Friday, February 26, 2010

You are cordially invited to my pity party.

You are cordially invited to join me

for a pity party

on Friday, February 26, 2010

from 5 o'clock in the afternoon

until midnight

there will be cocktails and fattening foods!

well, there you have it folks, it's official, I'm feeling sorry for myself in a big way. I decided I would call the insurance company this afternoon, you know, just for fun and rejection. The person I talked to today informed me that no appeal has been made to the first letter they sent me informing me that the band was not medically necessary. I said, "but my doctor got the additional information, I went to the psych evaluation, the nutrition meeting, did everything I was supposed to and the doctor sent all that in." He said, "I'm so sorry, I'm not showing any of that."

Big tears start to well up in my eyes, my lower lip begins to quiver, I muster the words "Thank You." I cry. Mind you, I'm at work. Sitting at my desk on a very cold and rainy day, the reception area of my office is filled with men who work with me and they are all just hanging out, so to go to the restroom, I have to cross the room. Everyone staring, as I make the cry baby walk of shame to the ladies room.

I make it back to my desk, call the doctor's office, they are closed on Friday. So, now I'm thinking I've just wasted a whole month waiting to hear from someone and there is nothing to hear. I want chocolate and mashed potatoes and all things comforting and bad.

So, I typed a letter to the receptionist at the bariatric center requesting some clarification on the situation and faxed it over there. I guess I'll spend another weekend not knowing what's up. Anyhoo....pity party I shall have. I'll try not to drown my sorrows in chocolate though.

I hope everyone has a happy weekend. I'm glad it's here!




Drazil said...

Oh Tess...I'm almost crying for you. Try to remember it's like an author getting his work rejected....never give up....every rejection is one step closer to an acceptance. You'll get it - I know you will! I'll pray!

Bonnie said...

Tess - Didn't the insurance company tell you on Feb 18th that your case was under appeal and you'd have an answer by March 8th? WTF!!?? I apologize, but I don't remember why they turned you down before. What are their requirements? What is their malfunction? The insurance coordinator in the office should really be helping you fight this. If she/he is not helping and you meet the requirements, I would call the insurance company again and say you were told on February 18th that your file was under appeal and you would have an answer by March 8th. This is bullshit. Sorry to get so riled up, but I used to work for an insurance company and one of the reasons I left was the runaround we'd give people about claims. I wasn't a claims person - I was a hospital relations rep - so hospitals would complain to me when their claims weren't getting paid. If you clearly meet the requirements for the surgery and you are getting turned down, you need to contact your Insurance Commissioner and file a complaint. I hate to say it, but where insurance is concerned, DON'T BE NICE. Demand to talk to a manager. We had reps at our company that didn't have a clue and would give people total crap for information. Make sure you always get the name of the person you talk to and some kind of reference #. In summary, I will absolutely cocme to your pity party, but we need to turn it into a pissed off party because this runaround is unacceptable.

Bonnie said...

I hope it doesn't come to this, but I googled the Louisiana Insurnance Commissioner and here is the link

They have a complaint form you can use. I am so sorry you have to go through this. I hope the insurance coordinator in your surgeon's office can get to the bottom of this.

Band Groupie said...

I'm fashionably late, but I'm here for you! I can't tell you how many people I've seen go through several appeals and then get approved. I think it's the d*mn insurance companies way of weeding out the people who aren't totally stubborn and committed...hang tough girl. So sorry... ((hugs))

LDswims said...

I'm excessively late but I'll toss back a bottle or two with you. This sucks! I am so sorry you are having to endure this. I hate these insurance jokes! Hang in can do this. I'd be jumping down a few people's throats on Monday...but that still doesn't help this weekend. Ugh! I'm thinking about you! Chin up...this is still about you and you are still in control!

Lonicera said...

Hang on in there Tess...don't give up! We're all rooting for you.

Girl Bandit said...

I am super late but just want to say don't give up...fight for it. Someone is stuffing you around...I can only imagine how frustrated and sad you felt on Friday....Take care and chin up...if you can.