Everything posted by RSREED53
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how long did you wait to be approved?
It took awhile for the approval to confirm. Usually 2 wks. My surgeon had to do conference call with my insurance co to get my surgery OKd. I had it done last May. I am doing alright, 40 pounds lost--want to lose another 40. Ronda
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Denied AGAIN with BCBSIL
Glenna, once you contact your doctor, they will schedule you, and give you the PreOp Diet that has to be followed for 2 weeks, usually. That PreOp is like a detox, designed to shrink your liver so that the surgeon has optimal conditions to do your procedure at surgery. Oh, also at scheduling, the doctor will order some labs and an xray to be done, if not already, in your surgical prep orders--this is routine. If I have missed anything, I stand corrected. Your time at surgery, and recovery, will be smoothe--I am betting so! Ronda
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Denied AGAIN with BCBSIL
Glenna, congrats to you! So happy to hear you will be getting surgery soon. I worked 4 years before getting my revision surgery. It is so worth it!! Keep us posted on date and your progress--right now, I am finding need to be engaged with successes from the board here--loss is kind of stalemating my successes right now due to having a birthday last Sunday and just generally a high stress week. I am working to get right back on track, tho! Take care, Ronda I DID IT!!! I DID IT!!! I GOT APPROVED!!! I am soooooo excited I can hardly stand it!! I haven't even called the surgeons office yet LOL I told my sister & my best friend!! I cannot believe that it worked out, after 2 denials from BCBSIL I was starting to loose hope... for all of you who are in the process be patient! I have been working toward this for the last 10 months!! Now to call the surgeon & figure out what to do next... Wow, I am in shock... my new life will begin soon!! Thank you all for your support it kept me going through all the months! Glenna
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Denied AGAIN with BCBSIL
Say your prayers. Yes, it seems like a very good sign. :rolleyes:Ronda Ok, so I don't know what to think... I called BCBSIL and was told that I needed more information from my Dr regarding the type of program that I was on for the 6 months of MSWLP. So my Dr wrote a letter explaining that I was on a low calorie diet with exercise 3 times a week, daily food journals & exercise notes; that i came in every month for a weight check etc... so I sent that over with the personal letter I wrote as to why I want the surgery. When I called yesterday they told me that they have my fax, but have not reviewed it & that my surgeon's insurance coordinator might get more information. So she did call in and magically between my call and hers they had reviewed the fax then sent it on for Dr. review & she should call back in a week for an update. My question, for all you out there, is: Is that a good sign? I am optimistic that this is a step closer to surgery, like maybe before they denied it due to the lack of information and it never got to the Dr review part? What do you all think??? I have been doing this since Dec of last year & I just want the approval so the waiting is over... Thanks for all your help! Glenna
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Gastric Sleeve Nightmare V.2.0
Dishdiva, I hope you are recovering much better than before. It was great to hear from you--thanks for your update. I wish you continued success with your recovery, Take care, Ronda
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Denied AGAIN with BCBSIL
xchange, I am glad you are home and doing well. Congrats on your sleeve surgery! Ronda
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Hiatal Hernia
MIne was repaired 1o yrs ago when I had my RNY--no problems thereafter! I do sometimes chew 4-5 Tums, but the hernia has not been a problem postop. That surgery was an open incision one, so did not have the scope procedure. Now, my sleeve was done by laparosope May 31st. I am all healed up mostly, lost about 45 pounds now, and still working to get the remaining 40 off for maintenance. Good luck--the repair surgery is good--my hernia was the size of the surgeon's fist, so I needed it fixed! Ronda
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Pregnancy Update - Pictures included
Tiffy, you look cute and ready for baby to come! Glad for you, and hope your labor and delivery goes without a hitch! Too bad she is not coming in Oct--my birthday is Oct. 16th, which is next Sunday. I could be her Grandma! Gonna be 58. Thanks for sharing your pictures with us here. Tatum will be here before we know it--on my niece's 16th birthday, I might add. Take care of yourself and get the rest you will need for the hospital and baby's arrival. Ronda
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Denied AGAIN with BCBSIL
Just be proactive in every way with this. I took 4 years before getting OKd last spring for surgery May 31. It is worth it! Doing very well with my sleeve. xchange, congrats on getting your approval, and those waiting I will keep you in my thoughts and prayers that your day will come very soon. Hang tough! Ronda
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Gastric Sleeve Nightmare V.2.0
Dishdiva, I hope you have a speedy recovery. So sorry you have had a very difficult postop recovery time. Ronda:rolleyes:
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I Was Preapproved And Now After Gastric Sleeve Surgery Insurance Is Denying Claim. Beware!
Njjewing, I would be in the middle of Aetna with my approval letter and ALL documentation for their approval regarding your sleeve--get an atty if they renege on their commitment to your care coverage because what they are trying is a scare tactic because of your complications and a higher bill. Don't let them get away with that! Now is not the time to back down from them. I am sure your doctor's staff will help with any and all paperwork needed to clear the matter up--also, I bet somebody mistyped codes and faulted on the clerical work during claims processing. It happens. Best of luck to you, and I hope you are having better success with your new sleeve. Ronda
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Officially a Member of the 50's Team!
October 16th is my birthday. I turn 58--gosh, in 2 more years I will be hitting the big 6-0! Ancient, not really! Ronda
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Burger Salad
Sounds good! I bet a Turkey burger with cheese would be even more healthy--altho the beef is a nice change. Ronda
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Protein Powder opinions... What do you like?
Muscle Milk Lite 26 g protein and Premier 30g protein are my best choices--I get vanilla powder and whiz fruit and berries in mine.:DRonda
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Done!
I stay away from carbs, caffeine and lactose--also limit my gluten. 40 pounds lost and sleeved May 31, 2011. Feeling great! Ronda
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I Was Preapproved And Now After Gastric Sleeve Surgery Insurance Is Denying Claim. Beware!
Contact your state dept of insurance to complain about treatment of coverage. If they no longer cover the surgery, then that is fault of your employer. HOWEVER, I would send all documents of approval to the Insurance Commission--the carriers usually HATE to be investigated by the State! Worth a try. I would not give up the ship with them. Hang tough! Ronda Dont get me started on Anthem BCBS. I am with them as well, good insurance but they do suck. All my pre op testing was covered, I am all set to set a surgical date and then I was then told it wasnt no longer in my contract. I HATE INSURANCE COMPANIES!
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Surgery is tomorrow!
You should not have Water retention. That could be blood pressure probs. Glad DallasMom has had surgery and wishing continued success! Ronda
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I Was Preapproved And Now After Gastric Sleeve Surgery Insurance Is Denying Claim. Beware!
I would get my approval letter from the ins copied and sent to each of the parties needing payment. In the meantime, get a lawyer to go to bat because that sounds fishy--it is breach of contract to not pay for services once the ins co. OKs it. Good luck! Anthem BCBS pre approved me for surgery. I had my surgery in July and now they deny the surgeons bill, the hospital bill and the anesthesiolists bill. I call and they say we will send it back over in the mean time I am on the verge of going to collections. BUYER BEWARE. Insurance companies suck.
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Make ahead Muffin Melts
Sounds great! Cannot wait to make them--no muffin for me, either, but would try wheat toast or flatbread. Thanks for sharing! Ronda
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Gone forever
I can do toast if I want, but my thing are the little round oyster crackers. I have to really take care not to overdo those. I get hungry for the crunch. If I take too many carbs, the weight starts going up. I really don't want to get into to many carbs ever again! I do eat a carb smart wrap once in a while. Lettuce leaves work better than iceburg slices. My thing is the food sits in the back of my throat and I get nauseated from gagging. I am 13 weeks out now, so imagine the sleeve is still healing. Right now, I can chew nuts, make egg omlettes sometimes, eat turkey franks, and just had a good experience with a little meatloaf that I warmed in the microwave. I make a lowcarb cheesecake sometimes for a special treat, but can do sf jello, and sf puddings pretty well. If I really want to eat some grain, I make organic oatmeal with flax seed in it. That tastes good with soymilk or Almond Breeze and stevia in it.
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Surgery is tomorrow!
Just wanted to add my best wishes to those about to have surgery. Will keep you in my thoughts and prayers. Ronda
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Surgery is tomorrow!
You will be fine--great postop progress! Will be thinking great thoughts for your surgery. Ronda Thanks guys...surgery is so late because the dr had to double up as he is going to be out on tues! Oh well, what can i do about it? I think my husband and i are going to go to a mid day moviE to break up the time a bit! Just so anxious to get a view of the losers bench! (although i have lost 17 pounds since my appt with the dr on 8/4!)
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August 31 Surgery Date!
You will be fine! I am excited for you! I am 2 months postop and 38 pounds gone! This works!
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Low carb versus low calorie
. Net carbs for me!
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Had my sleeve surgery Monday
I am struggling with my BMs 3 mos postop. It is miserable, but the sleeve is good--38 pounds gone! Glad you are doing well after your surgery, Caye.