Wednesday, September 27, 2006

Worried ... Frustrated ... Angry ...

The past week has been tough. I've been trying to keep a positive attitude and trying to control my anger and anxiety .... but I haven't been doing a very good job at it.

Worried ...
I'm worried because of the "12-month doctor documented diet history" that is a requirement of Blue Cross Blue Shield to pay for the surgery. I know I've done the 12 months of dieting. I know I've talked to my doctor 3 times throughout this past year about my diet and exercise program and he's approved the plan and encouraged me to continue as I was. But I'm worried that he didn't bother recording those conversations and details of the program that I provided to him in my medical records (progress notes).

Frustrated ...
I'm frustrated that when I call BCBS they say 3 doctor appointments within a 12 month period where diet and exercise program was discussed with my doctor fulfills that 12-month requirement. But Hurley staff is saying it needs to be 12-monthly visits throughout the year and they won't submit my paperwork for insurance approval until that documentation is shown.

Angry ...
I'm angry because I just found out that my PCP hasn't even sent the right parts of my medical records. They sent all the test results and lab work reports (which was noted on the request to exclude), but none of the Progress Notes --- which was specifically requested in the original request, but apparently someone can't read.

I talked to Hurley this morning and that's when I discovered that my PCP hadn't sent the right stuff -which is what is holding up everything from moving forward.

So I called my PCP office and of course everybody is too busy to talk to me or take my call. I went round and round with them like this a few weeks ago and the only thing that got the job done was my showing up at their office --- phone calls are never returned. But in order to show up at their office I have to take time off work. Grrr!!! I just feel like I can't trust him or his staff to treat me with respect and courtesy. Oh sure, he's nice enough when I'm at his office for an appointment, but to request anything out of the ordinary (like making a copy of my medical records) they can't seem to handle. Plus, here I am doubting if he even wrote down the information we discussed in an appointment --- if I can't trust my own doctor, why am I staying his patient?

So pray for me. I just need the peace of mind to get through this and keep a positive attitude. I KNOW I've met the requirements for the surgery, but it's proving it that's going to be the hurdle. And if I get denied and have to start over with the 12 month diet, I'm not sure I will handle that very easily. Just thinking about that possibility brings tears to my eyes and makes me angry and frustrated.


1 comment:

  1. I have to say that the insurance aspect of WLS is the most frustrating thing I've ever gone through. It seems that this whole process it just too much work for the medical profession.

    I'll be praying for you while I anxiously await hearing myself :)


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