Insurance Update

Hey guys......  Ok, well I am still in the dark with the insurance company. The 30 days that the insurance had to give me an answer on my appeal was up yesterday, the 12th.  I called them on Thursday and was told " It says here in the notes that they are closing the appeal today because there was no denial from the Medical group in the first place"   Wait........ WHAT???   What do you mean there was no denial!?  I was told by my doctors office that my authorization was denied because Dr. Santore is not a participating provider in my insurance plan.... so that was why I sent in the appeal with the letter of medical necessity from my doctor.
I'm flipping out by now....... are you kidding me??  I've been waiting for a freakin MONTH for you to tell me that there was no denial in the first place?  I called my doctors office back and talked to the nurse in charge of sending in for the authorizations....... she told me that the insurance company had called her the other day to find out the reason that I needed to see Dr. Santore ( although, they already had the stupid doctors report that states WHY) ....... All this insurance crap is so confusing!! and FRUSTRATING!   I'm not exactly sure what happened, but basically where I am right now is right back at the beginning........ im not authorized, but i'm not denied either...... they re-opened my authorization for Dr. Santore........ my nurse said this could be a good thing, because my medical group is the one who re-opened my authorization after speaking with my insurance company....... so I'm hoping that they reopened it because they are going to give me the approval.  I honestly don't understand why its so complicated!! It's not like im asking them to cover anything cosmetic, I NEED this surgery to be able hopefully live a pain free life....... or a semi-pain free life. 

I am SOO glad that I am going to be going to Texas to visit my cousin next week, that will at least keep me busy for a week without having to think about all this other stuff hopefully....... and in the meantime before I leave, I'm going to pull out my camera and mess around with some shots this weekend.  Tomorrow I have a photoshoot with my friend Nicole,  I can't wait to edit those pictures! :) 

To my hip chicks, Ashely and Kristen, I'm thinking about you guys, I'm so glad you made it through without any complications and now you can concentrate on recovery!! yay!!   Marianna....... You're going to do GREAT on Monday..... and Serena and Sarah and Becky..... it's almost recovery time for you guys too!!  You'll all be on the "other" side soon....... and we'll be cheering you on from the sidelines!  I love you guys!!

Mixed Emotions

I'm not usually at a loss for words when I sit down to type..... my fingers just usually start typing and everything spills out of my head onto the page.... sometimes in random order, so i apologize for any future confusion that might occur...... but for some reason when I sat down to write this blog, I found myself just sitting here staring at the computer for a few minutes...... I think it's just because I have such a mix of emotions floating around in my head/body/heart right now that i'm not sure how to express it all. Ever since I was officially diagnosed and made aware of the surgery (PAO)  that I would need to have in order to correct my dysplastic hips, I have been on a roller coaster of emotions..... even more so than I usually am.  I was able to find a few "Hip Sisters"  who have been through what I am going through right now, they turned me towards this amazing yahoo group called Hipwomen, I found it comforting to read everybody's posts, their updates on recovery status, questions from the "newbies", and more importantly the VENTING, it made me realize that is OK to be angry, It's ok to self wallow every now and then, it's ok to feel lost and alone.... BUT it also made me realize that although this is going to be a LONG process of healing and recovery, that I'm NOT alone, no matter how much I might feel that I am at times. I loved all of the support and positive engery that is found on the yahoo group, but I wanted a little more interaction with my "hip sisters" ...... so I created Hip Chicks..... its a facebook of sorts, just for us Hip Chicks ;)   I have found AMAZING friends, and an even more amazing support team that I know I am going to need to get me though this.  So to all my hip chicks..... I love you guys, and I am SO thankful for your support!!!  xoxoxo

I've been doing alot of reading of blogs from people who have gone through or are going through what I am right now,  I found a great one yesterday from somebody that has had a PAO through the surgeon I will be going to, Dr. Santore.  I have heard so many good things about him already and this blog just helped reinforce what good hands I will be in.  I also found a new hip sister on Hip Chicks last night that actually lives by me.... yes.... RIGHT BY ME!  Yay!!!  She's actually having surgery by Dr. Santore on Monday, the 15th,  so Marianna if you're reading this, you are in my thoughts, and I know you're going to be fine, You'll be on the "other side" soon! :)

I guess the reason why I am such a mix of emotions right now is because of where I am in this whole process... i'm in the pre-waiting stage...... no, not the waiting for surgery stage.... but they waiting to see if I can even have surgery..... My stupid insurance denied my authorization to see Dr. Santore because he is not on my health plan...... I sent in an appeal with a letter of medical necessity stating that there is no surgeon in my health plan that is qualified to do such a procedure because of how specialized it is.  They have until this Friday, the 12th, to give me an answer on my appeal.  So this whole time while i've been in the pre-waiting stage, i've been trying to mentally prepare myself for what i am going to have to go through, I've been trying to figure out how to re-arrange my life in order for this to happen, since it's such a major surgery, it will have a major impact on my way of life for awhile...... I've been trying to lose the weight I need to lose, i've been trying to get stronger physically because I know the stronger going in, means the stronger coming out...... But it just hit me....... WHAT IF....... what if my insurance doesn't even approve me?  What then? I don't have the money to pay for it myself, I don't even have the money to pay to see somebody out of network....... and then there is... ok, what if my insurance approves me..... but Dr. Santore doesn't?  I mean every blog i've been reading who has been able to have this surgery has had Mild to Moderate Dysplasia...... I only have Mild Dysplasia..... what if he thinks its "too mild"  to do the surgery?  Trust me... it doesnt FEEL mild.... the pain is there and it continues to get worse...... I'm just afraid of getting my hopes up of being able to have the surgery and a chance at a somewhat pain free life..... only to be told that I'm not a candiate for the surgery.   I think I'll feel better once I'm able to see Dr. Santore and actually be told that I can have the surgery..... until then, my thoughts will continue to entertain the "what if's"   Ugh!!!!