DreamsOfSkinny

Well that's great! My doc was supposed to have my peer to peer today but when I called his office they dont even know if he did it but said he wants me to come in tomorrow to talk. :-/ Hoping this means a Good thing..... But think maybe denied again and he's trying to figure out more info to find a way to get it approved

My doc told me losing all the weight should help with headaches in general.

Well if you get it 100% free that's great. I have $2k more for my OOP max but that includes any medical treatments me and my family have so the surgery may cost me like $1500 after any other tests I need.

Wow! 9 months is a long time.

You look great!! Just wondering since you say you lost slower and you look young, are you having any loose skin issues?

I hope to join all of you soon! I've been denied and am having a peer to peer review on Thursday. Crossing fingers!!!

Omg!! 11 months! I think I'd pay OOP lol not patient at all

And she said the insurance is just trying to find anything to not approve me. The Med. Dir. Called their office for a peer to peer at lunch time and left a message with the answering service. When my ins. Coordinator called back the ins. Said the peer to peer was already done. She was livid when i talked to her today. Coordinator said she scheduled it for Thursday an gave the Dr's cell phone to make sure they are reached this time. I am really not hopeful at this point and it'll probably go to an appeal but the coordinator said theres no reason they shouldn't approve me by their criteria bc I meet it all. So I'm just praying! I do have a a follow up appt with my surgeon this Friday which we were hoping to use as pre op so I guess if it gets approved I'll be ecstatic as I'll have pre op appt done and can schedule!!! Prayersssssss

So I called again and got ref. number for call stating that I only need 1 co-morbidity and bmi of 35+ for past 5 yrs although the medical Dir. Of Ins. Said I was denied bc I didnt have bmi of 40+. Second issue the insurance chose 2 of my lowest weights for 2 yrs and didnt even mark down for a whole year EVEN THOUGH my dr. Submitted all health documents! I talked to my ins. Coordinator at Dr office today

My Dr just told me to loose 10 lbs. I'm trying to appeal my ins. Denial but still want to lose the weight so if it is approved I'm ready to go! Are you on protein shakes? How many calories a day? Are you only clear liquids for 2 days prior to surgery?

http://theworldaccordingtoeggface.blogspot.com/2010/03/plan-for-success.html?m=1 Just found this blog that has a lot of quick and easy -portion controlled- meals and ideas on how to get your protein in. She makes tons of things from the powders.

I were told these were as well as another issue I was dx'ed with---intercranial hypertension

Just curious if anyone has gotten this type of denial overturned. What did you do? My ins states I need 35 bmi + 2 comorbities for last 5 yrs. 3 or 4 out of the five I'm over 35 and more like 38-41 (current 40.6). My ins. States the next step is having my dr. Do a peer review by having a call w/the medical director that denied it.....any ideas?

I hope so too and that my surgeon can make whatever case he needs to for that phone call.

I have to now call my Dr office tomorrow to make sure they get all the highest weight I was for each year right! Bc I know I should be 35+ and have 2 issues. Asthma and high cholesterol.

Ins. Director said my BMI had to be over 40 for last 5 yrs. This aggravates me as my benefits state 35+ w/2 comorbities OR 40+. I also am annoyed bc my Dr. Office submitted the wrong weights for each year! Now the dr. Office has to wait to get the denial letter and schedule a peer to ppeer reviews to have the Dr. Talk to the medical Dir. That made the decision

OMG! Can we trade bodies?? I want to look like that at 200-215 lbs! You look GREAT! I would have guessed you were much lighter. You wear it so well.

Really?? That kind of sucks. Guess I shouldn't ever mention my real name lol!