Fusilli66

I was so excited to get the call yesterday that I was approved for my surgery on 10/11! And I was so happy with the whole process. My insurance has always been GHI - CBP for City of NY Employees. Years ago I had looked into getting the surgery, but they didn't cover it at all then. Now they do (for a few years I believe). Anyway, there requirements are BMI of 40 or 35 with a co-morbidity. Also the 6 month thing and psych evaluation. Mine was 40.2 and I had 2 co-morbidites - sleep apnea and osteoarthritis (which not every insurance company accepts, but they do).
Originally my doctors office said they had to schedule surgery in order to submit it to the insurance company with a surgery date. I thought they were nuts. I asked them, what if we schedule surgery and then they deny. They told me not to worry, I had met all the requirements and there was no reason for them to deny it. They just said the only problem with GHI is that they take about 5 weeks to approve so we would schedule for 6 weeks out.
Then, once all of my doctors visits were complete and I had the clearance from the cardio and all the others I got a call from the doctors office scheduling me for 10/11 which was only 4 weeks out. I told them it was too soon because of my insurance company. But they told me, no it wasn't because GHI is now EmblemHealth and although GHI takes a long time, EmblemHealth is much quicker and thats who they were submitting it to. So they submitted last Monday and I got the approval yesterday in only 1 week! Very happy about the whole thing.
I just wish the surgery was sooner now! I just can't wait. It's 3 weeks from today and they time is going very slow but I'm sure it will be here in the blink of any eye.
So that's my insurance story for any of you GHI/Emblem people out there.

I was so excited to get the call yesterday that I was approved for my surgery on 10/11! And I was so happy with the whole process. My insurance has always been GHI - CBP for City of NY Employees. Years ago I had looked into getting the surgery, but they didn't cover it at all then. Now they do (for a few years I believe). Anyway, there requirements are BMI of 40 or 35 with a co-morbidity. Also the 6 month thing and psych evaluation. Mine was 40.2 and I had 2 co-morbidites - sleep apnea and osteoarthritis (which not every insurance company accepts, but they do).
Originally my doctors office said they had to schedule surgery in order to submit it to the insurance company with a surgery date. I thought they were nuts. I asked them, what if we schedule surgery and then they deny. They told me not to worry, I had met all the requirements and there was no reason for them to deny it. They just said the only problem with GHI is that they take about 5 weeks to approve so we would schedule for 6 weeks out.
Then, once all of my doctors visits were complete and I had the clearance from the cardio and all the others I got a call from the doctors office scheduling me for 10/11 which was only 4 weeks out. I told them it was too soon because of my insurance company. But they told me, no it wasn't because GHI is now EmblemHealth and although GHI takes a long time, EmblemHealth is much quicker and thats who they were submitting it to. So they submitted last Monday and I got the approval yesterday in only 1 week! Very happy about the whole thing.
I just wish the surgery was sooner now! I just can't wait. It's 3 weeks from today and they time is going very slow but I'm sure it will be here in the blink of any eye.
So that's my insurance story for any of you GHI/Emblem people out there.

I ate an awful lot of Egg Drop Soup in the beginning, and still do sometimes. It goes down easy and the eggs are Protein. Win Win in my book. Enjoy.

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

I have to say that things like this just piss me off and scare me at the same time. I know every insurance company is different, but you have 2 co-morbities and your BMI is over 35 - how dare they deny you. I would certainly try appealing - it seems like you should qualify - but I don't know what the requirements are for your insurance.
I hope it works out for you - I haven't gotten that far yet. I am hoping that they will be sending in my paperwork on Monday as by then they should have everything they need. My BMI is 39.9 and I have sleep apnea so we will see if I get approved.
Good luck to you!

I'm so glad you guys liked my post. It is truly how I feel and I was hoping I would help someone else. Pay it forward. I was never nervous about the surgery but there was a little apprehension. But reading posts like this kept me inspired, pre and post op and I wanted to do that to. Before surgery I didn't tell very many people that I was having it. Since surgery I tell almost everyone. I have no reason not to and I want to be an advocate for it and inspire others. When I look in the mirror sometimes I can't believe what I see. And this is still at 190 lbs! I can't imagine how I will continue to feel 20 or 30 lbs from now. Quite frankly, I am so happy at 190, that even if I never lost another pound again I could live the rest of my life at this weight and be happy with myself. My goal is set a little high, higher than what 'they" consider a normal BMI to be. But I don't really care. I'm 45 years old, 5' 5", I was 140 lbs. when I was 21 and really don't expect or even want to be 140 lbs again. I think 165 is good for me, for my body. I like curves, I like a little meat, I like having a full butt, thats just me. It's all about doing this for yourself and making yourself happy!

I'm so glad you guys liked my post. It is truly how I feel and I was hoping I would help someone else. Pay it forward. I was never nervous about the surgery but there was a little apprehension. But reading posts like this kept me inspired, pre and post op and I wanted to do that to. Before surgery I didn't tell very many people that I was having it. Since surgery I tell almost everyone. I have no reason not to and I want to be an advocate for it and inspire others. When I look in the mirror sometimes I can't believe what I see. And this is still at 190 lbs! I can't imagine how I will continue to feel 20 or 30 lbs from now. Quite frankly, I am so happy at 190, that even if I never lost another pound again I could live the rest of my life at this weight and be happy with myself. My goal is set a little high, higher than what 'they" consider a normal BMI to be. But I don't really care. I'm 45 years old, 5' 5", I was 140 lbs. when I was 21 and really don't expect or even want to be 140 lbs again. I think 165 is good for me, for my body. I like curves, I like a little meat, I like having a full butt, thats just me. It's all about doing this for yourself and making yourself happy!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am almost 4 months out from surgery now and have lost almost 60 lbs (some pre-op but most since surgery). I have gone from a size 20 to a size 14 in the blink of an eye and I'm still losing. My life has changed in so many ways. I feel better, the constant pain in my back is gone, I breathe easier, I have energy to do things and for sure I look better. I was aware of all of these things. But Sunday I was made aware of something else.....how much happier I am. Obviously I'm happy with the loss and all that has come with it, but I didn't realize that I am just generally a happier person. I am always in a good mood, I'm not moody at all, I have little stress and I just love life again, something I hadn't done in a long time.
On Sunday I went to a super bowl party and having seen someone I hadn't seen since last summer, she of course mentioned my weight loss and how good I looked. But she ended it with saying that there is something in my face that she can see that I just look happier. So interesting. I hadn't realized it before how unhappy I was, and how I was putting that out there. I didn't realize that I gave off an unhappy air.
I am very lucky, I have a good life, a husband, 2 great sons, a job, a home. I am one of the lucky ones. But I never felt happy. I guess I was depressed, although I did antidepressants for a while and they didn't change anything. But the fact is I was standing in the way of my own happiness by allowing myself to get fatter and fatter. I don't know why, but I was. There was very little I enjoyed in life, other than food. I was my own worst enemy. And I am so glad I am not anymore.
I just wake up happier, I like what I see in the mirror, I like how my clothes fit. I like just throwing something on to go to work and not having to spend 20 minutes figuring out how to make it look ok. I just get dressed now, any pants, any shirt, any shoes and they all look good. I like how I feel. I used to feel like I was wearing a fat suit that I couldn't take off. I always felt heavy, bloated, lumpy. Now I feel lighter....metaphorically, as well as literally.
This surgery was the best thing I ever did - it has changed my life in more ways than I ever thought it would. It isn't just about dropping pounds, its about changing your life physically and emotionally. Thanks for reading, I just needed to share!

I am 4 weeks from surgery and I am constantly thinking of things I want to do that I haven't been able to because of my weight. I'm sure this has been posted before, but for us newbies, lets keep track of the things we want to be able to do after we have lost our weight....
I want to...
Buy underwear & bras at Victorias Secret instead of Lane Bryant

According to your signature you are going for a pre-op visit and not pre-op. Therefore, why do you have to lose weight so fast for a doctors visit? Who was it that told you that? Unless it was your doctor or the doctors office, I wouldn't listen to that. I would, however, call the doctors office tomorrow morning and find out if that is true.
I wouldn't start the pre-op liquid diet before they tell you too. Every doctors office seems to say something differs - 2 weeks, 4 weeks; no pre op diet. I am dreading that I have to start a 4 weeks on Tuesday. But I certainly wouldn't start before my doctor tells me to. He actually specifically said not to follow the liquid diet for more than 4 weeks.
Again, you should check with your doctors office.
Good luck to you!

I agree, they are annoying. But if they weren't there these message boards wouldn't be free. Something has to pay to keep these boards up and running. So I'll put up with the ads, if it means having a great board like this to go.

It does sound like a mistake in the doctors office, but that technically you do owe that amount. First thing I would do would be to call the insurance company and find out what the costs were, what they paid, and what the insurance company says that you owe the doctor. If it is indeed $1340 then I would call the doctors office and tell them that this was not explained correctly, you were told you were paid in full and therefore don't feel like you should have to pay for there mistake. Then I would negotiate a settlement with them. If they do accept other insurances in network, then why should you pay out of pocket more than an insurance company would pay them for something else. That has always pissed me off. They will charge $100 for whatever - Joe's insurance pays them $10 and they accept that in network, but you are out of network so you have to pay the full $100 for the same service that Joe got for $10. Threaten to not pay and let it go to a collection company, they will for sure settle with you because if it goes to collection the doctor will have to pay the collection company a portion of whatever they collect.
I recently did that with my original bariatric surgeon. He was out of network, but he does take plenty of other insurance in network. I got a bill for $1400 for 3 visits - 1 consultation with the doctor (all of 15 minutes) and two visits with a Physicians Assistant or Nurse (not sure which) where they weighed me and I left. This was worth $1400???? I ended up negotiating it down to what the insurance company would have paid and the whole thing cost me $260. Try that.