Eureka-C

I was denied by BCBS of CA on August 3rd:mad:, due to the experimental nature:confused1: of the VSG. I finally wrote an appeal letter. It doesn't have all the references like some I have researched, but I hope it works:001_unsure:. If you want to read it, I would love some opinions. Its posted on my blog From Thick to Thin: Insurance Appeal Letter Wish me luck. It has been a long 3 months since I first went to the doctor back in June.

Plan for 2-3 hours. For me it was an interview about my weight loss struggles and then a personality test that was long.

I have been drinking the Nectar brand protein drinks. They are fruit flavored. So far, my favorite is the cherry. It tastes like kool-aid, but I have to water it down a bit as it is strong. Also, my nutritionist said I could add a scoop of powdered milk to my milk or milk drinks to up the protein since I don't like so many of the others. btw. some others said you can get sample sizes of the Nectar brand online.

the first step for me was information. I went to about 4 seminars. The one at the doctor I chose was the most informative and included a quick physical, and meetings with several people including the nutritionist, RN, Surgeon, Insurance specialist, and a presentation. It was about 4 hours. I also read everything that I could on the internet from studies to personal blogs.

My husband couldn't pee after his appendix surgery and he was in some real pain sweating and turning red. One nurse told him that he wasn't trying hard enough. Luckily a shift change happened shortly after that and the new nurse after checking his chart came straight over, asked if he was in pain. When my husband said yes, the nurse immediately recathiterized him. He filled almost two bags with urine. The nurse said his bladder was so full, the swelling sealed his urethra shut. He just has a strong reaction to anesthesia and it takes his body about twice as long to recover.

I too was denied recently. Bc/bs CA. I was devastated. At first I decided to self pay, and I applied for a loan, but then several people on here explained how they appealed other bc/bs plans and got approved. So now I too am appealing. Luckily my loan was approved as well and I have 60 days to decide whether or not to take it. Good luck on your appeal.

How long did it take them to process the appeal? Would you be willing to share your letter with me. I won't copy it, just to get an idea of what works, and make it my own. That is hopeful news, thank you.

I think Tiffykins said it all. The only thing that I would add is that I think it is important to have the lower sphincter muscle in the the stomach to hold food there for a while and allow it to digest/stay full. With the RNY, I have read many expectations that in a few years, the connection on the lower end will stretch, and food will just pass through, leaving the person with an empty/hungry stomach w/in a relatively short time after eating.

My husband has that, and one of his favorite things to do is take a tennis ball, while he is sitting on the couch and roll it back and forth under the arch of each foot.

Wow! I am impressed. I wonder, do guys typically lose faster?

I looked into appealing, but as the reason for the denial was "experimental procedure" and I don't have any other health concerns (other than mild edema) at this time. I don't really have a leg to stand on for appealing. I am doing this because everyone in my family has diabetes for 3 generations back. All due to being overweight. Most don't live over 65. I don't want this to be me.

Good to know beforehand. That would scare me. Thanks for sharing this.

I have read lots of "good,bad, & ugly" posts on here. It doesn't take long to search around and find. I don't even have a date set yet, so maybe you can come back and tell all of us those things you would have liked to know before your surgery. Good Luck!

I live in the Dallas area as well. I have 150+ lbs to lose I haven't been scheduled for surgery yet.

To make the coke go flat fast, just drop a mentos in it. Of course it tastes a bit minty afterward, and there won't be much liquid left in the bottle. :confused1: