phyllser

Sorry to hear about your setback, Don. It's a real struggle trying to find the right combination of doctor/facility to meet Medicare's mandates. That's why I'm driving 60+ miles to my doctor appointments! One doctor wanted to put me on a waiting list... 3 years! I don't think so! Then... here's the kick... after I did everything right, Medicare rejected the hospital claim, $17K+. I talked to them this week about why and they said the hospital coded the claim for an automatic reject. So then I called the hospital and told them that Medicare said to change the code and resubmit the claim. You know what they told me?? That's okay. We already "adjusted" your bill and you have no balance. So Medicare was willing to pay but the hospital didn't want to be bothered so they wrote it off! Go figure! My secondary paid $527 and that's all they got!

Found this on another site.100 Reasons to Lose 100 Pounds To feel good about ourselves. To have GREAT sex! So we won't think people are laughing or talking about us. To buy clothes in a normal store and actually get clothes with some style to them that fit correctly. To have more energy! To be able to tie your shoes/paint toenails. To be able to sit on a floor and get up gracefully. To wear a bathing suit. To cross your legs or sit Indian style. To fit into an airline/theatre/bus/whatever seat without spilling over and without having to see "that look" from the person who has to sit beside you. So our ankles won't swell. To fit into a booth at any restaurant. To not need an extension to a seat belt on an airplane and to have the tray table not balance on our bellies. To not worry about being decapitated in our cars with our seat belts on if we should be in an accident. To not turn beet red after moderate exertion. To be able to pick something up off the floor. Panty Hose that fit! To go to an amusement park and ride the rides. To be able to sit in any chair without worry of breakage. To not have to apologize when caught in a narrow aisle and have someone need to get by. To go dancing, sky diving, bungee jumping.... To be able to go horseback riding or ride a bike. To not worry about rashes and sweating. To not have to listen to "caring" people ask why you don't diet or worse still... "gee youhave such a pretty face". To not worry about spilling food, sauces or gravy down the front of your blouse/dress/shirt when eating. To not have to think up some excuse for not doing something because you know your weight will impede you. To not have your belly hit the steering wheel and to be able to fit comfortably in the driver's seat. To have a bra fit comfortably and to be able to buy underwear at Victoria's Secret rather than at "Tubby the Underwear Guy". To not have to worry about the weight limit of step stools, ladders, motorcycle, exercise equipment, etc. To not get stuck in a turn style. To not wake up feeling achy in the back..or to have ache free legs and feet. So the bathroom scale won't creak and groan when you step on it. To be able to leave the tablecloth on the table at a restaurant instead of dragging it with you when you get up. So you won't look the other way when you see yourself in a monitor where they have security cameras. To never be embarrassed about your size. To not count tying shoes as daily exercise. To not have to wait for the handicap stall when there are plenty of other stalls available. To not be more out of shape than seniors. To not break toilet seat when leaning to one side. To be able to put on wedding rings again. To try to make a double chin and fail! Buy clothing bargains to fit the next year ... and they do! Not to have to worry about plastic zippers or having your pants bust open. Normal waistbands rather than elastic! To wear knee socks correctly instead of worn like slouches! To look good in a tee shirt! To try on slacks or jeans and have the pant leg actually fit over leg! To be able to get close to sink and not come away with a wet belly! To get out of a stuffed chair GRACEFULLY and not look down to see if the chair has come up with you! To not worry if the hairdresser's smock will fit! To not be self-conscious about eating in front of others! To not be afraid to ask which hairstyle suits your face. To not have people checking you out after looking in your grocery cart. To not feel (and look) like a sausage in stirrup pants. To have your friends NOT be embarrassed to be seen with you. To get promotions/hired or close that sale. Pants that stay up because your waist is smaller than your butt! No more boobs! (this is for the guys!) Wearing shorts or tank tops without fear of arrest or grossing out others! To not have the fear of being rejected. To successfully flirt! To not worry about how to get in and out of the back seat in a two door car! One size fits all and it fits you! To have a lap. To not have the car you are ride in slant in your direction. To be able to use toilet paper as it was meant to be used and not to have to invent ways to "get the job done". To not have to watch TV news reports on fat people in hopes that you haven't been caught on camera! To be able to get between cars in a parking lot without wiping the dust off with your belly and your butt. No more heat rashes and chafing in the upper thighs. So that the cloth in the thigh area doesn't wear away long before the rest of the slacks do! To meet a friend online and not be horrified to have to send a picture of yourself. To not take fat references and fat jokes personally. To know you can go anywhere because wherever you sit you CAN be comfortable and look at ease. To shop at the mall and not have your back ache from lugging your huge butt and stomach around! To be able to stand still, carrying nothing and still look poised. To be able to cross your arms across your chest without them resting on your stomach! To have your feet get smaller. Using your mouth to taste and chew food rather than as just a route to get the food from your lips to your stomach. Blood pressure returns to normal. To avoid other health complications from being overweight. To be able to borrow a co-worker's jacket for an important meeting. To meet someone for the first time and their eyes don't pop out of their head with amazement...because they never knew you're fat! To see your reflection in a mirror or store window without turning away! To wear a watch with a regular length watch band. To look in the mirror when getting your hair cut without thinking you have the biggest face in the world. To not mind getting your picture taken. To not avoid going to the doctor because you have to get "weighed" in. To wake up each morning feeling energized and ready to go. To not even worry about squeezing into small spaces. To not have to enter an elevator and check the weight limit. To look in your closet and have problems deciding which stylish outfit to work since you have so many that look good and fit well. To not have to lie perfectly still in bed at night for fear of breaking the bed! To buy tie shoes instead of slip ons! To be able to walk any distance without looking for a bench to sit on. To look forward to shopping and just trying on clothes! To be able to drive by any fast food place without salivating! To be able to shop at the same store for food instead of having to remember where you shopped last night for the junk food so you can avoid that store for a few days! To not feel lower than low when an innocent child remarks about your size! To not constantly be thinking of where your next morsel of food is coming from. And the 100th reason to lose 100 pounds..... I'M WORTH IT! -- Author Of List Unknown

Okay, gals. I guess I'll just chill. You all seem to have it all figured out. But from everything I've read, if Tricare has not already approved LapBand, they are on the verge of approving it. I never assume that the person on the other end of the phone necessarily knows what they are talking about, especially when it comes to government entities. And I've been a military dependent for longer than some of you have been alive. Also, I'm a retired RN with more than 6 years experience working with insurance company as a pre-cert nurse. I've learned you never accept a "no" the first time around. I wouldn't be throwing in the towel and saying, "oh, well, I guess I can't get it paid for". But that's up to you.

Good for you, Ruby!! Sounds like you are making great strides in battling the "head" thing. You've expressed so many things that we've all dealt with, including the "confessions"! We're going to overcome all this stuff!!

Distant0098 Phyllser/Phyl 282/272 IndioGirl/Janet 210/200 forgve70x7/Nichole 235/225 cazulay/Cece lindaa frustrated/Ruby 205/195 marcyinak/Marcy Brandy 166/156 jackie506 Stacymak 236/226 Mango24 SHAND Chimboree Kirajh/Kari NewCC ribearty Car 187/177 ssankaofa73 237/227 Dini 152/144

Darn! i missed Biggest Loser again! I thought I set up a season pass. I better fix it! No, I won't be there in time for the fashion show.. We leave here a week from tomorrow, but taking a long time to get down there. We're making several stops on the way down to spend time with my sister in OR, our son in the bay area and friends who have a place near Visalia. Glad your adjustment went well today. I was quite impressed with Dr. Bobby when we went to his seminar last winter. I liked him a lot. I wonder if he would give me a fill or two if needed while I'm down there. I'm seeing my hairline receding a little in the front and noticing some hair loss, but nothing too dramatic.

And now add: DINI 152/144

So good to read your post and your positive feedback! Good report! Hope your night is restful and uneventful.

:sick :preggers: You forgot my favorites: Hormones AND WATER RETENTION!! I still do that!! Retain water AND blame any weight gain on that!! :funscale: :opps2: :pop2: :beer: :pizza: :cake:

Add: Car 187/177 ssankaofa73 237/227

Hey, Girl, How did your fill go today??? We really need to get a life, don't we?? You and I are ALWAYS here!!

So you're under the influence of the one on the right??? :decision: LOL

I wasn't done!! I also took 1/3 of a burrito and scraped out all the insides and discarded the flour tortilla. So I was able to eat healthy and have a very tasty dinner. then I had a bite of birthday cake. I don't like to waste my calories and tummy space on the stuff that's not giving me good nutrition. So, I'm trying to say that my thinking regarding food has changed pretty drastically.

Ah, so that's my problem.... transfer addiction! I AM addicted to this site!! And to all my BAND BUDDIES!! I so agree with everything you said, Janet. Loved your rant/your will power "dissertation"! You help keep me on the right track. I find I have become very... hmmmm, I don't know what word I'm looking for, but, I think very carefully about what I'm going to eat. Like last night we ate at our daughter's because it was GS 19th birthday. His favorite.... burritos and my daughter's homemade burritos are wonderful. But, I knew that wouldn't be so good to eat, so DH and I made the Lentil Taco recipe that someone posted a few days ago. All healthy stuff except for a thin layer of Jiffy Corn Bread on top of the casserole. We added some ground turkey to the recipe, and some thin sliced jalapenos and chopped fresh cilantro. It was delicious. I also took 1/3

Who told you that Tricare is not paying? I have Medicare primary, Tricare for Life secondary. I had my surgery in July. Tricare has paid on every one of my claims so far including some I was specifically told by my doctor's office would NOT be covered and one that Medicare rejected. My total out of pocket expense has been $202. I recommend you do some more research because I think someone has given you wrong information.

Good for you!! Ain't it great... we get a NEW START every morning! Let's see how many GOOD days we can string together!

Our prayers are with you tomorrow, Amy! We'll be waiting to hear from you when you get back online. Welcome, Dana!

:update: Distant0098 Phyllser/Phyl 282/272 IndioGirl/Janet 210/200 forgve70x7/Nichole cazulay/Cece lindaa frustrated/Ruby 205/195 marcyinak/Marcy Brandy 166/156 jackie506 Stacymak 236/226 Mango24 SHAND Chimboree Kirajh/Kari NewCC ribearty

I cut/paste this from someone's post on another site. Hope it helps. Phyl The following are instructions that Tracey from SWLC forum has provided - they really do make the process easy. just go to your profile on the top under CP and enter the ticker URL in the BB section between 1. Go to www.tickerfactory.com 2. Select Weight Loss 3. Select your ticker rule. There are pages and pages of them so find one you like and pick it. If you want to go to page 2, do not hit next, hit the 2 at the bottom. Once you select one then click on next. 4. Select your ticker slider. There are pages as well so find one you like but if you want to go to page 2 or 3, click the number not next. Once you find one you like, click next. 5. Choose a pin number. I personally use 12345 so I never forget it. 6. Enter your starting weight, goal weight, present weight, height, etc. 7. Select either weight change or weight. Weight Change shows your total weight you want to lose and how much you have lost to date. Weight shows your actual starting weight, actual weight today and your goal weight. Mine is set to weight. 8. At the top of the next page where it says IMPORTANT. Save that web address, that's the one you need to use to update your ticker at a later date. If you don't have it then you have to start over sometimes. 9. Go to the box on that same page that says BBCode and copy all the info from the and open your profile here on the forum and paste it in your signature line. 10. Click submit at the bottom of your profile on here and then do a ticker test post to make sure it shows. *** If you copy the whole code out of the BBCode box, it doesn't matter, I usually fix them and edit them after for you but all that is required is what's between the two img buttons. Good luck and email me if you need help. _________________ Tracey

That's something to think about, isn't it?! I guess it's easier to have "will power" considering what we have invested in this endeavor: surgery... discomfort, pain, money (in some cases), etc. And, if we've "told", we know we have people watching us to see if we're enjoying some success. And, then there are the "FOOD COPS", like you, Janet! And, my DH, my live-in Food Cop! I may resent that at times, but he's really a partner in this with me and I appreciate the part he is playing. He helps keep me on track, fixes most of my food, etc. We plan our meals together. And he's on my case if I'm snacking too much or snacking on the wrong things. And he's reminds of what I went through having this surgery. So, there are a lot of things contributing to our new found "will power", I think. I had some unusual conversations regarding my surgical bills today, BTW. I've been checking on my claims online... Medicare and Tricare. I found that besides about $200 I was billed for the surgeon, my entire hospital claim, $17K+, was denied by Medicare. So, I've been following up on that all week. Today Medicare called me back and after a considerable length of time on the phone waiting for the claims person to research why it was denied, I was told that the hospital filed the claim using a code that is intended for automatic denial. So, she told me to call them and have them change the code and re-submit. So, I did that this afternoon and the hospital billing person looked up my account and told me that, yes, it was denied by Medicare so they wrote off the remainder of the bill (Tricare paid $527), and my balance was zero! Huh?? So they don't want to get paid by Medicare??? Okay! Whatever! I tried, didn't I?? As long as I don't have a balance, I guess I'll let them bite the bullet! My Tricare EOB stated that I was going to have to pay about $2500. Don't you just have to shake your head and wonder about the "system" sometimes?? I mean, Medicare is ready and willing to pay their part but the hospital says, "No. That's okay. We just wrote it off."

Hang in there, Green!! It's gonna get better SOON!!

:sleep :clap2: God Bless You!! You're younger than ALL our children! Hope you have a wonderful, healthy birthday! :happybday2: :mad: :happybday:

Sorry! I forgot Chim!

Thanks! I posted some photos on the before & after thread. Don't know if this link will work, but here it is. http://www.lapbandtalk.com/f17/before-after-pictures-pix-only-4642/index76.html#post600921 Not a big change, but I can see the boobs, belly & butt getting smaller!

Hey! I like your new signature! Very cool! You're right! Chim is working TOO hard. Chill, Chim!! Janet, you were born in '55? same as my BABY sister!