Wednesday, May 1, 2013

Insurance Approval!

  Finally, after weeks of being on the phone between the hospital and insurance company, my surgery requests were APPROVED!!!

  Initially I found out that the hospital forgot to put in a request for my mastectomy, yet, still put in the request for the reconstruction. My heart sank when I found out that we could be facing a delay on the surgery date. I immediately started making calls (hello rollover minutes) to everyone I could possibly get ahold of. On April 19th, my requests were BOTH forwarded to my insurance company. Normally, requests take about three to five business days, but because this is a "limited benefit", mine was apt to take a little longer. In the past few days, they bumped my request to "urgent", yet, I heard nothing...every time I called they would say it was still pending. I really think I lost my mind, especially when one of the case managers asked why it was shown as an outpatient procedure. Again, another heart sinking moment. Outpatient?! How in the world can this be outpatient?! I did a paper about "Drive Through Mastectomies" in my freshman year of college...didn't they ban these years ago?!

  Fortunately, I wised up and stopped calling the financial office at the hospital and contacted my surgeons offices directly. Though it states I am "outpatient", it's a twenty-three hour hold, so I will be staying in the ambulatory care facility until I am ready to go home. I have NO intentions of being admitted to the hospital, barring any complications for me, thank you! As soon as my plastic surgeon's nurse called me, she eased my mind, and also had her insurance coordinator make a call to my insurance company to see if they could move the request along.

  This morning was a normal shopping day (not sure that is ever "normal" for a mother taking the kids along to the grocery store). Got the kids doughnuts for breakfast and a large coffee for myself (okay, okay, I cannot stop caffeine, I tried) and set out for our grocery shopping adventure. While shopping, my children were finding humor in making me look like your stereotypical "crazy Wal-Mart shopping mother", crying over sitting in the cart, crying over feet touching hands, crying because the other is crying, you know what I am talking have seen women like me before, if you're not one of them! Of course during these shenanigans, my phone rings, and it's the insurance company. Honestly, all I could hear was "still pending", "other cases before you", "not sure we'll have an answer, try Friday", in between my daughters wailing because Mommy wasn't paying attention to her adorableness. I suddenly became the stereotypical "Mom on the phone talking in the store about something way too TMI for anyone else to hear, while telling my kids to quit crying".

  I cannot tell you where my anxiety level has been, not knowing what the status would be. Not knowing if I would have to rearrange everything based on the potential of this getting delayed. All I wanted was to be able to enjoy the last few days before the surgery worrying about something other than knowing if I was going to have the surgery at all...seriously, let me worry about what freezer meals to make. Once I got home from Wal-Mart, I unpacked the groceries, fended of the pantry scavengers, and decided to give the insurance company one last call before I gave up for the day. Thankfully, I reached a women I had spoke to before...who was amazing during the previous call. Every time I have called in the past couple weeks, they tell you to hold on so they can look through your information. Clearly I must have some interesting stuff in their system, because it takes about five minutes for anyone to really say "it's still showing pending". This time was different a very nonchalant and clinical manner, the voice over the phone told me both requests were approved this morning (thank you to whomever called me this same morning saying it was still pending). I had to ask her to repeat herself. Immediately after hearing "approved", I started sobbing and profusely apologized to the woman on the phone, though I don't think she knew what to say, part of her voice indicated that she didn't really mind, and was happy to give me the news.

  FINALLY!!!!!!! Everything I have been waiting for is happening. Finally, I get a second chance at life..even though my first hasn't been tampered with yet. Nothing is saying I'll be 100% free of breast cancer, but my chances (after the surgery) decrease drastically. I get to watch my kids grow up. I get to lay in bed at night and not search for lumps in my breast. I get to guide my babies through their lives, watch them reach important milestones, watch them fall in love, get married, have kids (if they want). I am getting a chance that my Mother could have been given years ago. What if someone had told her that because her Mom and Grandma both had breast cancer, that she could also have a PBM? She would be here with me, my kids would know her. I am getting a chance at life that my Mom should have also had. I swear, she is the one making this happen. She is protecting me. When she passed away, I knew our bond was too strong for her to "leave me", sorry if you think this is crazy, but you would have had to really know my Mom to know what I am talking about. I swear, this is her work. She is still guiding me, loving me, and protecting me.

  What a sigh of relief. I feel like the weight of the world has been lifted from my shoulders. All I have to do now is love on my babies, do a few last minute "pre-op" necessities (waxing my armpits is at the top of my list, speaking of TMI...there is NO WAY I am letting that hair grow, nor will I let my husband dare shave my armpits), possibly get some bench pressing in (you know, just because I can't for a few weeks, so why not give it a try during the weekend?!), attend a formal event for my husbands work, and it'll be Monday before I even know it! The hotel is booked, pre-op appointment is scheduled,  Josh's Mom is set and ready to watch the kids and dogs, and I am really ready to go.

  I have no apprehension going into this. Yes, I am removing my ability to nurse another child (really though, after you read this post, you probably would agree that I cool it with more babies anyway) and I may be losing part of what our society deems as "feminine, but, I get to LIVE with SO much less worry. I sincerely appreciate all of the support of my family and friends. I appreciate that I am getting this chance.

All I have left to say...BRING IT ON! Nothing can stop this motivated Momma! 

1 comment:

  1. I’m glad to hear that news, Katie! You must've felt quite relieved when you heard about the approval. It’s one worry down, and after that, all you should concern about is the surgery itself and getting better afterwards. I hope you recuperated well from the surgery!

    Stacey Neal @ Romero Insurance & Financial Services