Take That, Red Tape!

I scoff in the direction of retarded insurance policies designed to deter us from our medical goals! After a week of calling the ENT's office every day to see if anyone had cancelled so I could get in as early as possible (as opposed to waiting until July 18th, pssht) I came home after a day of late work to find two letters from my medical provider. Now, normally, these envelopes come about a week after I have seen my doctor and they're usually a questionnaire about how the service was and, normally, I throw them away because really who has the time? Well, the first of the two says, "Based upon information provided, Sharp-Rees-Stealy Medical Grp (sic) has approved a referral to the following: The Chainsaw, D.D.S., blah-blah-blah."
Sweet! I don't even have to go to the ENT! It's ridiculous that I'd have to waste his time and mine for him to look at me for the same thing again, seriously.
So I go on to the second envelope expecting it to be an accidental second copy of the first. It says, "This letter confirms that Sharp-Rees Stealy Medical Grp has been notified of a proposed treatment plan for you and has reviewed the plan for medical necessity and health plan coverage. The information obtained concerning the treatment plan indicates a hospital admission has been approved to the following: Leforte without* bone graft."
Yay! I didn't really have any worries about the surgery being covered because the first was handled without me ever seeing a shred of paperwork. My boys and girls in the offices are earning theirs for sure.
* I really do need, and am getting, a bone graft for my missing tooth/implant-to-be during my Leforte procedure, but I always knew it wouldn't be covered. But, by doing it at the same time, things like hospital stay and anesthesia will already be paid for. I did the same thing by having my wisdom teeth extracted during the SARPE. Just being efficient!
So it's great to get these letters. I'll set up an appointment to see The Chainsaw tomorrow morning and see how much steam we can get going here. In a perfect world, the first week of July would be best for surgery, but anytime before September can work.

Adjust

Went into Dr.Styrt's today. He and the Chainsaw had a conversation with my molds in hand and decided on one last adjustment before the big day. When that big day is, we have yet to learn. But it's nice to know that they are being proactive about things. It means that I've got four weeks to convince my ENT to see me ASAP so that by the time the teeth are where they want to be, the insurance approval is where I want it to be.
Like, in my back pocket. Sucka.

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.

Omigod...

...insurance is maddening.

I would explain, but I don't even understand the mess that's going on.

Go Bananas!

I am so happy. I went to GNC last night to restock on my protein shakes. To my utter surprise, they had a new flavor on the shelf...

BANANA! I tell you it doesn't get much better than this. The possibilities are endless. Use orange juice instead of milk and Bam! Breakfast shake! Add a touch of chocolate syrup and Bam! Frozen banana shake! Mix in a scoop of peanut butter and Bam! Elvis shake!

Pre- and Post-surgery weight gain just got a lot more tasty!

Two Years Later...

As I said, they took new pictures and x-rays when I went in a couple weeks ago. Well, as I'm sure you can tell, I was NOT prepared to have my picture taken but I thought I'd give you all the comparison anyway. This might be a rare case where the Before actually looks better than the After! Ignoring the disheveled hair and beard-in-process it might not be too bad. And it seems like my teeth are more yellow now than before but I'm hoping it might just be the photo. (At any rate, those are going to get whitened one way or the other when it's all said and done.) So here is the Before and After:

Sweeeeeeeeeet.

Guess what I had taken today? If you guessed "surgical molds" you are correct! That's it! Bam! I'm ready for The Chainsaw! They also retook pictures and x-rays so I'll get those posted as soon as I can. So, as soon as we were done I called my primary care provider to get a referral to see my surgeon a second time. They said my ENT had to be the referring physician so they were kind enough to call him for me. (You may recall, the last time I went through these referral hoops, it took me almost half a year.) So hopefully I'll hear back from Veronica or Kim at The Chainsaw's office with an appointment for my second consultation. Anyway I'm totally stoked that I'm ready to go because it looks like my timeline for a May cut-up date should be attainable.

Whoooohoooo!