Everything posted by Kami63
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Got my denial letter from BCBS today :(
Thanks! Nutrition went well today despite being soaked trying to get there lol.
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Got my denial letter from BCBS today :(
Forgot to mention I passed psych he will recommend surgery! On to nutrition tomorrow. Also got records of my two bulged discs in my back to send with the resubmit. Good night and my prayers at with the families in Oklahoma tonight. Too much tragedy lately
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Got my denial letter from BCBS today :(
What do they need? Flashing neon signs? That is crazy and I am sorry to hear that
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Got my denial letter from BCBS today :(
Oh no! I am do sorry. I had that problem with Cigna. Hang in there! Maybe the appeal will be quick.
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Im oficially sleeved with a slight complication.
Oh my gosh! I am sorry that happened but you are so on your way to being healthy. Congratulations and good luck on your new journey!
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BCBS- got my approval today!
Liggleliggle it looks like you are doing great!
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Dr Nick Nicholson- Dallas, TX
You should probably call the office to ask about the leak test. I am pretty sure they do one during the operation... Don't freak (easier said than done) you will be fine and his staff has been great answering my questions (still awaiting approval) they call me back right away. I had a freak out moment one Friday afternoon after my coordinator was gone and she called really early on Monday to answer my question and put my fears at ease. Good luck
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BCBS- got my approval today!
Oh! Sorry I mean surgery #1 was putting in the band so I only have two surgeries to go lol thanks and I will
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BCBS- got my approval today!
Thanks, it will be done in two surgeries at least 1week apart so by the end I will have had 3 surgeries but I am ready to take the risks to get the tool that will help me be successful. Be sure let me know how it goes at he seminar!
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BCBS- got my approval today!
I can't say that mine has been quick because of insurance issues. I had Cigna before and they wanted me to be dead or dying to even take out my band so this has been a 2 and a half year struggle. BUT I went to my consult on 4/11 and they had to submit for approval to get the band out. Insurance approved on 5/2 the removal and denied the sleeve on 5/7 due to no nut or psych and some other ppwk. We knew that would happen but they wanted to be sure of the requirements before I started jumping through hoops. So I had Psych appt Friday 5/17 and nut appt will be 5/21. Then resubmit for sleeve approval. So it has been relatively quick since consult considering... So I will say that they will give you a list of recommended people to do your Nut and psych and the majority are one month out but I called everyone on the list because I cannot afford to wait one month as my insurance will change 7/1 of this year So I saw Dr. Patrick for Psych he got me in within 1 week and he was great! Also for Nut I am going to the Forrest park dietitians bc they got me in within 1.5 weeks. Hope that helps if you are looking for quick turnaround. Insurance took 1.5 weeks to review original sleeve request so I expect it will be about the same when we resubmit next week. Good luck and I look forward to hearing about your journey
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BCBS- got my approval today!
Great! I loved his seminar. I am a revision candidate. Dr Nick did not do my band another surgeon did and t had complications. Got approval to take that out. Still working on approval to get sleeved. Had my psych appt yesterday and I have my nutrition appt Tuesday then we submit for approval. Have you had a consult yet? I love Dr Nick and hi office staff they are amazing! My other surgeon was rude and so were his staff.
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BCBS- got my approval today!
Breederb hello! It looks like we have the same surgeon! How far are you in the process?
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BCBS- got my approval today!
Congrats all!
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Social eating post op (solid stage of course!)
Thanks all !
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Social eating post op (solid stage of course!)
So first, I am not sleeved but I wanted to see how post op sleevers feel on this topic. My boss takes our team to lunch a lot! Great perk for most I have a little social eating anxiety now with my band bc I am never sure when it will eject my food ... Even Soup some times . Obviously I know there is a 6 wk period where I will have to decline post op. But after that do you guys ever face these situations. Do u order an appetizer or take 7/8 of it home? Just curious thanks ahead of time for sharing Ps this could apply to any eating out.
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Got my denial letter from BCBS today :(
Thanks bscott92863 all went well today with psych! There are two parts the interview with te Dr. And the test that was 370 questions (whew!) Dr. Told me that I passed the interview portion and he will have the results of the test on Monday. Hope I passed he test
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Got my denial letter from BCBS today :(
Thanks bscott92863! I am really close to my psych appt Friday. Supposed to be 2 and a half hours... Seems long but I think that is with completing all of the paperwork.
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Bcbs Alabama So Irratated!
Congratulations! Good luck. It is not far off
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My band has been evicted!
Kristina that must be so liberating!congrats and enjoy your new life without the band
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Got my denial letter from BCBS today :(
Naija2atl: I agree with being honest with myself. I had 5 years to gain the weight back and had a bad back injury as well. I got up to 315 when I couldn't walk for 6 months. I can now walk for exercise and I do nutrisystem and I am down to 275 (40lbs gone!) which is less than my pre surgery weight. I have documentation of my back problem and after they took all of the Fluid out of the band I did not reach for those milk shakes anymore. I have documentation that I have been consistently losing since my back started getting better. I have also dealt with some of the issues that made me turn to food to begin with and can submit the notes from that as well. To be fair to me though, I did not gain weight until I had complications with the band and followed the rules to a T with no slider foods. I know the sleeve is a tool and I know that if my band had not failed that I would have been successful. Thank you for your take on my situation. Seriouslychange: yeah my doctors office wanted to submit before I did anything to make sure of the criteria so that is why I said I knew it was coming. They have my back and know my story better than anyone so I have no doubts if it is possible they will make it happen Purplrose323 hello! I am sorry u had to reschedule. I don't have the date yet of the removal, they want to wait until they get an answer in the sleeve. My doc does it n two surgeries so I will definitely get it out, the insurance already approved that due to the complications thank heavens. Good luck to you I hope you get approved . Thanks Catheryn3 nice to have some blessings!
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Got my denial letter from BCBS today :(
I knew it was coming but I can't help but feel upset. I am a revision candidate from the band to sleeve. They have approved my band to come out. That is a prayer answered in itself. I have had pain and complications for almost 5 years and 2 insurances have denied taking it out. I will be doing that in June. The letter said I have to have a Nut and Psych appt. which is normal. But the letter said that I need to PROVE that I followed my diet and exercise program after my first surgery. Which part? While the band was working I lost 32 pounds. A few month after surgery I had complications and got to where I couldn't eat at all so obviously I gained weight in starvation mode. That requirement is really open for them to say anything. I am a little scared now that this is not going to work out.... Sorry to be so negative, I'm usually so positive. But I am so fed up with these insurance companies not treating me as an individual case instead of the herd. I think I need a pep talk... On the bright side I've got the psych appt Friday and the nut appt next Tues so they can submit again next week with those and whatever the docs office decides will prove that I was compliant after my first surgery... Meanwhile I'll try not to freak out :o/
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Lap band
Robyn the choice is definitely your. While you can help her along with data and facts, let her read boards and band complications to get her to support you, the real fact is that YOU will have to live with the choice you make. I originally got the band because of low risk. The sleeve wasn't really in the picture then as a valid competitor and my husband was too scared for me to do the gastric bypass. I let him talk me into the band instead of the bypass. While I do not regret getting the band because I'm sure I would be 400 pounds by now, I have had complications that have really affected me and to tell you the truth him as well! From what I know now from my journey, I would have gladly gone through the risks on the front end to have a life long tool for success instead of one that only worked for me for 9 months and almost 6 years later I still have the darn thing. I would have made my choice and asked for support whether they would or not. Good luck with your mom and your WLS journey. She will probably come around even if it is after the surgery when you are getting healthy
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New to vertical sleeve talk- need a revision
Hello all. I was so glad to find this forum. I had no idea there were so many others with similar situations. I was banded in 2007 and started having problems in 2008 and had a horrible situation with my surgeon so I lived with pain for as long as I could take it until 2010 when I sought out a revision surgeon. He immediately removed the fluid and they tried to get the insurance to approve the revision 8 long months of testing and the insurance paying $25000 for tests the "denied" the revision. So I waited 3 years and got a new job and new insurance so we are trying again. They are already a little better because they at least have approved the band removal. I need to do a nutrition and psych appt and then they will apply for a redetermination with the new info. I have my psych appt on May 17th they said it will be two to two and half hours. Wow that is long. Was anyone else's that long? I have not gotten my nut appt yet. Still trying to get in with one. Earliest i have found that will do he baritrics is middle of June.... Anyway sorry so long but I have been through 6 years of trials.... Hoping to get this thing out and get my sleeve soon! And along the way I will be rooting for you guys to have success
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1 more frustrated with cigna!
I personally despise Cigna. I am a revision candidate so it is a little different but they wouldn't work with me at all 3 years ago I tried to get approved and they paid for $25000 in tests and then denied my revision... They are crazy! It took 8 months of the tests before they "denied" it. I waited 3 years and now I have BCBS .... Hoping they are not crazy too. Congrats on being approved and good luck with your surgery
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I have bc athem ppo CA.
Wow. Sounds fishy. Good idea to go to another surgeon. Good luck! Oh btw they have credit cards like care credit that you can maybe qualify for. They are all over the Internet.