writegirl
Work in Progress
@DianaCox @Larra as expected, BCBS denied my BPD-DS because my BMI is not 60. Dr. Boyce is going to do a peer-to-peer review, but I have lost hope of this getting approved. The patient "advocate" at Boyce's office is hostile and rude. She doesn't seem to understand why I would dare be upset that their office should have KNOWN what surgery I would quailify for based on BMI standards from the first freaking visit. I asked whether I should see Boyce again before he conducts the peer-to-peer review, since I haven't seen him in nearly a year and he might want to be refreshed on why he recommended DS to me in the first place. But, I was told "No, the only reason to see the doctor again is if you change what surgery you're asking for or to get surgery."
You know, I find this less than helpful. I get the feeling that the advocate isn't actually advocating for ME. I feel like my surgery is being treated like an inconvenience for her and I'm not sure she's going to do all she can on her end to make sure Boyce knows what he's arguing for before he conducts this peer-to-peer review.
When I asked how often these reviews are successful, she told me "It depends." And, when I asked her if I will be informed as to when this review is going to be conducted, she said "You'll know the result after the review." So, I made it more clear: "I would like to be informed before the review as to the date it is going to take place. Will you contact me?" Huff, sigh, "Fine, I'll let you know."
It seems to me that the fact that whatever WLS I get is an enormous LIFE ALTERING decision for me is utterly lost on this office. I'm rather frustrated by the whole way my case is being treated. I know it's not the advocate's fault--she was not working in the office on the date of my initial consultation. But, many people in that office have dealt with me since then and they should have known on day one that my insurance wouldn't cover the DS and I should have been told sooner than the day before she was about to send my case in for approval. The entire thing has been handled badly by this office.
I'm in no-man's land right now and can't plan my life till the peer-to-peer review gets denied (I'm sure it will) and I have no idea when that will happen or how long I'll have to wait for an answer. I'm starting to get pissed
You know, I find this less than helpful. I get the feeling that the advocate isn't actually advocating for ME. I feel like my surgery is being treated like an inconvenience for her and I'm not sure she's going to do all she can on her end to make sure Boyce knows what he's arguing for before he conducts this peer-to-peer review.
When I asked how often these reviews are successful, she told me "It depends." And, when I asked her if I will be informed as to when this review is going to be conducted, she said "You'll know the result after the review." So, I made it more clear: "I would like to be informed before the review as to the date it is going to take place. Will you contact me?" Huff, sigh, "Fine, I'll let you know."
It seems to me that the fact that whatever WLS I get is an enormous LIFE ALTERING decision for me is utterly lost on this office. I'm rather frustrated by the whole way my case is being treated. I know it's not the advocate's fault--she was not working in the office on the date of my initial consultation. But, many people in that office have dealt with me since then and they should have known on day one that my insurance wouldn't cover the DS and I should have been told sooner than the day before she was about to send my case in for approval. The entire thing has been handled badly by this office.
I'm in no-man's land right now and can't plan my life till the peer-to-peer review gets denied (I'm sure it will) and I have no idea when that will happen or how long I'll have to wait for an answer. I'm starting to get pissed
