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If located prior to surgery I am sure the doctor's office will include it in the authorization. This was the case with me and there was no problem with authorization and payment by the insurance company.

OOPS! double post!

While this thread is about frozen dinners, I also like purchasing rotisserie chickens. By switching up sides and using different sauces I can get several tasty meals out of one.

Nutritionists live in an ideal world. We live in the real world. Nutritionists' advice is a guideline. Some of us are very busy. We don't cook; I don't know how to cook. Low-cal frozen dinners with preservatives are better than my OLD eating habits.

Amen!

It gets better, believe me. I went through the same thing, everything made me nauseous in those first weeks. I had to resort to sipping room temp Gatorade G2 which helped tremendously unfortunately I see that will not work for you. Call you doctor and see what they suggest. Do keep sipping whatever you can because for the most part, that is all we can do in the beginning days/weeks.

Protein drinks are still an issue for me, hopefully eventually they will work for you.

Hang in there!

I've met the requirements of "completing" the supervised diet within their time frame. Their documentation states nothing about the starting of the diet within 2 years of the Bariatric appt. So yes, they are in the wrong. I would be really pissed if they denied me completely and I had to redo it.

It's a stall tactic. I zero doubt in that. They took their legally allowed 15 days to respond. I'm sure they'll take their 15 days to respond to the appeal as well. I've only been paying into their plan since April, so they want the deductible from me. With almost a whole business week off between Thanksgiving and Christmas, they can effectively stall me off until next year.

Besides my bmi is 46, I'm diabetic, with high blood pressure, and cholesterol. I've been obese for almost 30 years. They really have no medical argument against my surgery. They simply put their bottom line before my health. Like I said before, I have a Cadillac plan with Fiat service. It's pretty pathetic!

It's not about medical necessity, which you obviously meet, it is about the plan requirements. I had to jump through the six months of appointments/diet and my plan is pretty much at Cadillac level as well. Everyone involved told me that missing even one visit during that time could possibly mean I'd have to start over so it really isn't personal. Of course if you choose to believe it is, there is nothing anyone can do to stop you. Good luck with everything.

I got denied today for the lamest reason. They took almost 15 days to tell me that 2 months of my supervised diet weren't valid, since the technically didn't fall within their 2 year limit.

The problem is I've met my deductible so these guys are effectively going to stall me off until 2013. Then I have to pay more.

So we have to send them information from 2 other doctor visits. Then wait 15 more days, which will make a 2012 surgery impossible.

So what's the out of pocket typically for VSG? I have a Cadillac plan.

I do not see the denial as lame. The requirements are fully stated and two years gives a good amount of time to meet them. Someone/somewhere simply screwed up. Did you see a doctor at any point where those two visits can be reconsidered? If I remember correctly even a visit to the PCP could be counted. If so, resubmit. It is the first few days of November, there is still plenty of time to receive surgery before 12/31. Is your surgeon's office not involved in this, they should be able to correct this. What I would do is ask to be put on my surgeon's schedule while waiting.

Medical providers can charge whatever they like but most never receive anything close after contracted rates come into play. It's almost comical comparing the payment to the actual billed charge.

Oh and I'm surprised at the assistant surgeon charge mentioned above. Most surgeons have fellows/residents that assist. Mine is a teaching surgeon so there was no charges from his assistant. I had no problem with it because he's training the next generation of bariatric surgeons. They have to learn somewhere, why not at the right hand of the best!

I was told no salad for 4 months! <---yes, MONTHS!!

I'm just over three months out and started having salad last week. During my last visit surgeon said I should be able to eat pretty much anything by now. I still play it safe and try new foods carefully.

Did he give you specific reasons why he suggests you eat this way? My surgeon and nutritionist suggest I eat 5 small meals daily which, right or wrong, I interpret as 3 main meals with two Snacks.< /p>

I have little success with health choice, even pre-op they left a bad after taste to me. I would say you need to review the nutrition panel while shopping and go from there. Keep in mind just about everything frozen will be high in sodium, that sort of goes with the territory.

Yes anyone can regain weight after bariatric surgery as it is only a tool. It takes a serious change in habits, specifically where they related to food, to be successful. If you are not ready to make these changes and feel this strongly against surgery then you are doing the best thing by backing out.

I have UHC to but I think it depends on the policy. I was approved before I even met with the surgeon - I had contacted UHC and was assigned a nurse who provided me with the paperwork to prove my 5 year BMI 40+ history. Once I got it signed off from my primary and sent it in I received the approval letter in 5 days. Then I was given the choice of surgeons, if I wanted maximum benefit it had to be at a Center of Excellence. I actually had to jump through more hoops for the surgeon than I did for the insurance co.

You had pretty much the same experience as I did except my PCP did not have to sign off on anything. I really think going through Optum Health helped loads, you are basically pre-approved before even starting the official program with a physician. Once I completed the six-month diet supervised program and the paperwork was submitted to UHC it only took about a week to receive approval. My nurse coordinator with Optum actually called me with the decision before my doctor's office did.

Call and speak with the doctors over at Methodist. Not sure how much their self-pay rates are but maybe they can work with you. http://www.methodisthealth.com/wmc.cfm?id=35059

One thing, trying to get on a busy surgeon's calendar at such a late date could be an issue, you need to be prepared if it doesn't happen.

Perform a forum search for blood clots, there have been several threads with some good information posted.

Well...look at it this way. If there is something off then now is the time to find out and do something about it. I pray you are right on track but if not let them give you all the help you may need to be healthy...isnt that why you had the surgery? Let us know how it goes!

Hang in there! If you're doing everything your doctor recommended and you're losing weight, you should be fine. Don't over think it.

Sending you good vibes.

Thanks very much for the replies and support. The visit went well, he is pleased with my weight loss but is now insisting that I exercise on a regular basis. I know this but mentally the idea of losing calories when I am eating so few is a major challenge, has been from the beginning.

The labs were a little questionable since I had a delay in finding Vitamins that could be tolerated after surgery. Vitamin D was low but it's been so since before surgery so that does not concern me right now. My cholesterol jumped 20 points in three months(!) and my AC1 is elevated. I have NEVER had an elevated glucose level, fasting or not, and this has set me on edge. Doc says this was the body reacting to surgery over the time period and the new way of eating but still.

I have a visit scheduled with my PCP in about a week and will have her pull labs again to double check these results.

hi there can you plz help me im trying get to were you at I got sleeve on sept /27/2012 my weight was 379 now it's 353 im only 3 weeks out but my gold weight is 200 I nd some help to get there plz help

You really should not try and compare to a man's weight loss. It's a set-up for heartbreak. They lose weight differently and quicker than women do.

Tomorrow is the 3 month post op visit with the surgeon and I am dreading it. Today was the blood draw and I am almost hoping the results are not back in time. Am I losing weight? Yes but I do not feel healthy and am terrified of what the labs will show. None of this is rational, it is just how I feel and needed to vent about it.

Did you have to do 6 month diet?

I was told UhC has 2 plans - 1 that requires this and 1 that requires 5 yr weight history.... I'm PRAYING mine is the later. My coordinator is going to list my bmi of 40 w/2 com. Plus 5 yrs of weight history along with dietician visit, consult, recommendation medical necessity, and pysch eval next week. She said we should hear back within 2 weeks and will find out what they say.

Yes I did and it flew by! Honestly, the six month diet/nutrition plan was a very good idea as it gave me time to adjust to the idea of surgery.

I did this one day with some Sonic tater tots. I bought a small order and drove up to the trash can 10 feet away and through them in. Of course, I crammed 4 in my mouth before I got to the trash can.

But here is where we are all different. For me, simple carbs definitely are a trigger food. If you have an addiction, as I did to carbs, then partaking of them in small quantities prevents you from ever getting over the addiction. Giving them up completely (or "depriving myself"...as people here are so fond of saying) was the only thing that really decreased the craving. Having a few in moderation actually raised the craving.

It's a proven fact that if you want to increase an animal's (or person's) desire for a particular substance, you give it to them intermittently and sparingly. Ask any dog trainer and they will tell you not to give the dog a treat every single time they perform. This keeps them wanting the treat more.

Interesting point and something to seriously think about.

Had a few of those moments as well over the past couple of months. I made a decision not to deprive myself as it would only increase the craving. Hit the corner store, purchased a small bag and had 4 or 5 cheetos which satisfied the need. I threw the remaining ones away and moved on.

While there will be some that will say this was a bad idea, I still see it as a victory. Once upon a time I would have eaten a grab bag size or larger without a second thought so to have 4/5 and be good was an accomplishment for me.

Have you tried hemp Protein? I love this stuff mixed with a little mango purée (mighty mango by Naked)

Never heard of it but just found the website. They have trial sizes which is right up my alley. Thanks OTR!

I have UHC. To date they have covered everything you listed leaving me responsible only my co-insurance & co-pays until I hit my out of pocket. They have been beyond wonderful to deal with from my initial inquiries with the Optimum Health program onto to surgical approval.

It would be ideal to drink the shakes but like you, I can no longer tolerate them. I have tried different brands and wasted way too much money since being sleeved in July. I have one or two more to try before giving up for good. I'd have already thrown in the towel except I know how important Protein is to a body.

The unwich is my order of choice when my fellow employees do Jimmy Johny's weekly. It is nice to enjoying lunch right along with everyone else.