Since I last wrote I was just getting to the stage of planning all the appointments and final details for the operation. I had received the surgery packet and was sorting through the string of events to schedule to get done before the big day. There were a lot of tests to have done and that was a challenge trying to get them all scheduled without missing to much work in the process. With the recovery period being 3 months long and not being able to work in all that time, I needed every hour on the clock and to save as many pennies that I could to keep my bills paid and my bank account in the black for the duration of the recovery.
There ended up being some time conflicts with some of my tests and I had to take off more work than I wanted too, but the tests got done and that is what matters. Those last few weeks were becoming very painful. I wore my TENS unit all day and still had a lot of trouble with pain. My general doctor gave me some pain pills and anxiety medication to get me through the last couple of weeks and that was helpful, but I did not like the foggy feeling it gave me. At this point I think if I put off the surgery any further I would be in real trouble and walking or being on my feet would be very limited.
The time was getting closer and the last thing I needed to get done was ordering my knee walker. One day at lunch I went to the medical supply store to check out what they had and get one lined up. The lady was helpful and took all my information to get it setup, but recommended I call my insurance company to see if it would be covered and how much the copay would be. After leaving the store I got on the phone with my insurance company and after discussing the details of my durable medical supply coverage the girl wanted to check and make sure I was all pre-certified for my hospital stay too. She then sounded concerned and said that my approval for some things was still in pending and that I might want to see what the hold up was for. She ended up putting me on hold and was intending to transfer me to another agent for that department, but came back to tell me that I needed to call my doctor's office because there was some trouble with the codes and the doctor needed to address the issue or I was going to be denied. I called the doctor's office immediately after this and was transferred to the billing gal who told me she had submitted all that the insurance company had wanted and she would contact them again to be sure, then call me if there were any problems. Needless to say, I was a bit overwhelmed at the prospect that after all the preparations to this point that I may not be approved for this surgery and there were only a handful of days to get there, with Thanksgiving being one of them. Later that afternoon the billing lady called me back and told me that I was in fact denied for the surgery. She said she would inform the doctor's administrative assistant and next step would be to do an appeal. She told me I needed to get started on my own personal appeal letter to go along with the doctor's office paperwork to be submitted to the insurance company. My heart sank upon hanging up from that call. I was stunned and still had to go back to treat my patients for the remainder of the afternoon. I was numb just holding it all in for the last couple hours of work. When I got in my car the flood gates broke and all the way home I was in tears. This was one of the most overwhelming let downs I have ever experienced. I went home and went straight to bed and got on my computer to vent to all my friends and cry my heart out. While on the computer I started to write my letter and googled information on how the insurance works in situations like this and how this could have happened. I got all my ducks in a row and pulled myself together for the next day. I called the insurance company again and got more information and then called the doctors office and left a voicemail with the information I had from the insurance company. I followed up the voicemail with a fax to the doctor's office restating all the details that I had learned. My phone was silent all day Wednesday, then Thursday was Thanksgiving, and then still silent all day Friday. At this point I was completely discouraged and had resigned myself to the fact that this was not going to happen, at least not on December 5th, there just was not enough time to get an appeal done.
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