Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts

Wednesday, November 21, 2007

It's real now!


An Updated Timeline!

4/20/07 Weight loss consultation with PCP
4/21/07 WLS Seminar at Centennial
5/21/07 2nd month of 6 month diet
6/22/07 3rd month of 6 month diet
7/24/07 4th month of 6 month diet
8/21/07 5th month of 6 month diet
9/17/07 6th month of 6 month diet
9/24/07 Scheduled Nut appointment and surgical consult
10/3/07 Nutrition appointment
10/8/07 Surgical appointment
10/9/07 Upper GI Scheduled
10/17/07 Checked to see if my paperwork to insurance has been turned in. My insurance rep at the Dr.’s office told me I was missing my 6th month weight consultation. After an evening of anger, the situation took care of itself.
10/18/07 Weight loss packet faxed to Cigna
10/22/07 Weight loss packer returned unreadable
10/23/07 Weight loss packet mailed to CIGNA
10/26/07 Information entered into CIGNA computer. Calling daily to check on progress.
11/2/07 CIGNA reports that packet is in out-patient approval dept. After numerous calls to Dr's Office, situation seems to be corrected. Once again the waiting game has started once again!
11/4/07 Created time line
11/5/07-11/6/07 Calling CIGNA Daily! No answer as of yet!
11/6/07 Paperwork finally recieved in correct department, or at least that is what CIGNA is now reporting!
11/7/07-11/12/07 Calling CIGNA Daily! No answer as of yet!
11/13/07 Good news or bad news? Good news, there is no bad news! Got insurance approval for RNY. Date set for
12/18/07
12/3/07 Pre admit at hospital.
12/18/07 I will get an early Christmas present! Surgery at 5:30a.m.


Let's add another date into this mix! 12/13/07 my sister has her RNY surgery! So, at the Christmas table this year, there will be "3 Losers" on the losers bench! Sometimes it's nice being a loser!

For those who have followed my progress. Thank You for your support and understanding as I make some major changes in my un-healthy life! A lot of thought and prayer has went in to this decision. Let me emphasize that statement. A LOT OF SERIOUS PRAYER has went in to this decision. I love the qoute below by Oliver Wendell Holmes, it speaks very loudly to what I am doing. Read the qoute below and then decide..."Are you at anchor, or ready to sail?"

Have a great day!

"I find the great thing in this world is not so much where we stand, as in what direction we are moving: To reach the port of heaven, we must sail sometimes with the wind and sometimes against it, but we must sail, and not drift, nor lie at anchor" ~Oliver Wendell Holmes~

Tuesday, November 6, 2007

Like sands through an hourglass....


…so are the days of our lives! The hourglass is not moving to my specifications! This is where I am today! The waiting is unbearable, not only for me, but my family also! I am normally a very patient man. It seems recently I’m not. Every day I call CIGNA to see if I have an approval code. Now I am nice when I call, but I call none the less. And for the most part, the people at CIGNA have been nice too. But guys, I need to be honest also. I am angry, depressed, and just don’t feel good! Now, before I get yelled at, I am seeing a Dr. for the depression. I am actively working through the process. But I am human! I am aware of my actions around my family and other people, but I am trying to keep those in check. Keeping my attitude in line around other people is very easy. My family, that’s another story. It seems we only hurt the ones we love. And that’s the case. So, I am really working hard at not biting Beth or R.J.’s head off at any given moment. They have been real troopers through this, and keep reminding me that it will happen! I know it will, but just not soon enough!

There was a post on the main board yesterday about WLS and how males were to macho for support groups. Well, guys I must not be macho! I need the support that you give! I also will support anyone who needs it…male or female! I’m not asking for a lot, I’m just asking for the sands that are running through my hourglass to stop for a moment and give me an answer!

Like sands through an hourglass, so are the days of our lives! No matter what happens, we cannot control how fast or slow those sands move. But we move on, we persevere, and like Gloria Gaynor say…”I will survive”!

Sunday, November 4, 2007

A WLS Timeline!

When I started the WLS process, I knew there would be road blocks. I knew there would be rivers to forge, mountains to climb, and heights to soar! OK, enough with the poetic waxing! I have been trying to put together a time line from when I made up my mind to now. I realize that this might not be totally accurate, but it is very close what is happening. So, with out further ado:

4/20/07 Weight loss consultation with PCP
4/21/07 WLS Seminar at Centennial
5/21/07 2nd month of 6 month diet
6/22/07 3rd month of 6 month diet
7/24/07 4th month of 6 month diet
8/21/07 5th month of 6 month diet
9/17/07 6th month of 6 month diet

At this point, I thought all my paperwork would be turned in. Unfortunately no, and if I had not followed up with insurance, I never would have known. At this point I found out that my Nutrition appointment and Surgical Consult needed to be scheduled. Now back to the regularly scheduled program:

9/24/07 Scheduled Nut appointment and surgical consult
10/3/07 Nutrition appointment
10/8/07 Surgical appointment
10/9/07 Upper GI Scheduled
10/17/07 Checked to see if my paperwork to insurance has been turned in. My insurance rep at the Dr.’s office told me I was missing my 6th month weight consultation. After an evening of anger, the situation took care of itself.
10/18/07 Weight loss packet faxed to Cigna
10/22/07 Weight loss packer returned unreadable
10/23/07 Weight loss packet mailed to CIGNA
10/26/07 Information entered into CIGNA computer. Calling daily to check on progress.
11/2/07 CIGNA reports that packet is in out-patient approval dept. After numerous calls to Dr's Office, situation seems to be corrected. Once again the waiting game has started once again!

11/4/07 Created time line

Where are we? That seems to be the Million Dollar question. Once again I will start calling on Monday to check on progress!

“T
he great thing in the world is not so much where we stand, as in what direction we are moving.” ~ Oliver Wendell Holmes ~

Have a great week!

Friday, October 19, 2007

Looking for Dionne Warwick?

First of all let me say a big Thank You to all of you who responded to my "A Tad Upset" post. That is the main reason I Love this group of people!

So, what's next? All of my paperwork has been found. This includes the very first Weight Loss consultation in April! YEAH!!!!! Centennial has in turned faxed all of my paperwork needed to CIGNA ! Anyway, I am going to be upbeat, positive, calm, compassionate, kind hearted...oh yeah PATIENT with my wait. Or as a friend of mine said "Graciously Tenacious"! I love that phrase!

So, Thank You! and to borrow a line from a Burt Bacharach/Hal David song (I know, I'm showing my age)..........

"Say a Little Prayer For Me"

Thursday, October 18, 2007

A Tad Upset !


Hey guys,

I apologize for this post...yes I am apologizing for the anger I feel! I have met several of you from the Centennial support Group and other functions throughout town, and I am truly blessed in knowing you! But I am angry this evening.

You see I am a patient of Dr. Dyer, and have been undergoing my 6 month diet. Approximately 3 months ago, I was informed (wrongly) that I would be finished in Sept. with my 6 month. Right as I finished the diet, my case was transferred from one rep. at CMCWLS to another. Well here is where I get confused. Like I said, my diet should have been finished on Sept. 17. After that appointment, I emailed my insurance rep at the clinic to find out what was the next step. I found out the task that needed to be completed and immediately set up arrangements to fulfill these said appointments.After all was finished, I gave it a week only to find out my paperwork was not sent to insurance. I was informed that we needed to wait on the transcript form the surgical consult. Once again igave it a week. As I was following my information on the Patient Portal, I noticed my weight loss records were not checked as completed. I immediately called CMCWLS only to find out, are you ready...they only have 5 months of weight loss records. According toCMCWLS, the records they have are from May -Sept (5 months of weightloss records). Angry was not the word used to describe my emotions. I called my PC P's office to find that my WLS journey was begun in April, not May. So according to Summit Primary Care, I have 6 months of weight loss records.

I know how I feel is not relevant to the care that CMCWLS gives out,but if I did not follow up on this, would I have ever known that files are missing? I have heard of the roadblocks that we face when we have WLS, especially from the insurance companies. I just never expected it from my Dr.'s office.

I understand I am ranting, and once again I apologize for my feelings. Tomorrow I will call my PCP and request that the files be sent again. Hopefully we can move in the right direction.I truly love being a patient of Dr. Dyer. I think CMCWLS has the best program in town! I thing CMCWLS patients and the support group here are truly one of a kind!

So, I really don't want to change services. I guess I will hold my tongue now and go to bed. Maybe Iwill feel better tomorrow!

Thanks for listening! Scott

Thursday, September 27, 2007

Anyone have an extra GPS?

Map
You know, I think this would be a lot easier with a GPS. You know those things in newer cars! They tell you what road to turn on, how to get to your favorite restaurant, and my personal favorite…”Please make a U-Turn”, right in the middle of the interstate! Sometimes technology is too smart!

I think I need a GPS for the insurance system. As you know, I have just finished my 6 month diet. My 6 month files were to be faxed on 9/15. Guess what? That’s right, it was not done! I called Centennial, where I am having surgery, on 9/21, to find out they did not have my files. Here I go, calling my PCP, preparing to unload! The girl in medical records was super kind and completed the task with in an hour. Now that’s service with a smile!

On Monday 9/24, I found out my file had been transferred to another financial person. At least she had my 6 month files! YEAH! Yep, here it comes…another roadblock. It seems I have to have a surgical consult, along with my nutritional eval, before things may be submitted to insurance. UGH!!!! I am going to my nutritional evaluation this morning, and can’t get into my surgical consult till Mon. 10/8. Hurry up and wait! Seems like the story of my life!

Well, below is my weekly weigh in! And if anyone finds a GPS for insurance companies…please let me know!

Have a great week!

9/24
First day of 6 month diet 355.9
Last Dr. Appointment 297.1
Last Sundays Weight 294.5
Weight this AM (9/24) 291.9
Weight loss this week 2.6
Weight gain this week 0.0
Total weight loss 64

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