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Jersrose43

Gastric Sleeve Patients
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Everything posted by Jersrose43

  1. Jersrose43

    Supplement insurance in case of complications?

    Supplement means they cover copays and such. Not services that are rejected by others. Make sure you read the fine print
  2. If you follow the rules of your coverage and get denied for lack of coverage for vsg you should be ok It's when you bypass the insurance completely and go cash pay that complications are also denied Make sense?
  3. I don't think you were ready nor appropriately prepared for a lifestyle change This is a way of life not a diet. Not temporary. I hope the new clinician helps you. Find a nutritionist who is experienced with bariatric patients and maybe they can provide the eating support you need. And finally join an eating addiction group. I never considered myself a candidate but guess what. I sure as heck am. I see it and I want to eat it!!
  4. Jersrose43

    Submit to Cigna Today!

    So not Cigna fault your doc didn't submit the September weigh in.
  5. Jersrose43

    Cigna / Deductible

    Guess you answered the question for yourself. All plans are different Especially if exchange vs employer and differs from employer to employer even if it's the same company
  6. Jersrose43

    Authorization

    If you have not finished the 6 months yet - are you at 5? Otherwise why are they bothering ? Missing a lot of details here
  7. Jersrose43

    Authorization

    They have to give the insurance something and once approved can change it easily
  8. Jersrose43

    From Cigna to United. Need Advice!

    Your united policy is specific to the employer so because you don't work there United won't be able to tell you anything at all. United does cover it if the employer chooses the rider. 85% of united business is self insured therefore each employer can choose what they pay for and what they do not There are legislative requirement but weight Loss surgery is not federally required. There are 13 states that mandate you must cover it. You might want to google it.
  9. Jersrose43

    Insurance reimburse me?

    And even if they do reimburse you. It would only be their normal reasonable payment. Which tends to be 30% of what a doctor and hospital actually charge. Wait. My charges were $42k for hospital. Insurance paid $4800 The surgeon was $20k and insurance paid $4200. Anesthesia was $3800 and they paid 100%
  10. Jersrose43

    Elevated Liver Enzymes

    Remember that the liver is the body filter. He is removing the medication because it may be too much for your smaller body.
  11. Jersrose43

    Elevated Liver Enzymes

    The elevations can have multiple causes. My dad has very high levels but he is alcoholic and his liver si finally showing signs of failure. Mine were high before being sleeved and combines with two other tests doc said I was becoming prediabetic. You also said you've been working out with a. Trainer. It could be you have damaged some muscles and you enzymes are high due to that. Here are some ideas http://www.medicinenet.com/script/main/mobileart.asp?articlekey=6274&page=3
  12. So call insurance and find a new one. Have a first consult you lose nothing. Then before you make the final change-- call her and discuss how you feel. May be a one off thing. Maybe she had staff quit. Or someone higher up doesn't support the practice. If this is always the way it was run then perhaps you should go.
  13. Be really specific what is included. Anesthesia, hospital, radiology, pathology, etc. Also what aftercare and for how long
  14. Jersrose43

    Losing my support system

    Reading between the lines but if your friends all had some form of WLS and they're running a support group and all had same surgeon as you. It seems like they've taken the perspective that you are blaming their doctor for your negative experience. They're probably thinking you knew there were potential for a challenge to this surgery. There are many who don't have as wonderful experience as others. It is unfortunate that you are having a rough road but perhaps you need to stop talking to them about the surgeon. It really isn't the surgeons fault this happened unless he did something negligent which you didn't say he did. But they feel you are saying it to them. Just stop discussing the surgeon and laying blame there. It is what it is and you're getting better. You don't need them to listen to you assign blame. You need them to support you. Which to me is more about getting you the right nutrition, the right sources to help you through this.
  15. The point of medical tourism is to go and pay cash I think. So you may be challenged to find something that provides insurance
  16. Jersrose43

    HELP!

    I went to a wedding At 4 weeks out. That was a year ago. I lived to tell as you can see I had white wine - I would sip and when it got warm I got a new one. I drink at least two vodka tonics a week since 8 weeks out.
  17. I have found dresses at old navy for $10
  18. Jersrose43

    BCBS of Florida

    All insurance offered by employers will have employer specific Benefit coverages. Not insurance company specific. So 20 people can have bcbs Florida and 20 different kinds of benefits if they work at 20 places or buy it direct.
  19. Hubby had a heart attack last week Admitted obviously. After 5 hours after being admitted he's still sitting in ER. I don't think they forgot they have others ahead of you. Their issues are running long. No consolation for your anxiety but they certainly didn't forget you
  20. Jersrose43

    FMLA

    And we have a winner! Couldn't agree more!
  21. Jersrose43

    Fatigued at 9 months out!

    Exhaustion is my middle name. No Vitamin deficiencies but nut was my b levels higher. So at 1 yr started shots once a week. Trying for one month to see if it makes a diff I take Centrum complete and a centrum for women every day.
  22. Jersrose43

    Insurance coverage

    CMS federal guidelines are here. I skimmed did not see a pre surgery requirement period. http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=57&bc=AgAAgAAAAAAA&ncdver=3 Also if you have Medicare advantage they may add additional requirements like an EGD or other testing but have to be minimally the same
  23. Jersrose43

    Major break down

    I think you need to get to your surgeon ASAP. That doesn't sound right. Oozing and pain this far out. Maybe even call him and gave service page him. Is it oz zing a color or smell? That would be a sign of infection.
  24. Jersrose43

    Fed up

    I know exactly how you feel and I hope I haven't come across to others as judge. But sometimes people do post that they return to their old habits. I ignore for the mostpart. What really bothered me last week was a person with 9!!!! Posts being judgment on someone 2 months out. No she had not had surgery. The Facebook groups are equally as bad and I block those idiots thankfully. I hope you continue to return and find the support you need. I am a year out and happy as so&&. And enjoying my birthday today with SEVERAL vodka tonics. Let the judgement begin
  25. Jersrose43

    Anthem BlueCross

    You can call them and ask for a copy of the medical policy which can details the specific items you need The medical "packet" comes from the surgeon who will usually require more than an insurance company requires

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