surgery date.

Now comes the bad news. I literally, just 2 minutes ago, got my letter from my insurance (BCBS of AZ) DENYING my surgery revision request. They said that they did not receive any information from Scottsdale Bariatric that deemed my revision "medically necessary." It's after office hours but FIRST THING tomorrow morning I am going to call to find out exactly what was submitted. Melissa specifically said that she would have my info submitted to insurance with the claim that I had one of the medically necessary reasons for revision. Technically, I don't. But there are approved reasons that don't really have to be proved other than my surgeon's say-so. *Long deep sigh* I knew this wasn't going to be easy. But obviously I haven't even begun to fight back so this isn't over. I will dispute it and have Scottsdale Bariatric re-submit my info with the "medically necessary" reasons that I was originally told they would. I'm just annoyed because my proposed surgery date was November 17th. Yeah...that's not going to happen at this rate.

I'll post any updates as soon as I get them. Thanks for checking back and reminding me to post ;)

FINALLY!!

Sorry about my previous post...I know it left a lot to the imagination, hopefully you made it interesting.

A brief explanation for the madness:

I have been trying for forever to get my surgeon to give me some info on my revision, and I wasn't getting it.

An update:
Having had it up to HERE (if you could see where here was, you'd know how pissed I was) with being ignored, after being promised I was a "v.i.p. patient" I decided to discard my halo and send a very un-Steph-ish email to the surgeon's office through their new patient email section. In not so many not nice words I expressed my intense dissatisfaction at my treatment of late and gave them until this Friday to make me feel better or else the next time I contact them it will be with a new location they can send my files too.

"Coincidentally" my surgeon's assistant (Melissa...I've explained her in prev. posts) just happened to get more information to give me today and actually called! Amazing how it just happened to be right after I sent the email that she didn't bring up. (I'll confess now, I still love her even though she drives me crazy sometimes.)

Long conversation and lots of eye rolling short, they FINALLY have an exact date for their training, and that means I have a time frame for my actual surgery date! Their training date is November 15th, so that means my surgery date should be within the following week. At first that bummed me out, but I realized, after much rational and grown up non-temper tantrum throwing thought, that really even if I went through someone else at this point, they wouldn't be able to get me in any faster. And it would cost a lot more and I'd have to take way more time off work to travel out of state. No thanks.

So it looks like the ball is finally rolling and I am excited about that, even if it's later than I had hoped. All is on the well-ish side...for now :)