Rena's got this

I called today and found out that I've been denied. The six month diet by the registered dietitian did not have any doctor's notes annotated with it. Also, my co-morbidities aren't severe enough for the past 3 years. My BMI wasn't 40+ for the past 3 years either (3 years ago it was 36.6), so that came into play. I'm going to have to talk with my primary care doctor and see if she can write a letter with all the reasons that I should have this surgery. Looks like its going to be a long and drawn out process. Mexico is looking better and better.

LOL....I have a good friend with that name, so that won't work! There was one person who made my life miserable at one point. Her name is Dolores. Maybe I'll use that one.... Found out today that my insurance denied me. Not totally unexpected, as BCBS of AL routinely does this. Now I have to get all my appeal ducks in a row to resubmit. I was so hoping to get this surgery by the middle of December, but it might not happen.

I tried to go to this page, but it isn't a complete web address. Can you repost it?

Oh yeah....I have an evil fat brain. He won out tonight, and ate pizza. Not just one slice either, but the whole thing. Granted, it was a small, thin crust, veggie pizza (Tombstone), but I couldn't just stop at one slice...nooooo. I'm gonna give my evil fat brain a name, and see if that helps me defeat him. Any thoughts for a name?

awwwww.....you lucky dawg!!!!! Congrats! I'm calling again tomorrow...can't wait until Thursday.

It's hard to have patience when you are this close to the end. I couldn't stand it, I called BCBS again today, after only 5 business days. Of course they said it was still being reviewed, and that it could take up to 30 business days. I'll be calling them again on Thursday....

My doctor was surprisingly supportive...it was the dietitian that she sent me to for my 6 month diet that made me feel that I was just using her to get the surgery. It didn't matter that I lost 10-11 pounds while using the tips she gave me. It makes you feel like you are doing something not quite ethical, and I hate that.

I work at Auburn University. We are self insured, but BCBS of AL is the administrator. We have different coverage than anyone else using BCBS of AL. I've been told that everything will be covered except for $100 for the hospital copay. If they take their time and don't approve me before the end of the year, and I am not able to have the operation before the end of the year, I will have a 2014 deductible to meet, but it is only $150.00.

I'd write a letter explaining your use of the e-tools. It couldn't hurt.

That makes it difficult to plan. I know that the average total cost is around $21,000.00 but I don't know what all that includes. Lordy...if I had to pay that much, I'd just forget it and go to Mexico!

I know what you mean. I have BCBS of Alabama, and they say it could take up to 30 business days. So frustrating when I'm trying to have this surgery by the end of the year! My surgeon's office submitted it on Nov. 11th.

I've just finished my 6 month requirement and am waiting on insurance approval. It seemed to be one of the longest 6 month periods in my life! People told me it would go by quickly, but it didn't seem to for me. I did learn some good dietary techniques during the 6 month period, but I really don't think that such a long time was necessary. I lost 10-11 pounds, but it was mainly due to being sick, and having some deaths in my family. I'm trying to hold my weight steady until I hear from insurance. I do expect to lose a bit more with the pre-surgical diet if I get approved....crossing my fingers on that!

OMG....it has only been a day since I called BCBS to see if I've been approved, and I want to call them again! Is this usual? Can I not wait until at least next week??? I MUST learn to have patience.... Please Lord, give me patience, and give it to me NOW!

My Dr. is Dr. Wes Turton, with West Georgia Bariactric. He does the sleeve almost exclusively. If you will look at the back of your insurance card, you will find a number for the BCBS customer service. Call them and ask them how much you will have to pay for a one day hospital stay. If you tell them it is Mobile Infirmary, they may be able to tell you exactly how much your portion will be. My brother was treated at Mobile Infirmary years ago after a workplace accident (Oil Rig). They saved his life.

Lol....I was soooo tempted to wear my heavy shoes and lots of clothing. I wouldn't go as far as putting a lot of rocks in my pockets though. Turned out that I didn't need to. My BMI was 41. After my 6 month diet, it is 39.9, so I'm hoping that doesn't matter much.

My paperwork was submitted to BCBS of AL on Monday, 11/11/13. I called BCBS today and they said it was still being reviewed, and then they reminded me that they have up to 30 business days (not including weekends) to review my case. That is a month and a half! Ridiculous!! I'm going to be calling them at least twice a week just to be the squeaky wheel! I really want to get this surgery done before the end of the year.

My surgeon actually gave me a form explaining exactly the amount I would need to pay after insurance. You may want to ask your surgeon for something similar. My insurance is BCBS of AL also. My paperwork is in review right now...

Couldn't help myself....I called BCBS today. They haven't finished reviewing my paperwork, and they reminded me of the "up to 30 days" policy. They received my paperwork on Monday 11/11/13. I'm finding myself more upbeat these days...thinking that this might actually happen! Might also be because when I get up and open my bedroom door....I have four 8-week old kittens galloping down the hallway to greet me! Puts a smile on my face first thing in the morning!

My surgeon forwarded my paperwork to BCBS of Alabama on Nov. 11th. Supposedly they have 30 days to reply, so I'm not going to get my hopes up for a sleeve date by the end of the year. I'll just keep plugging along. My surgeon's office says they are booked up anyway through Christmas. Bummer. I have a lot of vacation time that I need to take between now and then, and it would have been the perfect time for me to get sleeved.

I'm so glad for you! Your tenacity in continuing to fight for what is rightfully insured is inspiring. You only have a week and a half left before surgery! Do you have to do some kind of pre-op diet?

I started out with that type, but it kept leaking and I spent most of my nights trying to adjust it instead of sleeping. The one I have now (Wisp), leaks a lot less, especially when I keep it clean. When I've had my mask for 10 months, my insurance will pay for another mask, and I might try a different full face mask. I've come to realize just how important a good sleep makes me feel.

I've been on my cpap for 6 months now, and I must admit, I feel so much better. I'm not so sleepy during the day now. I have moderate apnea, but was hoping it was severe my insurance states it must be severe to count as a comorbidity. My surgeon's office submitted all my paperwork yesterday though, so we'll see how it goes. I'm trying not to let myself get excited just yet. The only problem I have with my cpap is when I have nasal congestion. I can't use it when I can't breathe through my nose!

My surgeon just submitted everything to BCBS of Alabama. I thought there was a 15 day wait, but after calling the insurance office, they told me they had 30 days! Argggghhh! Should I start bugging them in a week or so anyway?

Dang ladies...congrats! I'm waiting for my surgeon's office to submit to insurance, then my 15 day wait begins. I'm borderline with co-morbidities, Borderline with BMI for the past 3 years and am hoping that everything is ok. BCBS of Alabama has a reputation of denial on the first try. Makes me ill thinking of it.

The six months has been excruciatingly long. I think every day that my knees won't hold out much longer. Tomorrow is my last dietitian appointment, and hopefully they won't wait too long to submit my paperwork. That said, I have learned a lot from my dietitian.