lovestoned

Thanks all of you guys!! Your words really do help. I really am feeling better already. Self pay MIGHT be an option for me. I would have to talk to some people and figure some things out first. Does anyone know if it would make a difference if the surgeon wrote the insurance company letting them know that my surgery is medically necessary? I mean does that even make a difference when weightloss surgery is completely written off?

The bad news just keeps coming :-( Turns out that the supposed authorization number was just something not unlike a case number. I was in fact DENIED :-(( I just contacted my employer to see if there's anything I can do and their response was "ABSOLUTELY NOT" they told me that it was removed due to high costs. I'm NEVER gonna know what it's like to be thin again without this surgery. I'm completely devastated.

I don't even know where to begin :cry 4 months ago when I started this whole process of having surgery I was told by the "insurance specialist" at my hospital that all was good with my insurance...that I would be covered. Stupid ME never called the insurance company to verify this, after all, HE IS the "Insurance Specialist". After getting a surgery date of August 17, and after many tests and appts. and getting paperwork for these people I get a call on Aug. 7th from the hospital letting me know that weightloss surgery is EXCLUDED from my plan through my employer and that it was MY responsibility to have double checked that :think So of course I've been devastated for the past 3 days BUT this morning I get a call from the hospital AGAIN and get told "Congratulations, you've been approved" WTF??? So I'm all like "are you sure?? but what about this and that..." She reassures me that I've been approved and that she even has an authorizaton # :whoo:But something told me to call my insurance company and verify this. I called them and they said that the claim was presented and DENIED on Aug. 7th :faint:. YOU GUYS, I'M GOING CRAZY OVER HERE!!! :wacko:I know I need this band to help me lose weight...without it I know I can't succeed at losing the 140 lbs I need to lose. What do I do? I feel desperate, depressed, impotent :help: along with many other emotions!!

LOL I'm posting a reply to my own thread LOL I just wanted to add that I've been a nervous wreck ever since they gave me my potential surgery date of Aug. 17 and it's just not right for them to play games with me like that...I'm a freakin human being...and here I am confiding that this paperwork had been sent to the insurance company weeks ago. I really feel deceived :-(

WOW am I frustrated!! I've been getting the run around from Mount Sinai (sorry if I'm not supposed to name names) but turns out they've got a few new members in the dept. and they really need to get their act together. About 2 1/2 weeks ago, I was told by my surgeon's NEW medical assistant that they had all my paperwork and that it is ready to be submitted to my insurance co. for approval AND she even gave me a surgery date of August 17. I told my boss about the date and told her that it's pending Insurance approval. OK cut to now...I called my health insurance co. to find out the status and they told me that they haven't received a thing from Mt. Sinai :faint:So of course still keeping my composure I call Mt. Sinai and and basically say "what's going on?" So I get this run around about how the nurse practitioner is still reviewing my chart to make sure that all my paperwork is complete...WHA WHA WHAT? Didn't this woman tell me 2 1/2 wks ago that everything was complete and ready to be sent to the insurance company?? OKAY so I speak to the nurse practioner today and she tells me that it is NOT complete because they still need a letter from my PCP (I sent that like 2 mos. ago) and knowing ME, I know that I called to follow up and make sure they received it. SOOO, this means that NOTHING was sent to the insurance company despite what I was told. I mean this is really frustrating because this is supposed to be a "Bariatric Surgery Center for Excellence" named so by the American Association for Bariatric Surgery. UNBELIEVABLE. I'm so angry that I just wanna switch over to NYU at this point :think but if I do that, that means starting the WHOLE process over again right??? Another thing is that my surgeon is not involved in any of this process...soooo....I haven't seen or spoken to him since the initial consulation which I find so impersonal but I guess that's normal right?? PS. Mount Sinai NEVER returns my calls when I leave messages :phanvan Today they did though...MIRACLE Sorry for the rambling :lie:

Hey all!! I'm scheduled for banding next month. For me it's either the band or nothing. I'm just too chicken to go through with the Bypass. All of us here have a problem with food. I'm sure that most of us binge too. Hopefully the band will be a tremendous help. Whether you get the band or do the Bypass, if you continue to binge in the long run you'll gain weight with either surgery. Trust me, I need to make this band to work for me since I'm looking to lose about 140lbs :-o Good Luck with everything. If you keep reading enough posts, I'm sure you'll realize that the Band is the way to go :-D

Hi there! I can totally sympathize with you Rachelle and Judy145. I also have a lot of anxiety in general and I too suffer from panic disorder. Currently I have a surgery date of Aug.17 and I have moments where I'm just elated and other moments when I'm like "I can't believe I'm electing to be cut open and have some foreign object put in my body". BUT whenever I come on this site I KNOW I'm doing the right thing for myself. Rachelle just take it 1 day at a time. I also start imagining "the worst" but how does that help us? In your heart you should know if this is right for you and for now that's all you need to know :-D Good Luck with everything.

Sorry that you can't change surgeons :cry. I'm scheduled for lapband next month and I'm looking to lose about 140 lbs. Gastric Bypass has never been an option for me and I hope that it never will be. My surgeon believes that I can do GREAT on it. He told me that on average people lose about 50-60% of their excess weight with the lapband (versus 70-80% with the RNY). Although 50-60% is the norm, that doesn't mean that with discipline and hard work we can't very well exceed that "norm". I trust what my doctor tells me, especially since he's with a "Bariatric Surgery Center for Excellence" :car:

Hello all I'm Lovestoned, I'm from the Bronx, NY and I'm scheduled for Aug, 17, 2007 with Dr. Kini at Mount Sinai :-D

I'm scheduled for August 17th (pending insurance approval) and I'm as scared as I am excited. I just wanna tell WANABTHIN that I know exactly how u feel. For the most part I am the fattest person in the room and on the beach I'm usually the fattest and the most covered up too. I'm a travel agent so I travel as much as I can. I'll be on a short cruise in early August and I'm hoping that that'll be my last vaca at this weight. I'll be doing a longer trip in Dec. and I hope that I've lost a considerable amount of weight by then. Enjoy your vacation as much as possible...after all, you only have 2 choices...enjoy it or don't enjoy it...so the best of luck to you and all of us Augusteers :-)

Hi there! Yes that's definitely an insurance issue. 80% of all insurance companies require the 6 mos. of supervised dieting. The other 20% (which consist of United Health Care & Oxford) require a 5 yr history...which is actually easier because all you have to do is request all your medical records from the past 5 yrs exhibiting all your different weights and you're set. Of course you have to have been overweight for at least the last 5 yrs. Dr. Marina Kurian has recently joined the NYU staff. I met her when I went for a consultation at Lenox Hill. She performed Al Roker's surgery. She's great. I'm getting my surgery done at Mount Sinai in NY. They're also a Bariatric Center for Excellence. I never looked into NYU...maybe I should have but I went with Mount Sinai over Lenox Hill simply because I felt it was a better "fit" for me.

So sorry to hear about your dad. I know what that's like. My BMI is 48 and I'm thinking that's a little high but I think that every facility is different. 1 of the surgeons I was checking out said that if I lost at least 5lbs that it would help her (and me) a great deal. The surgeon I'm going with requires that I go on a liquid diet for 10 days pre-op. On that show 'Big Medicine' (anybody watch that?) they require you to do a liquid diet for a lot longer :-o In any case it probably is a good idea to discuss this with your surgeon!! Good Luck with EVERYTHING :-D

Oh my goodness thanks so much you guys. I'm known to be a little fatalistic so I have spent some time on the complications forum AND the "life after band removal" forum. I'll follow your advice and stay away from those forums from now on :-) I'm glad that I'm not alone in this! Positive thoughts!!! Although I do feel obligated to leave "instructions" and "final wishes" in case of the worst happening. Has anyone else done that? Or am I just a little over the top? :-o

I'm confident in my choice of surgeon I would just like to know if anyone is familiar with Dr. Kini's work?

Thanks for the support Doxie and Valzie!! Your enthusiasm is contagious. I really am excited and reading your comments give me strength TRULY! WOW I love that our dates are pretty close to each other...makes me feel closer to u guys! Have either of u gotten insurance approval yet?