Friday, June 26, 2015

Just another hurdle

Let me just start by saying I have struggled with my weight for years. I overcame an unhealthy weight in high school, maintained that for a few years and then had children. So for the last eight years I have watched the numbers on the scale creep up. I have tried every diet I could think of, tried to exercise regularly, bought the things needed for success, but frankly my willpower against food is weak and each diet failed, I would come up with a million excuses not to go walk or run, and the products I bought gathered dust or became clothes racks. My self-confidence took a huge hit, as did my physical and mental health. I was spending more time and money managing the symptoms of my weight and not dealing with the core issue. So a few months ago, fed up with the roller coaster I was on, I began the ever drawn out process to get approved to have a bariatric surgery done. Thankfully my husband provides our family with decent insurance and they do cover bariatric surgery, but with stipulations (of course). I had to complete weight related evaluations and care for 3 months, be at certain BMI, have a comorbid disease, have a secondary recommendation for surgery, be cleared by a cardiologist, have blood work and all sorts of tests done and give up my first born before I got approved. Ok, maybe not the part about the first born, but everything else for sure. For weeks it seemed like an endless number of doctors’ appointments, copays, and waiting rooms. Despite the headache it took I kept in contact with the clinic often, got my ducks in a row and was so relieved when my final clinic appointment rolled around and they were finally able to submit to insurance. I felt like the light at the end of the tunnel was getting brighter, like my struggle might be coming to an end. I impatiently checked several times with the insurance precertification department wanting to get an answer and get my surgery date scheduled. After lunch one day I called to check one more time and I was told I was declined. DECLINED! Somehow the medical director at the insurance company did not receive my secondary recommendation or the proof of my comorbid condition. Now I am not sure if this is an oversight on their part or an error on the clinic’s error, but you best believe that it will be fixed. I contacted the clinic and they are jumping into hyper-drive to appeal the decision. I want to do on the record to say that I HATE insurance companies. I understand they are a necessary evil and if we didn’t have it we would probably be living in a box with the medical costs we would incur raising three kids, but the hoops and red tape that one has to jump through to get approved for treatment is damn near a second job and it is exhausting. They say do not pray for patience because God will surely give you reasons to practice it. I guess this is one of those times. I am trying to stay optimistic and I suppose the bright side is I can continue to swim for a while longer (I won’t be able to for a month or so after surgery) so I will treat this as just another hurdle and keep focused on the end game.


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