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I sat down and desided to scour the internet until I could find out if Medicaid did indead cover WLS.  I had heard that they did not cover it anymore.  During my research I found OH.  I did a lot of research on the local hospitals and doctors all the while trying to find someone that took medicaid.  Finally I registered and almost immediately Amy Williams sent me the name of a doctor in Atlanta that accepted Medicaid.  I called them and asked and they told me no but told me about their upcoming seminar.  

I kept looking into that doctor's clients and found several that had the same insurance I did.  So I went to the seminar....and low and behold not only do they take Medicaid but they even had different folders for everyone according to their insurance company.  That made everything a lot easier.

My journey started almost three years ago. (9/03) That is when I went to my first seminor. That hospital/doctor required you to contact your own insurance company and find out the requirements and then submit it all yourself. I have Medicaid and you can't just pick up the phone and call them. So I was at a complete loss. It was all too overwhelming for me. So I reread their info several times, always hoping to find a solution.

I filled out all the information in the packet the next day.  Then I made an appointment with my PCP.  She was in favor with my decision to have surgery and the surgeon I choose was her second choice.  I looked into it but her favorite said on the website that they did not take my insurance.  He was also a private doctor and I felt that the one I choose had more doctor and office support.

This then started the long wait for doctor's office staff to follow through with their end. 

I had to wait two weeks to get the letter of introduction to send to the surgeon so they could send in for insurance pre clearance so I could get my first appointment.

I then took several weeks for the surgeons office to call and schedule my 1st appointment.

I went to see the surgeon.  I had heard others talk about the first visit and it wasn't anything like that.  The first doctor that examined me didn't sound too hopeful that I would qualify because they only do Laps and I have several abdominal scars and she thought I had a hernia of some kind.  I guess she was the predoctor because a few minutes later the one i refer to as the surgeon came into the room and examined me and said he did not think I had a hernia and he critized my past surgeons for make large sloppy incisions but he thinks it will all be fine.

At the end of the visit, as the were walking me to the checkout, I asked "so how much am I supposed to lose before surgery?"  The said I didn't have to lose anything "just don't gain any".  This info was just So Cool.

So it is back to my PCP again to get all the referrals for all the clearances I need.  Then....
I had to wait almost three weeks for my doctor's office manager just to set up the appointments required before I could have it all submitted to my insurance company.

I had to call her many times and then finally when I stressed the time importance, she called me back within two hours with all the appointments.  Unfortunately three were within the next two weeks while the last one was more then 3 months away.  I called that last doctor to be put on the cancellation list.

Went to the cardio doc and he requires more tests.  First the EKG(expected), then and echocariogram, and then a stress test.  Each test took another appointment.  

EKG and echo went well.  The stress test was another story.  I was concerned about my asthma and my bad leg and walking on the treadmill.  But I guess I didn't have to worry about that.  My blood pressure was way too high to take the test.  So the chemically induced the stress test.  I was a bit worried about this as I don't like to think I don't have controll of my heart and respirations but it was a needless worry.  It went off without a hitch...except the reverse drug.  They didn't give me enough and I got some bad side effects so they had to give me more.

Went to pulmonary and they wanted to do another EKG which I refused.  They then left me in a room to wait to get my chest Xray.  Well they left me for 3 hours and when they finally did it the girl said she wasn't even at work that day.  They had to call her in.  They could have told ME that.  I was going to have to come back for a PFT anyway. 

The PFT was scheduled and on the day they set up they called me one hour before my appt to cancel.  They rescheduled for 3 weeks later and then cancelled again.  I got really pissed and hung up on them.  When I tried to reschedule they were really far behind as they only do that test for 3 hours once a week.  So... the appointment finally came and duh...they said I have asthma.  I could have told them that in fact, that doctor had been my consulting doctor for several of my past surgeries.  So now I have to come back to see the pulmo dr to get the results and clearance.  Then on to the sleep study.  It was so painful and uncomfortable I don't even want to get into it.

When I came back in I let him know about all the cancellations his office put me through.  He then promised me he would write my clearance during the weekend coming up and that he would be sure it was faxed to the right places.  I asked his assistant if I could trust his timetable and she said she would keep on him to be sure it was done.

I went for my Psych eval the next day.  All went very well.  She promised to fax letter to PCP.

The following Wednesday (the only day I can go to my PCP) I was on my way to PCP and called pulmo and cardio to stop and pick up copies of their clearances.  Both said no....that my time had expired.  That it had been too long (guess they are only good for 30 days) since my first appts.  I argued with both of the receptionists.  The doctors both knew that I had several tests and visits and they both said I was cleared.  I was just sooo pissed I couldn't stop crying.  I went to my PCP (I needed rx refills anyway) and she said she would call them both if I hadn't gotten any results soon.  

The cardio, after many more phone calls, finally mailed my dr and myself the clearance (but they just didn't date it at all).  The pulmo said they had not been able to tie the doctor down to sign the form.   Another week and then FINALLY both clearances were in our hands.  PCP then cleared me with relief.  But (you just knew there was a but, right?) my PCP's office assistant was supposed to get the paperwork together and fax it to my surgeon and then call me to go pick a hard copy for my records.

Several phone calls later....I finally get a call to come by and pick them up but (luckily I didn't just leave it) I found she did not fax them, so I just did it myself along with the list of everything I was asked to get.

After faxing my info the surgeon's litterature says they will call to say they sent it into the insurance company.  Well, you guessed it.  I didn't get a phone call.  So after waiting for 4 days I called them myself and had to leave a voice mail.  Then the next day I had to call again and leave another message.  Then again yet another message.  On the fourth day after leaving another message I called the actual surgeon's office and asked if the insurance girl was on vacation.  They said no and looked up my file.  It said I had only just faxed in the paperwork (someone so didn't put the right date on it).  They then personally had the girl call me withing 30 minutes.  She said I was missing something (yeah right) and would get back with me.

Two days later she called me to tell me she found what was needed in another doctor's report and was about to fax it to my insurance.  She then told me to call her on the 27th of Dec to remind her to check Medicaid's web iste to see if they received it and said she would call me as soon as they got it.  

Two more days later and she called me.  She said "I just pulled your approval off the web sit ean dwill be sending it to the surgeoin's office" and I said hold on a second.  You mean to say it is approved...already?!   I couldn't stop crying.  She of course said yes so now I am awaiting the surgeon's office to call me with a date (she said they would call within two weeks) but I know I will need one more test.  The surgeon was waiting for approval to do an Endoscopy.   Soon all......