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It's Official... I'm Neurotic

Birdy18

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So is it weird that I scheduled my surgery date (Aug 20 which is permanently etched into my brain, lest I forget) before I've had insurance approval? For a whole slew of life reasons, I actually need to have this surgery as quickly as possible.

 

First, I've moved from deciding on the band to the sleeve.

Initial PCP appointment? Check.

Psychiatric? Check.

Nutritionist? Check.

 

I have to go in to see my surgeon tomorrow morning so it can officially be noted that I've seen him for the sleeve instead of the band. THEN, in go the insurance forms.

 

In addition to everything going through my head - first surgery ever, weeks of liquid diets, fears of will this work - I'm now one thousand percent terrified that my insurance company won't approve me. I can't really afford the actual time to delay the surgery during an appeal so this has taken over my all-consuming thoughts.

 

I have BCBS Illinois/PPO, and from the looks of things it looks like that's a good thing. I had the least amount of prereq's - no requirements for 9 month long medically supervised weight loss attempts (hi, welcome to 28 years of my life kthxbye) - but aside from having a BMI over 40, I'm 28 and don't have any other health issues or co morbidities: no sleep apnea, normal blood pressure, no joint pain, etc. I know NOTHING about insurance approvals, but I'm wondering if not having any of those issues will actually hurt my approval or not?

 

I just need to know soon - put me out of my misery!! Anyone have any good luck with a BCBS of IL PPO? Would love to hear the positive insurance approvals at this point. :)

 

Yours in all my neurotic glory,

Birdy



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Hey,

I have BCBSIL/PPO too. You could not be as bad as me. I called them every other day (would've been everyday to check status). A little exaggeration there but I was on them. One thing I did and I am not sure if it helped at all but I wrote a letter and had it notarized and titled it an "Affidavit of My Experiences." I initially wrote letter June 25th and had it notarized. The insurance company had rec'd the info from my doctor's office, however they quickly responded requesting more information from provider. I wanted to at the time to send my own response (affidavit) but I held back because I thought I was being "neurotic." As time went by was becoming impatient and fixated on this (totally not my personality). Sherri was off work during holiday and insurance company stated they had not rec'd a response. By the time I talked with her and she indicated she had submitted papers to them, I did not care, I faxed my letter to them. It was 2 days later I called and found out I was approved to have defective band removed and to become Sleeved.

I was the person who believed in natural progression and the journey. I am learning things are imperfect and I need to be more proactive. I thought to myself if the insurance company is going to "deny" me, I needed to feel I did all I could for them not to deny me. I don't know if the letter made a difference or if Sherri's submission did it alone. I know I will no longer take a back seat to things I have for so many years. I've always advocated for others (family, friends and clients at my job) and it is time I advocate for myself.

Don't doubt yourself. Be ready for your next move. I called BCBS more than I called any entity. I thought they would be irritated but I realized "they" is an "entity" and entities have no feelings. I was like, it is not like the same person answered the phone.

Hang in there and believe. I get the turmoil though so how you feel is natural. I have used this site to calm me down. I try not to overwhelm my friends that know of my new surgery. (I felt like a public failure with band so I limited those who know of impending Sleeve). Be encouraged and believe you are already approved.

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Thank you for sharing your thoughtful comment and experience! It definitely makes me feel better. I know I'm not alone in that feeling. :) Insurance forms were officially submitted for me today and the insurance coordinator and nurse admitted that she didn't think I'd have an issues (with a BMI over 40) but did say a lot of those approvals sometimes seemed to be whomever's desk it landed on. She did say calling for follow up on a response after a week would help too.

Thank you so much for your words of encouragement! Also, do NOT feel like a failure. You're taking the step to do what's right for you, it just takes time. And like you said, I'll continue thinking positive thoughts. Woo!

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i dont no if im doing this rt but here it goes...i have a dreaded band(lapband)and am wondering if my insurance will pay for the sleeve. i had bcbs 5 yrs ago but have cigna now. i had no idea the sleeve was around when i got the lapband,i just wish i had not gotten the band.i lost 20 lbs. w the band w much vomitting then hunger an hour later.i have suffered enuf & i also didnt tell but a few people i had the band becuz of th poor results.i no i going 2 have 2 jump thru hoops 2 get apprvd 4 the sleeve,thinking of just tightening my belt get the surgery in mex.(?)but i no i dont need an additional bill!

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