I have arrived!

I'm sitting in my hotel room tired as hell.
It took me a cab ride, 2 planes and a 2 hour long drive to get here but we are finally here in Trinidad, CO.

Janet from Dr. Bowers office came to pick us up from the Airport and she was really sweet. It was nice to put a face to the woman who I have been talking to for months who helped me get here.
I say she helped me get here because she submits all the info and makes sure things are done correctly for insurance.

I have my pre-op surgery appointment tomorrow at 10AM MST (I think it's MST or is it MDT?). Either way it is 2 hours behind EST which is what I am used to.

It's time for me to go get some rest. More to come soon. From this point on there will be daily blogs for the most part again untl thing settle down so KEEP READING!

Another GREAT day!

Today I decided that it would be best for me to stay in a hotel than the surgery apartment available. I am happy with my decision and think overall it will promote my healing because I will be very ZEN in a space that I have control over who comes and goes. I sent the last of what paperwork I needed to send before surgery. I am officially good to go!

I had a check list of things that needed to be done.

Medical clearance- CHECK

Insurance confirmation for agreement to pay for surgery- CHECK

Plane Tickets- CHECK

Hotel Reserved- CHECK

Transportation from Airport and back- CHECK
(The airport is 2 hrs away from where I am having surgery and I don't drive so this is VERY important)

Medical leave approval- CHECK


The office coordinator for my surgeon asked me about my letter and how many I needed post op. The first one is free and any additional letters are $20 a pop. I don't know how many to get because everything is pretty much changed. I said 3 but I don't think I need that many. Maybe I will only need 2. I guess I will get the 3 to be on the safe side. I also asked about getting a copy of the OR report and I was told I could get that most likely before I leave town after surgery and that would be free. For the state I was born in I need that to seal my records so I will definitely submit that along with my SRS letter. Im due for a new passport so I will use a letter for that too so I can just be done with that and not have to explain anything ever again!
It still doesn't feel too real but it's getting there! I am getting more and more excited I must say. I am starting to have dreams about my post op body and all the wonderful things that come with that for me.

One month to go!

I have exactly 30 days until my meta with hookup which I am very excited about. I am currently working out to get my body into the best shape possible for surgery. I have already been cleared by my PMD and I got the clearance in the mail yesterday. My insurance stuff is all set. I am just waiting for my packet from the Surgeon's office which should have been here by now. I will email them tonight about that though and hopefully it is either in the mail already or will be in the mail ASAP. I think it has been sent though and just hasn't gotten here.
I just need to book my flight and hotel which is why I need the packet because it has hotel discount and travel information in there.

It still doesn't feel real yet so for now I am still just going through the motions.

Moving right along!

I went to see my medical Doctor yesterday to get on my medical clearance stuff. Due to my medical history I am required to get an EKG. I decided to do it sooner rather than later so that if it looked funny (which mine sometimes do even when there is nothing wrong but that is my "baseline") I would have time to get cleared by my cardiologist if needed.

So I went in and showed my Doc the letter from insurance agreeing to pay for surgery she was so happy for me. She has known me since I was a child and actually used to work at the same medical facility as my mother so she has seen me in both my developmental stages as a human being and through my transition. Most of her other patients dont want lower surgery so this is all new territory to her and she was open to learning so we discussed where I am at in my process, what procedure I am having and might need in the future. We also discussed how she as my primary MD would fit into that with annual screenings and any other necessary care. It was a really nice talk we had. She wasn't even seeing patients yesterday but because it was me she decided to make and exception so that I could get things in sooner especially since between filling out camp forms and other summer medical stuff she is really busy (she does family medicine).

I did my EKG which was one of the best she has seen from me it was perfect so no need for me to see the Cardiologist. She reviewed my transition history so that she could include that in my clearance letter which was important because if I am under a certain amount of years in my transition I would need 2 mental health letters as opposed to one letter. I only have one letter and fortunately enough based on MY situation my history seems strong enough to my surgeon and insurance to not warrant a second letter confirming the need for me to have this surgery and my readiness.
My Doc had a meeting to get to but agreed to write my letter and get it to me ASAP. She did give me a copy of my EKG to fax to the surgeon because worse case scenario if the letter doesnt get done or Murphy's law kicks in as long as my surgeon has the clean EKG and her contact info we will be able to get me in the OR without issue.

I am so happy that things are coming together. It still doesn't feel real just yet but I am still excited!

The opposite of Junk mail is....

What I have in my hands! It's PRICELESS! I just got the letter from my insurance stating that "based on the information received from your treating health care professional(s), _______ has determine that service(s)/care that you requested below on ________ is medically necessary."

It then goes on to say that to keep all parties informed they have notified my surgeon and the big name insurance of the decision.

Then after some more blah, blah, blah it says,

"Upon Recosideration, information justifies acute care admission for your genital/urological surgery for post-operative care."

So basically I am approved to have surgery AND approved to stay in the hospital post op since in the initial letter I got from these crazy people they basically said " We will approve surgery but you dont need to stay in the hospital post op."

It has the surgeon's name, my name, my insurance companies name, the hospital name where I am having surgery and then Tentative date.

This letter is MONEY! *Does happy dance*

Im so happy I can cry!- June 8th, 2010

After much calling, praying, more praying and more calling I got THE call today. Stating that the surgeons office got the letter stating that I will be able to get surgery and wont have to pay $11,000 up front. The surgery is in a few weeks and I only need $2000 to be set. I am SOOOO happy I could cry.
Thanks to all the guys (and gals) who kept me in their prayers, sent good vibes and wished me well. I plan to pay it forward when I am done.

One step closer to lower surger- June 6th update

A few days ago I posted here about my journey so far with insurance and getting lower surgery covered.

Well my latest update is really AWESOME. While I was at the Philly Conference I got a call from the Surgeon's insurance person saying that I may not have to pay as much as I originally thought. She is waiting to talk to some people then will get back to me.

Fastward to today.

I spoke to the woman from the Surgeon's office and she stated that the Surgeon and the Hospital is covered by a Small ass insurance and they have contracts with BIG NAME INSURANCES and one of the BIG NAME INSURANCE companies has a contract with my WHACK ASS INSURANCE. After calling around and speaking to some folks she was able to verify that under this random chain of contracts that the surgeon is In Network with my WHACK ASS INSURANCE. This means that I will only have to pay the co-pays and/or deductibles which last I checked for my insurance are $0 which is right in my price range!

Today the woman from the claims department for my insurance also called (The one I made nice with) and stated that the matter was being resolved and someone should call me soon. The person who was supposed to call me called about and hour later stating the same thing about "How the surgeon is used to working with Small ass insurance and they have contracts with BIG NAME INSURANCES and one of the BIG NAME INSURANCE companies has a contract with my WHACK ASS INSURANCE." She stated that they contacted Small ass insurance who should be contacting the surgeon's office to give the exact rates that BIG NAME INSURANCE uses which will be what my WHACK ASS INSURANCE will honor.
I had a date for sooner and one for later in mind. I officially took the later date while waiting for this matter to be resolved but now that things seems to be a go I plan to utilize the sooner date which means I need to start pumping to prepare for my surgery which may be in the next 2-3 months!

After all is said and done I plan to share more details regarding the surgeon and the insurance companies. While going through this I feel more comfortable not posting all the details on the net about the companies just yet.

I am doing the biggest happy dance EVER!
Cris

Lower surgery Update- June 1st,2010 and some other stuff.

Well today was a BIG day! I got my surgery date! *Does happy dance!* Only thing is that it was bitter sweet because the surgeon's assistant was willing to give me a surgery date that was closer which is what I really wanted. It would have worked out to be a date either within 2 days of my B-day or a week after my B-day. Unfortunately since I am still waiting for the insurance payment stuff to be figured out I decided to be safe and schedule for early 2011 (No, I am not telling the date yet!)

I did look into possibly getting a medical loan but that is not a feasable option for me right now but who knows I may explore it if other things don't work out.

Since the surgeon's already explicitly told me that they would adjust how much I have to pay based on what my insurance agrees to pay as the rate. I am even more committed to getting this rate in writing and to my surgeon's office.
My insurance isnt BIG NAME INSURANCE BUT when I am outside of my area It rolls over to BIG NAME INSURANCE in a way so I use BIG NAME INSURANCE providers (which this surgeon is) AND my insurance pays the BIG NAME INSURANCE rate. Since my insurance isnt directly BIG NAME INSURANCE that is what makes getting the rate trickier because usually when someone uses an BIG NAME INSURANCE provider they just pay the BIG NAME INSURANCE rate after the fact and if they don't know the rate they ask at that time.

Lucky for me I made nice with the Associate Director of Claims when I was waiting for my prior Authorization a few weeks back and I called her to ask how I go about resolving this matter. I explained that I need the rates or I have to pay upfront. She was upset not with me but at the fact that the rate was holding things up. She sent an email to whoever manages the linkage agreement between my primary insurance and BIG NAME INSURANCE.
I was told that they will make sure to get those rates to either me or my surgeon. If that happens then I will be good to go!

Since surgery is really in the works and almost set I decided to have a conversation with my Mother about this. My Mother in the beginning of my transition process was very Anti- medical transition. Since top surgery she has made a lot of progress but I wasn't sure if this would be too much for her. I called her and told her that I am planning surgery for my "basement" (My Grandmother's term for genital region). My Mother was very calm and mellow. She asked a few questions. She was timid at first then said that since we were at a good place in our relationship she didn't want to ask me anything to make me feel uncomfortable. She is in the medical feild so I explained it to her in medical terms and that made it easier for her. I told her ask anything that she wants and if it is "too much" I will let her know. She asked a few more questions about "function" and she was actually surprised that I wasn't getting a Phalloplasty (Once I explained to her the difference between a phallo and a meta). I did leave the door open to let her know that I am getting a meta for now BUT if for some reason I do not feel complete AND/or technology changes I can still get the Phallo in the future. She basically said, "It's good to leave your options open and you are young too!"

I went into the conversation feeling nervous not knowing what she would say or if she would try and talk me out of it. That was not the case. She wanted to get info on the surgery that I was getting, the surgeon I chose (probably so she could check credentials. That is something my Mother would do), She even asked if I would need anything. I dont want to ask her for the money because I want to be an adult about this BUT if things are getting close I am open to seeing if she will co-sign a loan if needed.
I did invite her to come. I thought she would be nervous or not want to but she was excited and honored that I would want her to be part of such a huge thing. She is already "planning" to take Family Medical Leave and help out where needed.

I am excited too. Today was a GREAT day!

Consult Outcome-May 29th,2010

Basically the consult was a waste of time. The surgeon seemed promising at the first consult but he won't be able to help me in a meaningful way. He is a skilled surgeon but for reasons I don't care to go into it doesn't look like I will be having lower surgery with him HOWEVER, if I have any complications he is close enough and skilled enough that I would feel more than comfortable having a revision with him if necessary.

After indulging in a few moments moment of frustration I reevaluated things and decided to for now stick with my plan A. The reason why is I was allowing the stress to get to me as well as outside influences. As of right now the original plan seems most practical for my needs, wants and budget. While the amount for the surgeon's fee upfront is annoying I know 3 things. 1) If I pick another surgeon for the same procedure it will be more 2) I may not get reimbursed with another surgeon 3) I will have to start all over again with the pre- approval process.

This is the plan for now and I will just prepare.

I need $11,200 to meet the balance and have a chipin (see below). As I save money I plan to adjust it to show how much money I still need. I didn't want to ask for help but someone told me that there is nothing wrong with asking for help since I have helped so many.
Anyone who wants to donate I greatly appreciate it and thank you in advance.

Consult day- May 29th, 2010

I decided to not let the issues with the other surgeon get me down. I am still working on that but in the mean time I have decided to move forward with following up on plan B in case I need it. I am going for consult number 2 with this surgeon. I had a consult with them back in November '09. They require all their patients to have hysto before he will begin lower surgery. I had my hysto since I last saw them. They are in network and take both my primary insurance and my wife's insurance so hopefully they will just take that upfront and not charge me the surgeon's fee ahead of time. I know the hospital stuff is definitely covered because the hospital where they have surgical rights is a "preferred" hospital for my insurance so that's a plus.

I'm about to head out. I am a little nervous but I am going to pray the entire way there and trust that all will work out for me to have surgery sooner rather than later.

I have my list of questions and I am ready to go!

I plan to come back posting nothing but great news when I get back!

Prepping plan B and putting plan A on life support

After yesterdays news I called the surgeon's office today and spoke to them about my concerns. They were really nice and agreed to "see what they can do" because they want to "work with me". I appreciated that. Even if they knock off $4,000 that would make a HUGE difference.

Since my plan B was fuzzy I decided to make one last attempt to clear things up. I was able to get some answers which was helpful and has lead me to feel the need to go back for another consult. This surgeon is DEFINITELY in Network for my insuranc and I know because the surgeon and the insurance old me. Also my first consult was paid 100% by insurance (they never pay 100% but rather an agreed upon rate).

I will discuss some of my concerns that was initially putting me on the fence. If I can secure answers that leave me feeling comfortable then that puts me in GREAT position for surgery to happen sooner rather than later.
I am prepping my plan be in case I need one and putting plan A on life support hoping for a revival!

The hurdles keep on coming!

I received an email today from the insurance person at the surgeon's office for my lower surgery. Basically it says that NOW (after all these weeks) that she realizes that the surgeon is no longer in network. WTH?!!?!? The email goes on to say the surgeon's fee alone is $11,000+ that I have to "pre-pay". Then on top of that they don't even know yet if the hospital is going to have me "pre-pay" so that will be more $$$$. I know that my penis is an investment and that is an investment I am willing to make. I just wish I had this information before I made my "in good faith" deposit to schedule a surgery date. Mind you this "deposit" is non-refundable. If I knew this was going to happen I would have used the deposit to a plane ticket to have a consult with another surgeon or even 2 that I was interested who are more UP FRONT about their insurance stuff.

I am going to go back to the drawing board and see what I am willing to compromise and what I am not willing to compromise. I may continue with this surgeon on this path and then again I may decide not to go that route at all and go a completely different direction. Honestly I am considering holding off all together and going overseas. If I am going to pay any large amount of money might as well get exactly what I want and for a reasonable amount which I know I can get overseas from very good Doctors.

Surgery date...

So now that I have all my affairs in order I should be getting my surgery date some time this week. The schedule has to be reviewed and I will be talking to the surgeon to see how soon I can get in for surgery. I am very happy and this all feels surreal. I don't know when I will post the exact date up on the journal since I like to keep at least some aspects of my transition process until I feel ready to share them but I will eventually share which surgeon I am going to, when and where.

I truely feel blessed for how far I have gotten in my process and I continue to have faith that all will go well.

May 13th, 2010- Usually 13 is unlucky

The surgeon finally called! I spoke to my insurance today and my hospital stay for surgery was approve which = to my surgery being pre-approved also. I spoke to the surgeon's assistant and she will be consulting with my insurance to get the "rates" that they pay. Once she has that she can see if there is going to be a difference between the surgeon's usual cost and what my insurance pays. If there is a difference I will have to only pay the difference in the surgeon's fee but NOT the hospital stay. So within the next few days I should know more about that.
I am excited to book a surgery date! I want that date for this to feel real but even then I wont get excited until I am on the table.

That is all for now.

Lower surgery update as of May 11th,2010

I am still waiting for my surgeon to call in for the peer to peer review which should have happened by now. UGH!

I will post more once that happens.

The only good news is that once the peer review happens I am good to go for surgery and will just have to schedule my surgery date.

The wait continues

I am still waiting for the surgeon to call insurance so they can make the decision.
I honestly understand the situation why the surgeon hasnt called yet. (Im not going into it all issus here). One of the issues is that the surgeon is in a different time zone and how they structure their day makes this conversation more challenging to have throughout the day. I am assured it will happen soon.

That is all for now on the Lower surgery front.

Quick - 5/6/10 update

Lower surgery and Insurance

I called the insurance office today and surgeon hadn't called yet. I called the surgeon's office and surgeon was in surgery BUT surgeon had it in top of the desk to do first thing when out of surgery.

I will follow up tomorrow.


Education

I got all the financial aid stuff finished for my Master's progam *Does happy dance".
I was able to accept my financial Aid package and now I am OFFICIALLY registered for my first course which starts soon. I already got a head start on the reading!


Conferences

It looks like I will be going to the Empire Conference, Philly Trans Health Conference AND SCC this year.
If any of you readers are going to be at any of these let me know so we can meet up and hang out!


I hope I can post tomorrow about my insurance response and hopefully I will be celebrating having booked a surgery date!

I got mail... or so I thought!

I came home and opened the mail box to see a letter from my insurance company. I got nervous because the surgeon was to call today so if this was regarding surgery that wouldn't necessarily be so good.

My heart is racing my friend and I are texting. He told me to see what it was.

It's some damn letter about some BS that has nothing to do with me. JUNK MAIL!

Ugh! I almost had a heart attack for NOTHING!

Still waiting and other stuff.

I am still waiting to hear from insurance regarding my lower surgery. I called them today and they said that my surgeon called them but due to time zone stuff they missed the call. They called back with the best time for the "peer to peer" conference to determine whether I need to be hospitalized after surgery or not. The surgeon is out of town right now traveling so they will have to follow up when back at the office which wont be til around Tuesday!
If the surgeon calls Tuesday then I will know something for sure by May 19th the latest. Hopefully I will know something by the end of next week.

I am still optimistic about the whole thing.

My boxing gear came in the mail today and I am excited to put it to good use!
There will be lots of blogging about that I am sure since it does feel like another chapter that I have opened. Another part of myself I am learning about. We shall see

My insurance company makes no sense and other happenings

The title explains it exactly! THEY MAKE NO DAMN SENSE! I got a letter today from my insurance company. When I opened the letter it was from the department that covers "inpatient" stays. The letter basically says that they will not certify for me to stay in the hospital overnight after bottom surgery. When I read further it states that "The proposed procedure is normally performed on an outpatient/short-stay (ambulatory) basis and there is no documentation of a medical condition that would warrant an inpatient level of care". ARE THEY SERIOUS! This is freaking crazy! It is okay for insurance to cut into my penis and remix stuff but they can't keep me in the hospital overnight?! They pulled this mess with my hysto. For my hysto I was fine with it because I know people who had the surgery and went home the same day. That is the beauty of that hysto technique. This is a different ball game!
I think part of the issue is that the procedure is being requested for coverage by the codes and the individual codes are done as outpatient procedures INDIVIDUALLY but these are being done all at once which I think requires a little more than me just getting up and walking out after surgery!
The letter does go on and tell me how to appeal and send further documentation and that they respond within 15 calendar days which is a plus. This letter was also sent to the surgeon's office the date says 4/13/10 so I don't know if that was the letter that the surgeons office got before when they asked me to get the documentation from my local doc and stuff but I will call them tomorrow and see.
To be honest I am not worried because when I requested authorization for me to get T shots covered by my insurance they denied me. I wrote a letter my doc completed some form and now my T is covered til 2014 at which point I will just have to get re-approved.
I think it will all work out but now I have to spend tomorrow on the phone probably between insurance and the surgeon's office which would be fine if it weren't Friday and I wouldn't have to be on the phone also for work stuff. Oh well this is my penis we are talking about so I just have to do what I have to do! I will just go in early and get as much work done as possible and go from there.

In other news I finally found out why my student loans (which I have been paying off by the way) were weighing down my credit report. Someone Messed up and my consolidation loan was pending and eventually got disregarded by default which causes my largest loan to appear defaulted though I have been paying it off! I found this out when I was trying to get financial aid for my MBA program. Luckily after playing much phone tag I found out how to get my financial aid stuff in order and rectify the situation with my old loans. This will help boost my credit score BIG TIME and allow me to start my program as long as all documents are in on time.

Things are moving which I am happy about! I just wish they would move a little faster!