Well this weekend was full of heartbreak, tears and frustration. I called Jackie on Friday, February 6, 2004 too check the progress. I had spoken to her the day before to find out if I would have to wait for the stress test to be completed before we could submit to insurance, and she advised me that we could go ahead and do it and she would go over everything that day. So with my fingers crossed so I could barely dial the phone I called her on Friday to check. She had some concerns about not have 6 months of noted Dr. supervised weight loss. I explained to her that BC/BS of Ma. didn�t require that. We talked about their requirements and she was going to call them and check. I too called to double, well ok quadruple check, and they told me the same thing they have said all along�THEY DON�T REQUIRE 6 MONTHS! I then got a confirmation number from them referencing that call and called Jackie back. She told me she had talked to them and she had an approval number and could book my surgery (OMG I am so excited), but they would not pre-certification or guarantee payment till after surgery and because of that I would have to place a $5000.00 deposit in order to have surgery (is this legal). Anyway, Jackie told me that once I have the surgery they will submit the claims and once (notice I never said if�I will gear for that battle) the insurance pays then my money will be returned to me, but they have been burned before so they do this to cover them. Now, we all know that Blue Cross Blue Shield NEVER EVER pays the full amount, so my question now for Jackie is�Once the insurance pays whatever it is they pay, do I get the entire deposit back? I think I need to check with the insurance commission and possibly an attorney to make sure my interests are protected. We are looking into refinancing our home to cover the deposit and I want to make sure that all the bases are covered.
On Monday, February 09, 2004 I called to chat with Jackie and found out she will not be in today, but I did speak with Roberta and she said the deposit was required by Bond Clinic and she was not sure if they only paid partial would I get my full amount back so she gave me a number in the finance department at Bond Clinic, I have called and let a message but have had no response as of yet. I will call later in the day to see if I can find out the answers I seek. Well I just got off the phone with BC/BS of MA, they are gonna know me by name before this is all over with, and they have told me that as long as the span is 6 years that will be enough�WOOOHOOOOOO. They also advised me that when they pay the allowed amount if Bond Clinic tries to keep any part of my money I should call them and let their Provider service contact them, because if need be they have attorneys that will get involved. So with all this it�s back to excitement however guarded right now. Ok, lets recap, I have all my pre-cert. done, six million calls to the insurance company, the re-financing of my house started, and tomorrow the call to Jackie to book me.