debbiek1

i got an answer from the company and that is right--only online or over the phone. she did make one good suggestion about the chicken broth. she said to get the unflavored and add it to my own chicken broth. i think i will try that since theirs is backordered. all i can say is--it must be darn good!!!

no, i dont have a surgery date yet. today i faxed the coordinator a copy of my approval letter. i better call tomorrow and make sure she got it. i never did get a bill for 200 dollars from the nutritionist. (Hope she doesnt read this forum!!!!) hopefully, that is one thing that did fall thru the crack. i went to see her on feb5. so you would think i would have gotten a bill by now. but i do remember her saying there were some computer problems that day.

can you get unjury in a store or do you have to order it online? i went to the website and they are temporarily out of the chicken flavored. is that common because it is so good? the strawberry sorbet sounds good. i think i would get sick of chocolate flavor fast.

on thursday i got my approval letter from bc/bs federal. actually it only took the insurance less than two weeks to approve it, once they got all the paperwork from the surgeons office. as i have complained before on this thread the delays and feet dragging were all the fault of the surgeons office. but its all over now so i will quit complaining!!!! now i have to get a presurgery appt and some preadmission testing and get a surgery date. lets do it!

got a check from the psychologist today. that was fast.

i never did call the coordinator to see if they submitted the diagnosis and the total cost---i am too busy eating to call!!!! no, just kidding!!! hopefully, they want this money as bad as i want the surgery so they are taking care of it. now, i dont really care when i have it done. i wanted it done in april or may before everyone in the office started their vacations in june and july. i was hoping to get a month off and it wouldnt be a big inconvenience. but since there are only three of us and vacation season is starting soon, it is going to cause a problem. it will leave someone working all alone. i guess now my goal is to be skinny by christmas. i have no decent summer clothes i can fit in and i refuse to buy any bigger clothes that i will only wear for a one season.

i am still waiting. but surprise, surprise the psychologist did submit the jan 17 claim to my insurance. i got an explanation of benefits today saying they paid him $187. they should have paid me. but that is okay.

called bc/bs today. they said they got the packet from the dr on april 12. but still needed a couple things. they need the total cost of the surgery and a diagnosis code. i will call the coordinator tomorrow to see if she has sent this in. insurance said to call back in a couple weeks. now my optimistic date is middle of june. which will be 6 months since my initial seminar at mt carmel. and 4 months after i completed all my requirements. people keep telling me that they are probably taking their time because they want me to be sure this is what i want. but i tell them no, it is taking so long because my paper work keeps getting lost. i know i sound very negative. and i hate that. i am usually more optimistic!!!

no, i havent given up. i just keep eating and getting fatter and fatter by the day!!! i will call the insurance co later this week and see if they ever did get it. about the six month diet--i forget do you have the same insurance i do:BC/BS federal plan? the coordinator made the comment that there was another lady with that insurance that got approved and she sent her paperwork in the same time she supposedly sent mine in. so it didnt sound like she had to go on a diet.

i called the insurance company today. i had been to see the dr at mt carmel on march 8. the insurance company said they have no record of the request for surgery, just a bill for the visit. so i called the coordinator at mt carmel, she said 8 pages were faxed on march 28(a full 20 days after my visit). she said she would fax it again. so i am no closer to an answer than i was 32 days ago. my journey at mt carmel started on december 15 and i got all my prerequiments done ASAP so i could get this thing done, but it has been one obstacle after another. i am really wondering if i shouldnt have gone somewhere else. but they are my insurances "center of distinction" . maybe i should just start over at OSU.

congratulations--Megan!!!! you are so lucky!!!! where are you having it done?

i am waiting----and waiting----and waiting. since going to see the surgeon on mar 8. i have kind of gotten disheartened since 10 days after my visit the surgeon still hadnt forwarded the request to my insurance. so i am starting to lose the "eye of the tiger" i cant stay that focused or it will drive me crazy. right now i am busy spending all the money i have left. i figure if i get totally broke then i will get a call saying i am approved. another thing that has me sort of depressed is that people are now saying BC/BS FEd is requiring a 6 month diet. when i called in novemeber they didnt say that. if i had known that then i could have started then and been 5 months into it while i was waiting. of course, i know i have no excuse--i should be dieting but..... i just feel like such a loser right now. unlike a lot of people i cant keep a secret and my life is an open book. and i have told everyone at work and everyone else i know that i am getting this done and now it just looks like it is never going to happen. sorry for being so down.

i went to fathman. he is in dublin. well, that is great. i dont even know how to submit a claim to my insurance anymore. all the drs have been doing it for so long. and i have no idea where my receipt is. great. it looks like i might be out 350 dollars. my only consolation is that since it was right at the beginning of the year there was probably a 250 dollar deductible. so maybe i am only out $100. the people at barix told me once i could go to michigan and get it done there and that for some reason bc/bs would pay more. it didnt make much sense to me. but like you i am beginning to think i should think about checking them out. at this rate i am going to be hot and fat all summer!!!!

the coordinator seemed pretty convinced that my insurance would require such a list of diets. but i told her that when i called they did not say that was a requirement. I went to see the surgeon on Feb 8. and i was all happy thinking that it was now in the hands of the insurance company. but i talked to my insurance about another matter on friday, which was 8 days after my appt, and they said nothing had been submitted yet. so i called the coordinator and she said that it sometimes takes her two weeks to transcribe the surgeons notes and submit it. so here i sit once again as anxious as all get out. I just feel that maybe this is not meant to be. The psychologist never submitted the $350 charge to my insurance. i went to see him on jan 17. now i have to start hounding him to submit it so i can get some of that money back. he made me pay him in advance. then the dietician lost my paperwork the coordinator is taking forever to submit it. it just goes on and on. i am getting so dishearted. i wanted to have this done by my birthday in april. i can forget that. now i am beginning to think i should just forget about it and try to do it on my own. do i really want to do this? every time i am out driving i see all these restaraunts i want to try and then i think--I wont be able to go there after my surgery.

well, that is a new one on me!! i never heard of geocaching. i went to the website and it sounds like a lot of fun. Now i gotta get a GPS--great another thing I want to spend money on!! your ailment list sounds just like mine.

hi Lady QT--glad to see columbus represented. i went to the seminar on dec 15. after you send your packet in you will get a reply packet detailing all the steps you have to take before you can see the surgeon. i only had to see a psychologist, the dietitian, go to a support group meeting and submit a diet history. you have 30 days to send the $300. because of the holidays i didnt get in to see the psychologist till jan 17. then i saw the dietitian feb 2. went to the support group on feb 6 and a two hour dietitian class of feb 8. after they get all those clearances you are supposed to hear from the coordinator in a week to schedule with the surgeon. but they seemed to have lost my paperwork and i didnt get to see the surgeon till last thursday. so now it is in the hands of the insurance company and i am waiting again. all this waiting is driving me nuts. I want this done NOW. i wish i could afford to just selfpay. but that would be stupid when my insurance will supposedly pay. hope this helps and may your journey go faster than mine. debbie

now that is an interesting question. i dont know. usually when bc/bs has a "preferred" physician they work out a deal where the doctor will accept less money. now whether a "center of distinction" is synonomous with "preferred" i dont know. but in either case the patient ends up paying less--10 percent plus deductible versus 20 percent.

in oregon the bariatric centers of distinction (according to BC/BS FEP) are: Legacy Good Samaritan Hospital Portland OHSU Oregon Health Sciences Portland St Charles Medical Center of Bend Bend

i have plan 104--maybe the difference is that i have single plan. i am glad to know the info you guys have given. i finally got to see the surgeon last thursday after months of prep work such as support group meeting, psychologist approval and consultation with a dietician. and they lost some of my paperwork so it has been a long haul. now it is in the hands of the insurance. i am going to one of their Centers of Distinction so i hope i can get this done soon. keeping my fingers crossed.

if you dont mind me asking, what insurance company do you have? i dont have the money to do it self pay either--but i would have to find a way. i figure i would save money after because i wont be eating as much or going out to restaurants as much!! but if OSU just got your chart in december then they are moving right along. Hopefully all will be smooth sailing--your date will be here before you know it!! hows about this snow??? i am playing hookie tonight(i work evening shift--i dont drive in more than 5 inches!!!:omg:

wow! that is a long time. i had heard that it took a long time at OSU that is one reason why i started at MT carmel. I havent heard anything yet. i went to see the dietitician and went to a nutrition class last week. that is the last of the things i had to do before seeing the surgeon, so i am hoping to hear from them this week. I certainly admire your patience and tenacity. If it takes me a year, i will just have to pay for it myself. i cant wait a year. i am just too impatient. my insurance will pay some if i go elsewhere but they pay more if i go to mt carmel or osu. one suggestion: if you want to lose some dead weight get rid of that boyfriend from MICHIGAN!!!!! Just Kidding---as a buckeye fan, i couldnt pass that one up!!!!!

i guess i should formally introduce myself on the ohio board. i live in columbus and am still in the process of trying to get the lapband at mt carmel hospital. it seems to be taking forever--i went to the seminar on dec 15 and still havent seen the surgeon. they have all kinds of stipulations and it takes time to make appts and go to meetings. i have a nutrition class this week and i am hoping that after that i will finally be scheduled to see the surgeons. mt carmel is a preferred provider for my insurance and i think it would be dumb to pay more just to get it done sooner. so i will just jump thru the hoops!! hopefully this thing will take place in april or may. i am 56, divorced with a grown married son and one grandson. i am in a relationship with an older guy who is thin and is very energetic and i cant keep up with him!!! right now i am 290 and 5'10". these last 40 pounds just came so fast and i seemed powerless to get rid of them. my knees and feet are killing me which makes it impossible to go for any walks. i joined lifetime fitness so i could use the pool to do Water walking and aerobics but only get over there once a week. i have high blood pressure, arthritis and now my ankles are swelling and hurting really bad. i have an office job so i sit most of the day. just recently discovered my TSH levels are low and i have a goiter, so now i am on synthroid. this is helping my energy level somewhat. i used to get overwhelmed just walking to the back of a superwalmart. now i seem to be better. i am always hungry. i need something to help with that. i am hoping the lapband will help. i have to do something if i want to live long enough to retire. i want to be able to live long enough to draw my full retirement which is age 66.

wow, things in texas sure move faster than they do in columbus ohio!!! i went to the seminar on dec 15. after that it took a couple weeks to get the forms. then i had to schedule an appt with a psychologist. then i had to get an appt with a nutritionist. then i had to go to a support group meeting which only meets once a month and i missed january's so i just went this week. now i have to go to a 2 hour nutrition class. hopefully, after this nutrition class i will have fulfilled all my obligations and i will hear from the surgeons office within in week and i can get scheduled in for my first appt there. once i actually SEE the surgeon then they will submit it to the insurance company. the surgeons did want a list of all supervised diets i have been on in the last five years. i really havent been on any supervised diets. i dont think the BC/BS federal plan requires that. they told me they only need a predetermination from your surgeon that you need the surgery. but i still dont know for sure if this surgeon is going to make me go on one. maybe after this nutrition class tomorrow i will know more. as far as the general out of pocket expense--bc/bs told me they would pay 90percent if i went to their preferred provider. but perhaps Disco Diva can tell us more about that, since she is scheduled next week.

Discodiva-thanks that is good to know. when i called BC/BS fed they just said i needed a recommendation from the surgeon. but the packet from the surgeons office wanted to know all "supervised "diets i have been on in the past 5 years, so i have been kind of fretting over whether i would have to go on a 6 month diet before i got this done. i havent been on any supervised ones. just the ones i have imposed on myself which usually last until noon everyday. i live in columbus and i havent seen many people on the boards from around here. mostly dayton and cincinnati. that is neat that you are scheduled on valentines day!!! the best present you can give yourself and your hubby--by next valentines day you will be able to wear the sexy red lingerie!!!!!

i also have bc/bs federal plan and i would like to know if they make you go on a supervised diet before they approve you.