WOOHOO!! I'M APPROVED!!

[Guest guest]

Hi All,

I haven't posted much, but I have learned a lot from everyone who has. I never

truly thought I would have a chance. I hoped and prayed and did homework until

I thought my head would explode from WLS knowledge. I even had to dump some

stuff out of my head...just so I could fit more in! I realized that today, as I

tried to recall some info I KNOW I'd read 10 times already.

After my consult, I just took a break from all the research and the e-mails. I

had all my testing done before I went and my brain and emotions needed a break.

Much to my surprise my insurance co (MVP-HMO) called early last week and the

woman reviewing my case said I more than qualify, but, wanted to know why I was

going out of network when gastric bypass was performed by two surgeons in the

group. She caught me off guard with the call and I stumbled out an explanation

of the BPD/DS procedure I was seeking and why, and that the RNY and VGB were the

only surgeries offered in-plan.

She said she would have to do some research on BPD/DS...I offered to send her

lots of stuff. Declining my offer, she said, " Your doctor seems to know it

pretty well " . I'm not sure if she meant my PCP or the surgeon, Dr. Pomp. I was

still straightening out my tongue from my explaination attempt. She then said

that I would hear from them by the end of the week.

What a l-o-n-g week!...Then...The week ended. What a depressing weekend. I was

sure they denied me and that's why I didn't hear from them....they would just

send me a denial letter instead of calling with the bad news. I was trying to

go out of network on an HMO and knew my chances were slim.(Now there's a word I

hope to become more aquainted with!) Well, then Mother Nature dropped by just

to mess with my emotions and send me hurling into depression. Not to mention

the appitite she brings along. Darn that Halloween candy! I never felt a bit

better after eating it either...no matter how many pieces I tried it with.

I finally broke down and called MVP today. They said my case was with the

medical director and after quizzing the recptionist about how often I could

check on it with out driving them NUTS..he said to try back later in the

afternoon.

I was jumping on the phone all morning and practially kicking the person off if

they weren't from MVP or Mt Sinai. I decide to vaccuum the whole house, to try

to wear off some anxiety. The phone rings. Ding-a-ling-a-ling. I don't hear

it. Thank God she left a message! You are all set for your surgery with

Dr.Pomp at MT Sinai, an authorization #, a " We wish you well " , and an apology

for the delay. Apparently the medical director was out all last week...sick,

and had a stack of paperwork to go through yesterday. I immediately peeled

myself off the ceiling and called to thank them.

I CAN'T BELIEVE THINGS WENT SO SMOOTHLY!!!

Oh, I almost forgot...when Dawn called to ask why I was going out of network,

she said that they have had such a tremendous (meaning good) response from

patients that have had wls surgery, that they don't even require pre-approval

anymore, for the r-n-y or vgb (unless you are trying to go out of network for

something else, of course) I thought that was a terrific statement from an

insurance co. Kind of like... they realize wls is a life saving tool for people

and benifits the company by reduced health care costs...in the long run.

Atleast that's the way I took it.

All my prayers to everyone still awaiting approval, going into surgery, and in

recovery.

Peg Galloup

Highest weight...so far...339 Now...311 BMI 53

MVP insurance Upstate NY

Pre-op (I've waited a year to type those words)

Nov 21 Dr. Pomp will be demonstrating his Turkey Carving Skills...on ME !

Anyone else out there being switched around that date? galloup@... ~ or

~ galloup@...

Learn from the mistakes of others.

You won't live long enough to make all of them yourself.

The Galloup Family

Fresh Squeezed Dairy Goats

Northeast New York

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