And then sometimes shit happens that makes the receiver want to choke someone.
I initially started this process back in August. I work for St. Elizabeth; I know people who have gone through the bariatric program with St. Elizabeth and had nothing but wonderful things to say. I know the surgeons, therefore, I wanted to utilize the same program. Our insurance is through Cigna. I got on their website to look up anything and everything about bariatric surgery coverage. Wonderful news, they cover 80% of it and St. Elizabeth is in-network! Even after the proceeding experience, I still would recommend St. Elizabeth's program- http://www.stelizabeth.com/weightmanagementcenter/.
Dr. Moon really is wonderful.
The first step of going through this process is sitting in on an hour-long information session. I called St. Elizabeth (end of August, keep in mind) and the earliest opening they had was early December; ok, fine...I'm determined, so I'll do what I gotta do and wait however long it takes. They take my information and ask me if I have insurance and, if so, who with? I give them my info, tell them Cigna, and they said "we'll see you in December!"
I get a call in October saying that they added another session in mid-November; would I be interested in coming sooner? Well duh...sign me up!
I get there and there's maybe 20 people attending. I sit down in one of the bariatric chairs. I'm sorry- I get horrible and judgmental here...but two people brought FAST FOOD to a weight loss seminar!
That's like bringing a beer to an Alcoholics Anonymous meeting!
But ok, I get it....we all have our problems and that's why we're here.
I listened to Dr. Moon lecture for an hour about how damaging it is to your body to be obese, the dark outlook on our future if we remain obese, the qualifications for gastric surgery (I'll educate you fine folks on that in a bit), as well as what to expect before, during, and after the surgery.
Now, here's some knowledge for you smokers; smoking effects how your body heals. I won't get detailed but, nicotine and carbon monoxide slow the healing process and put you at a higher risk for post-op complications (here's a link that gets into the details if you want: http://www.ncbi.nlm.nih.gov/pubmed/1323208
Dr. Moon told us that 90 days prior to and after surgery, due to all of the staples that go into the stomach/intestines, NO SMOKING.
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| No smoking? |
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| The world is ending!!! |
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| OMG! |
You would have thought he told people they had to kill their firstborn child.
Hands shot up in the air all over the room- "Can we still vape?!?", one woman asked, clutching her chest. "Does it have nicotine in it?" was the followup question from Dr. Moon, a nod yes from her, followed by "well, then no".
I wanted to stand up and say, "Look people, surely you're all here because you want to improve your health, quality of life, and extend your life expectancy, right? The surgery isn't a magical thing that fixes you- you're still responsible for dieting and exercising. There still has to be life changes; what's one more?!?"
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| Srsly, people? |
In my head, I'm chanting "I'm not here to judge, I'm not here to judge...focus on your own journey..."
So before leaving, I schedule my initial consult with Dr. Smith (Dr. Moon's partner) and it's December 16th...ugh. More waiting. The MA's there make a copy of my insurance card and take the forms I've filled out.
I show up a month later for my appointment only to be told "Uh...Cigna won't pay us therefore, we won't take Cigna."
*explosion in 3...2...1* "What are you talking about? Cigna has you on their website as an in-network provider, my plan pays for 80% of the surgery....what the fuck (yes, I dropped the f-bomb) do you mean?!?"
They get me the gal from the insurance department. She proceeds to tell me that yes, St. Elizabeth is in-network for any other surgery...except the one I want. "I've been here for three years and the entire time we've been fighting with Cigna to get them to cover us. We've had patients spend months going through the process only to get up to the point of scheduling the surgery, and we can't get an approval from Cigna because they say we charge too much."
"So why didn't someone tell me this back in AUGUST when I told you who my insurance provider was?!"
*crickets*......
"You've wasted four months of my life". Turn and walk out....followed by 5 minutes of sobbing in my car. Then a pissed off drive home, full of more determination than ever.
Do you see what I mean about the lack of communication in healthcare? Do you think that since my experience, they've told their staff to tell Cigna members to look elsewhere when they call about the seminar? I'm gonna bet no...
I called Cigna when I got home and told them all about my experience and asked them just who in the hell they will pay for; in the entire state of Ohio, they'll only pay OSU in Columbus (website here for more info: http://wexnermedical.osu.edu/patient-care/healthcare-services/weight-management/bariatric-surgery
...or they'll pay for the program through Jewish/Mercy here in Cincinnati: http://www.e-mercy.com/weight-management-solutions.aspx
Or, in Kentucky, they'll cover St. Luke in Lexington or St. Mary's in Louisville.
Gee...even as much as I hate Mercy, I'd hate to drive all over the country.
I've never had a positive Mercy experience; neither has anyone in my family, now that I think about it.
Last night, I sat through Mercy's version of the same seminar. No fast food and the doc didn't even mention the no-smoking, so it wasn't as entertaining (bummer). But I did learn that the Mercy programs has more benefits that St. Elizabeth didn't- they offer a free 6 month membership to all of their gyms, free lifetime cooking and nutrition classes, and right now, they're waiving their program fee that insurance doesn't pay for...it's a $750 fee. Thank you, thank you very much!
Now I'm just sitting and waiting for the insurance gals at Mercy to do their thing and call me.
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| Appropriate, since it's 6 degrees outside |
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