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honeycomb822

LAP-BAND Patients
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Everything posted by honeycomb822

  1. honeycomb822

    So Upset.......please Need Advice And Input!

    That is fine..we all have our differences, I know what I have just been through and actually have paperwork to prove what I am saying. You actually can call the NH State Board of Insurance and they will tell you that Anthem BC/BS of NH maybe liscenced but are not regulated. This was not meant to cause disagreements but to try and helper understand that no matter the reasons, do not let the insurance company make you feel like giving up. Bottom we are all here to help each other through the struggles tears and anger we feel when insurnace companies turn our worlds upside down. Would you not agree?
  2. honeycomb822

    So Upset.......please Need Advice And Input!

    I to thought this was true but it is not. in NH the BC I deal with does not have to answer to the state or fed. governmemt. I know you may well disagree but having just fought this battle and having a fed. government employee call me and tell me this information I was shocked. So as sad as it maybe, believe it or not....all insurance companies do not ahve to answer to anyone but themselves. Please look this up and you will see that it is indeed another sad state of affairs with insurance companies and having been told i first needed more info. an was then was turned down, I felt she should not the worst as I have just been through it. On a lighter note, I noticed our surgery date was the same congrats and I to just had my first appt, and I have also lost 10lbs.
  3. honeycomb822

    So Upset.......please Need Advice And Input!

    In reply to Geno....though many believe as you do that the insurance companies have these regulations, that in my case is not true. BC/BS in NH is considered a private insurance for my husband's company...they answer to no one even the government. I was beyond shocked when I found this out. This nasty little secret is the reason many companies can get away with their crap.
  4. honeycomb822

    So Upset.......please Need Advice And Input!

    It is true that big hospital's do have insurance coordinators, but what is not mentioned is when your partial denied, need more info. or outright denied the patient has to initial all appeals. The hospital will get the info. but my case proves even with the doctors doing the right thing, a patient still their own best line of defense.
  5. honeycomb822

    So Upset.......please Need Advice And Input!

    Hi Ginger, Please do not get down, I exactly how you feel as I spent the last year arguing with my insurance company. Be determined and most importantly know that you surgeon will help you in any way possible. I have a top bariatric surgeon from Boston Mass. and even with her help it took this long. Here is a lsit of all I have been through so you can see how horible these companies can get: had lapband out 4/2011 because it infected and almost killed me 9/2011- Surgeon submitte for revision and we were denied because they wanted updated info. 12/2011-was denied because BMI was not high enough and I was not sick enough(truely this is the honest truth) 2/2012-denied again still not heavy enough(gain40 lbs. at this point) 4/2012-BMI finally right, new medical info. submitted was denied again..why the company never updated any info that ahd been sent. Denial based on info. fro, 9/2011 5/2012-had outside appeal and talked with lawyer 7/2012-re-submitted thing outside appeal wanted was denied again(this time because they again did not us new information and BC/BS even had infor. that was not mine in this denial 8/2012-Surgeon had enough called BC?BS and informed them their info. was not anywhere near correct...after this coversation..surgery was approved and done last Tuesday. This no doubt the worst part but be strong and you will make it. Most importantly keep ALL information from the insurance company and the info. sent to them. By proving they were not being honest and doing their job they could no longer deny because I had all the info. to prove I meant all credentials they required. The icing on this cake is BC/BS refused to return the hospitals calls for approvals I had to fax them down today. As you can see this last year was hell but like me you will come out on the other side, just do not quit. Determination ticks of the insurance companies and really will pay off. Hope this helps.
  6. I was seriously ill in April and had no choce, my band was infected and had to be removed. I was devastated and very concerned about just what has happened, I have started gaining weight. I saw my doctor today and was told putting another band in could be very risky and lead to even worse complications. I am seeing a nutrtionist and having medobolic testing next month to see if we can figure out why the weight came back on so fast. I am very afraid that I will go back to how I was before the surgery. I went from 267 to 138. I am now 158 and am afraid to even get on the scale anymore for fear it will show more weight gain. Any ideas I will gladly listen too. All advice is welcome and it sure is nice to know I am not the only one this has happened to or that feels like every pound just makes you look terrible.
  7. I wish I could have the sleeve. We talked about it yesterday and with my bowle obstruction issues it could leak and my surgeon says that it is not worth the risk. Right now just holding onto the hope that the longer it is that I have no more complications then even tually she will re band me. I have one of the best surgeons in my area and if she does not want to do the surgery then chances are good that it should not be done by anyone so I just hope over time she will casnge her mind.
  8. I can not have the sleeve because I also have bowel obstruction issues I never had before. I was able to get down to 118 but was made to put 20 pounds back on and that was with the band in. I am hoping the longer I go without complications smy surgeon will reconsider. It is a HUGE reality check when a surgeon tells you they refuse o operate because it could kill you. I am having a metabolism test next month, believe it or not the doctor thinks the issue maybe that I am not eating enough. We will see that is for sure, I just get really depressed after all the work I did to lose the weight and then have this happen.
  9. honeycomb822

    Honeycomb822's Before and After Pics

    My Before & After Photos!

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