I know I haven't posted in a long time... but when you're dealing with insurance companies, all you can really do is wait... wait... and wait some more. I just knew that all of this was going too smoothly, and how naive I was to believe that this whole ordeal would be easy sailing. So, here it goes...
I've completed the program. I've done everything I was supposed to do. I was proactive. Everything was going my way (just the way I like it)... until yesterday when we hit that bump in the road! My Anthem insurance called me yesterday to tell me that Martha Jefferson was not considered a "Blue Distinction" facility, and therefore would not be covering my surgery. (I take that back... they WOULD cover it, but I would have had to pay 50% out of pocket AND they were going to process Dr. Trahan as out of network).
So, obviously that was not going to be an option for me. I mean, seriously, we're talking about a 20-some thousand dollar surgery. So my mind started freaking out: Had all of my hard work the past few months and all the money I've sunk into this just gone to pure crap?
Here's what made me mad: Lillian (Dr. Trahan's nurse) had spoken with Anthem not once, not twice, but three times... and not once was she told that Martha Jefferson didn't fit their protocol. So today I received the call from Martha Jefferson. Bottom line: financially it would be stupid for me to even pursue having the surgery at Martha Jefferson at this point.
So now that I've gotten you all worked up... here's the good news: University of Virginia IS a blue distinction facility, and thankfully, they were willing to accept all of my records. The only thing I have to do over is attend their seminar December 13th, meet with their surgeon (surgeon now will be Dr. Hallowell) and their dietitian... then we'll set a date. We had planned on December 27th at Martha Jefferson, and now it looks like I'm only going to be set back by maybe a week or two.
I'm sure UVA will do a fine job, it's just aggravating that I pay so much for my health insurance and cannot decide which surgeon I would like to perform a major operation. I've never had a major health issue/surgery so my experience with hospitals isn't broad... but what I can say is that Martha Jefferson is by far the most patient-oriented facility I've ever dealt with. Lillian was most helpful... and what impressed me even more, is that she was freaking out right along with me.
My hopes are high and have been restored. Anthem will now be satisfied and Cigna has been backing me up all the way.
I can't wait to be rid of this diabetes (ugh to side effects of medications) and to get my life under control.
Praise be to God for holding my hand on this journey...
Will update again soon.
