03/11/10: I don't know what to do or think

I hate this.  I hate not being in control.  I hate not even being able to steer anything in any sort of direction.

As of this morning, I had yet to hear back from my Dr.'s office about getting my letter of medical necessity from my PCP fixed.  So I called them back today.  Yeah.  My Dr. wants me to come in and say exactly what I said on the phone - the letter needs to include my BMI and the statement that she "deems this medically necessary".  I have an issue with going in to say that.  I said that back in Oct.  Stupid me, when I got the letter she did write, I thought, well, she's done this before, she knows what she's doing.  So I accepted it - and so did the people at my bariatric center, until last Friday.

I have an issue with going in because my insurance changed.  I pay for everything.   I don't have copays anymore - I PAY FOR IT ALL - at least until my insanely high deductible and absurdly high OOP-Max are met.  I don't want to pay money out to say something I've already said!

The girl I talked to a short while ago understands that and said she'd talk to my Dr.  She'll call me back this afternoon with my PCP's ruling - at least that's what she said.  If I have to go pay it, I have to go pay it.  But I won't be happy about having to miss time from work and paying full price to do it!

I got off the phone with them and I called my insurance company back.  At this point, I just want to make sure they have the paperwork.  And I want to make sure it's in the right place.

The first girl I talk to is a customer service rep.  Nice, friendly, helpful, sympathetic, cared about me as a person.  She doesn't see anything in the system yet but says 'you really need to be talking to someone in authorizations, can I transfer you?'

Yesterday's person told me I'm not allowed to talk to people in authorizations.  I knew from my advocate to be asking for that department.  So this person today, the one I like, transfers me.

In authorizations, another girl answers the phone.  She looks it up.  She says 'your policy doesn't need an authorization for this procedure, so it would go to determinations'.

My advocate also told me to ask for determinations.  So not entirely surprised there, either.

This girl in authorizations says 'you can't talk to people in determinations and we can't see their system'.

She then says - determinations has 30 days to make their decision at which point that is when my file goes to authorizations to send out the letter.  Authorizations would then have 30 days to send the letter.

So I tell her my pickle.  The career, the family, the progress, the time off, the fantastic window of opportunity that is shrinking every day.

And she says "we really don't care.  This is at our discretion and we will do what we feel is best warranted for our company needs.  And no, you won't find someone in this office that will care".

All told I was on the phone with the insurance company for about 8 minutes.  And in this conversation with these two women I went from feeling hope and upbeat back to I don't know what.

The hardest part for me here is what am I struggling with?  Am I struggling with not being in control?  Am I struggling with my hopes were so high for a quick answer that now that it looks like it can't and won't possibly happen, I'm just mad?  What's my issue?  Why can't I just let it be and take it one day at a time?  The insurance company has been playing jokes all along - that's what the "unweightloss" program is.  So why am I surprised by this?  Why is it upsetting me so much?

I'm insanely jealous of all the people that have insurance companies that get answers out within 3-4 days.  Even a week or two weeks.  LOL, I'm just insanely jealous of anything that has ever gotten a decision and is already banded.  I want so desperately to be on the other side!  I want this part of the process to be behind me!

My one saving grace is that at least I can lose weight for real right now.  I don't have to keep on with watching to make sure my BMI is still above 40.  I don't have to gain weight back when I spontaneously lose it.  In fact, I can try to lose it.  That, in and of itself, is such a wonderful change of pace!

I keep saying I just need to take a deep breath and focus on that.  This is all about weightloss - I can do this now.  Getting a band or not getting a band won't change that.  That will change my success rate - my keep it off rate, but it won't change whether or not I can finally, actually, really, truly try.  At the end of the day - right now, today, trying matters most to me.

And last thought - dangit, I forgot my sweater this morning.  I am so cold!  I usually keep it here but took it with me as I was leaving last night because it was the perfect weight for when we would be leaving the rodeo.  And wouldn't you know it - so tired this morning, I forgot it was sitting there waiting to be grabbed.  I'm SO COLD!