wannalose

I am just devastated for the 2nd time! The insurance wants MORE information from my 6 month visits. They said the doctor was not descriptive enough. They want diet and exercise progress. I know what I discussed with my doctor in each visit but I can't control what she types in her records. I'm so frustrated now. I've been denied twice over this. I'll appeal but I'm scared this is going to go no where. My biggest fear is that I will have to find a whole new doctor and do another 6 months all over again. I've been on this for 9 months now. I just dont know what to do. ... Maybe curl in a ball in the room and cry? Advise?

Yes! Eat more! Or even have a protein snack after like some nuts or hard boiled egg

I had my surgery on Monday, I actually had a rough couple days in the hospital. Came home and still a bit exhausted. I dont have too much pain which is GREAT! I have been having diareah though since I came home. Is this normal? Also, I can barely drink anything, Today is the first day I have had 2 Protein shakes, Of course it takes me an hour or so to finish it. I just want to recover healthy and quickly. Should any of this be a concern? I am sipping away...but I seem to be only gettign in about 30 oz of Water or liquids a day.

I thought the same thing when I did this....I'm in my last month right now and September 2nd will be my 6th month appointment! I'm so excited! It was worth it to save myself thousands of dollars. It has also given me allot of time to prepare myself mentally for this. My girlfriend just went and paid cash for it but she is very financially well off so it didn't hurt them at all. She has Zero regrets about doing so but I am not in her position. We would feel it if I paid cash. It will be worth the wait. Also..Consider it 5 months because I went the first of April and my last appt is September 2nd and I'm handing it to my insurance coordinator. So really I waited 5 months...The 6th month was just my 6th appointment. Good luck to you!

I am in my 5th month of my 6th month supervised diet with my doctor. I weigh 260 and have lost nothing in the 5 months. I do go up and down but pretty much my body likes that weight of 260. I am curious if this is going to effect Insurance approval or if my doctor is going to tell me that I needed to lose weight during the 6 months. I am struggling so much with this. I know my doctor thinks I'm a super slacker. What to do, what to do......

I'm so bummed, I called the insurance company and was told that the information that I submitted was not enough. She said that the first 3 months of my diet was not supervised (I submitted WW) and that the last 3 months with my doctor was not enough detailed information. They want to know progress on my diet as to what I was eating and how much and exercise if I was doing 10 leg lifts a day and went to 15 a day each month. I'm so bummed. I called the insurance coordinator with our bariatric clinic and she said I must have gotten a really tough case worker. STINKS only me this would happen too right? ANyways, She's going to look at the denial letter when she gets it and sees if there is enough for an appeal. She thinks worst case scenario is I would have to do an additional 3 months to please them with the WW. Of course I thought I would have needed more then just a WW booklet but she claims they approve them all the time. Such a sad day I need a pity party.

Yes I spoke with the Claims person. She said that WW was not enough that I needed a doctor supervised plan. I started going to the doctor 3 months ago and the information she submitted wasn't enough. They wanted a food Journal and notes on how my exercise was for example if I could only do 10 leg lifts in one month then the second month I could do 15 leg lifts. That kind of documentation. When I spoke with my Insurance Coordinator at the Bariatric clinic she told me that I had a really tough claims adjustor and she was surprised they were being that strict but she was going to wait on the denial letter and see what I need to do. Just Bummed me out

Are you SERIOUS? I'm doing a Happy Dance for you! I'm going to call today to make sure they got mine too My paperwork was submitted Wednesday the 8th but who knows...I'd love to hear news like that today! WHOOO HOOO!

How exciting! Have you heard anything back yet? I have just finished mine. I did 3 months of WW starting in January and the last 3 months was with a doctor. The Insurance Coordinator has submitted my information this week! I'm anxious and nervous...So many things going in my head! I just have to wait now.... Good luck to all of you!

I have my last doctor appt that will complete my 6 month diet this friday then I will give it to the insurance coordinate with my surgeons office and she'll submit to insurance. But I'm getting so scared now. The thought of the surgury is starting to scare me. I have been so ready and willing to do this the whole time and now coming right down to it. YIKES! I dont want to change my mind, but how do I know if I am READY for this? This isn't even approved yet, no surgery date nothing and I'm starting to get scared already. Any thoughts?

I do feel better after reading your messages. I am relating with everyone. I did do a Pros/Cons list and of course the Pros list just flowed over with reasons why i need and want to do this. I really feel I am as prepared as I possible can be. I have read all the great successes on all these messages boards as well as things that were scary as HE11! I am also nervous because I haven't even received approval yet from my insurance so I am thinking I need to prepare myself for "just in case" it doesn't get approved. It is very scary, I think if I were having any type of surgery I would be scared but this is so life changing and I cant' take it back. And would I want to? Just having those Pre-Jitters. I should be excited. I'm sure there will be a point I will get to that. Thank you all for the support. I will be ok. Deep Breath! Lets get through one thing at a time first!

My Psych Eval is today and I'm so nervous. I just need to get through this and 1 more doctor visit and off to the insurance while I wait and hope to be approved. I have no idea what they are going to ask. I was told it was a 2 hour visit. My stomach is in Knots. I wish I could have someone go with me to hold my hand. Is this a "Make it or Break it" moment? Wish me luck! I'm almost there!

He basically just had me explain the surgery to him in detail, I had to take a T/F test which was kind of funny but I imagine it was to make sure I was mentally stable. He called me this afternoon and said I passed and is forwarding my eval to Dr. Nicholson. All I need now is my last Doctor Appt for my diet which is June 3rd and then I will give everything to the office to submit to insurance. I'm so excited!

Uh oh..too late! haha, I need to chillax! I'm sure it will be fine. I want this to go smooth!

Well..I haven't had my surgery yet either, I'm still going through the approval process with insurance but let me tell you. I've done my homework on this surgery and it's VERY scary! but I know this is what is going to be best for me. I'm sorry you are going through LapBand Revision. That stinks to go through all that to just have it removed. I read all the successes the Vertical Sleeve has been for everyone and it just gets me anxious. I just want it here and get it over with so I can start my "new" life! It is really normal to go back and forth on such a big decision but you said you have been researching this for a year now so you know what you are getting into and what to expect. You wouldn't be human if you weren't scared about this. Maybe write down all the reasons you want to do this. I think you will be ok and go forward. I wish you best of luck! (((hug)))

June 3rd I will be submitting everything to the insurance coordinator for approval with BCBS of Illinois so I will keep you posted! I'm so excited! Almost there!!! I'm going to be a nervous wreck until I find out though "FOR SURE"

Great...That just burst my bubble. I was told by the insurance coordinator that my WW book for the first 3 months will suffice and she suggested I just go to the doctor for the last 3 months. I was hoping to submit for approval in June. Sounds like I will need to wait until September. Now will the Doctor be enough? or do I need to rejoin WW as well? OH man....This is becoming a stressfull nightmare for me.

I also have BCBS IL, I am still in the process of doing my 6 months, 2 more to go! I had started WW January 29th and was told I could use that as my Month 1, The insurance Coordinator said that I shouldn't have any problem turning in my first 3 months of WW with the insurance. I cancelled WW and started to go with my Doctor because it's cheaper. SHe also said that I didn't even have to do my weekly weigh in's I only had to make sure I had 1 weigh in for each month. With that said...Sounds like WW should be enough but I'm going to pay attention to see what they tell you. Good Luck! I know this is the hard part huh?

DH was just sleeved Mar. 1st and (of course same surgeon as me) and he didn't do a pre-op either. I see you and your Husband are both sleeved? Do you have children? I am in the process now of getting my ducks in order to send to the insurance for approval. My husband is "thinking" about doing it himself but not until after September. How is it with both of you doing this together? Just curious. Thank you, Sheila

I was told by the insurance coordinator that if I went January 29th as long as I go each month that January 29th counted as month 1, So I can go anytime during Feb, march, April, May and go June 1st and that counts as a month. Technically I would be going for 4 months but counting it as 6. Am I nervous about her submitting it that way? A little, but she's done this before so I assume she knows what she's doing.

I was denied because they said my doctor and I didn't discuss exercise enough during the supervised diet. We did discuss it and both he and the surgeon's office felt his notes were sufficient but they still denied me. Also, my BMI is over 50. I think you just never know what they are going to say. What I ended up doing was writing a letter with all the reasons I felt I needed the surgery, which included all the diets and exercise plans I had been on over the past 30 years and I sent it to them. I also noted what exercises I had been doing and how often over the past two years. I made sure I gave a TON of detail in this letter They say they will take any additional information you have and will review it if you are denied. I did not file an appeal, just submitted the letter after I got my denial letter. Shockingly, it worked and they approved me. I was very surprised. It might not be a bad idea to include a letter with your initial paperwork and see if helps get you approved. I think the more information you give them, the better. Good Call! I'm going to call tomorrow and talk with my insurance company, Let them know what I'm doing and if it will suffice. See, I've only talked to my Doctor once! He's not even going over any supervised diet with me, he just ran bloodwork and I told him I was doing WW. I am thinking I may want to go see him again soon and keep up with that. Can I quit WW and submit what I did with WW and go to just the doctor? I know your not insurance experts but the advise is really got my thinker thinking.

I just think you never know for sure what's going to happen. I wonder if it just depends on who reviews your information. My info was submitted when it was a 3 month diet requirement. I had done a 5 month doctor supervised diet and also submitted 2 months of weight watchers weigh ins (weighed weekly) and I got denied. But, I hear other people say it was a piece of cake for them so I think you just never know. Maybe sometimes people are cranky when they are reviewing them or something! Do they tell you why you were denied? That doesn't make sense if you have a BMI of over 40 and you give them the requirements they need. I'm going to be making some phone calls in the morning. I can't do this for 6 months to get denied. It will ruin me. The waiting is the hardest part! Love these Boards, Very supportive. Thanks

I have BCBS Illinois as well, I was told I needed 6 months of a weight loss program i.e. WW/Jenny Craig. I started WW back in January so I'm just continueing the WW through June. Do you know if they will accept it with Gaps? I have weighed in at least once a month but there are a few weeks here and there that I haven't weighed in. I hope that doesn't matter. The Lady at the bariatric center doesn't seem to think there will be a problem but I will be devestated in June if I get denied going this far. I suppose I can weigh in from now on once a week since I'm paying for it.