I woke up this morning with a strange sense of anxiety about the whole surgery approval process. Interestingly enough, right now I am not afraid to have the surgery.
You see I live in the desert–the actual desert which before the housing boom of the early 2000s was fairly desolate but now is the epitome of urban sprawl. However, it is also a medical desert.
With or without insurance access to very basic medical care is better than most places. When it comes to a specialist or if you have Medicare, finding an approved doctor or facility is often an exercise in futility.
Medicare does cover bariatric surgery but only at what they deem is a “Center of Excellence.” A surgery clinic or hospital earns the designation by the sheer volume of procedures. As with most things medical, volume equals predictable positive outcomes. If the two are combined, Medicare stamps it excellent.
The closest Medicare-approved Center of Excellence is 175 miles away. It also happens to be out-of-network with my advantage plan. The next closest Center of Excellence is over 300 miles away and I have yet figure out if it is in-network. The surgery center my doctor referred me to is literally just down the street from my house, is in-network but not considered excellent.
Since I obviously have yet to speak to a surgeon, I only know my procedure could be laparoscopic or open. Of course, I am advocating for a LapBand and that procedure is laparoscopic. Either way, the thought of driving 3-7 hours with fresh incisions and my history of blood clots does not sound like fun.
Thursday afternoon I spent nearly an hour on the phone with my plan provider. A really kind, diligent woman named Jessica and her supervisor, who I never spoke to, spent most of that hour looking up all the details of my coverage and where I could go to have the surgery. They both say the local surgery center 5 minutes from my front door is an approved location for my surgery. The seemed confused about a Center of Excellence though.
Friday morning I took my insurance card to that surgery center. I explained everything to the receptionist and she and another receptionist practically shooed me out the door. But, I held my ground. Finally they told me, the bariatric specialist was out of the office until Tuesday. It was all I could do to convince them to take a copy of my insurance card so when the specialist and I talk on Tuesday she would at least have my information in front of her. They agreed, reluctantly.
I was fine with all of this–I used to be an insurance agent so I am well aware of the process–until those moments when I was teetering between dreams and Sunday morning.
Right now, I am just anxious.
Right now, I am also wondering if my doctor has charted all my weight loss failure. I have 12 years of failure. Even though, he has only been my doctor for three of those years I just don’t know if he has written it down in his notes. If not, even if I manage to have the surgery approved next week I will not be allowed to move forward until those four months of chart notes can be tucked in my file.
Right now, the thought of next 48 hours feel obnoxiously cruel.
Right now, the notebook full of notes and the pretty pink Post-it notes full of phone numbers and doodles are stressing me out.
Right now, I am going to click publish and try to move away from these tense, anxious feelings.
Right now I am going to be present to enjoy my lusciously creamy, lightly sweet coffee in my giant mug while I still can.