Saturday, May 9, 2009

Ok, so,,,

...I apologize for the last post, especially when followed by a long period of silence. Not a very nice thing to do. Like telling someone that you know someone who has a crush on them but not spilling the beans.
To pick things up, when I posted it had been about six weeks (I think) since Dr.Styrt said I was ready for surgery...and nothing had happened. After that appointment (six weeks prior) I immediately called The Chainsaw to get an appointment. His receptionist Kim told me that she couldn't just make me an appointment, that my insurance had to approve the appointment. So I called my insurance and asked what I needed to do. [I was worried because I didn't want to go through the litany of referrals (from PCP to ENT to OS) in order to get there. Some of you might remember form the SARPE that this took about six months when it was all said and done because doctors schedules are pretty backed up. So despite that it's a simple 5 minute conversation in which I explain to the doctor what's going on and why I need the surgery, it can take months just to get in.] The nice girl on the other end of the phone said no it's no problem, I just have to have my ortho send a letter explaining the situation to so-and-so. Well great. I pass the info on to Dr.Styrt and they send the letter.
Wait.
Wait.
Wait.
Now we're six weeks later, nothing has happened, and I'm back at Dr.Styrts for an appointment that, had everything gone as planned I'd be getting my surgical hooks on. But alas, nothing has happened. So now we start backtracking and find out that HealthNet had declined the surgery. Lemme say dat agin, Declined the surgery. Not just an appointment. So after MUCH confusion and phone calls back and forth to/from Dr.Styrt and The Chainsaw's, we got it figured out. And while that sounds like good news...

I do in fact have to go back through the gauntlet of referrals to even get the appointment with my OS. Even though they've all already seen me for this process. The way I see it, this is just step 2 of what has already been approved. The way HealthNet sees it, new procedure, new approval.

So I've seen my PCP and have an appointment with my ENT on July 18. After a lot of (hopefully embarrassing) recounts of what this surgery is and why I need it and "you've already seen me for this"s, she said she would call the ENT directly to try to either get a verbal referral straight to the OS or at the very least, to squeeze me in sooner. I called her again yesterday to see where we were at with that and apparently the ENT was on vacation last week (good thing, so was I) but that she will check up again and get back to me on Monday.
I'm hoping we can get everything in line for me to be in a hospital bed about 7 weeks from now.

1 comment:

stephanie said...

We can be surgery buddies!!!

Either way, though, I'm pulling for you. Argh, insurance. Hopefully it all goes as planned.