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Everything posted by dede0314
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Strict insurance pre approval process
dede0314 replied to Womanvsmirror's topic in PRE-Operation Weight Loss Surgery Q&A
Thanks and No Problem. -
Strict insurance pre approval process
dede0314 replied to Womanvsmirror's topic in PRE-Operation Weight Loss Surgery Q&A
I appealed it and the denial got overturned. I gained 9 pounds. -
Strict insurance pre approval process
dede0314 replied to Womanvsmirror's topic in PRE-Operation Weight Loss Surgery Q&A
I have Aetna and initially got denied due to gaining weight during the process. So try your best not to gain any weight. Good luck! -
@@jane13 Thanks!!
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Congratulations!! Awesome feeling I reached onderland last week.
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4/25- 198.2 Thanks
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yeah my nutritionist said nothing over 10 grams. This article I read a while ago actually says 8 grams. http://www.bariatriceating.com/2015/09/mad-label-skills-for-protein-carbs/
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I'm taking pre-natal as my multi-Vitamin Vitamin D B12 I also take some Vitamins for my hair but that was my choice. the doctor recommended I take the above.
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Do you have a contact number or does your doctor's office have an insurance coordinator? When my paperwork was ready I admit I did call the insurance coordinator, but she was actually good at submitting my paperwork and submitted it to the insurance company the next day after my last appointment.The waiting game sucks. But I don't think there is anything wrong with you following up. I actually think its good to make sure your file hasn't been pushed to the side or forgotten.
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Pregnant 6 months after surgery
dede0314 replied to nrg33's topic in Pregnancy with Weight Loss Surgery
My sister got pregnant about 4 months after surgery. She is now 7 months and her and the baby are fine and she's only gained 2 pounds so far. -
When did you pay the hospital, before or after surgery?
dede0314 replied to Mom_of2boys's topic in PRE-Operation Weight Loss Surgery Q&A
Mine was after...So after the claim went through my insurance. The hospital I went through offer payment plans. -
How long was your hospital stay?
dede0314 replied to Andrea Guadiana's topic in POST-Operation Weight Loss Surgery Q&A
I stayed overnight. I had my surgery on a Thursday. So I had about 10 days before I went back to work. -
Its basically Aetna has third parties to review your information. So they are not Aetna employees. When I got my decision letter the external review it looked very basic it had three questions. Was the surgery excluded from my plan? Was the requested service experimental? And was it medically necessary based on my plan? So basically did I meet the requirements? Which I did solely based on my BMI. I also hired Lindstrom Obesity Advocacy to file my appeal.
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I had same issue. Did 3 month program gained weight got denied. Aetna said I could do 3 more months and if I lost the weight I would be approved. Did 3 more months lost 20 pounds and they still denied me, but they didn't say anything about doing 6 more months. I went through the appeal process and went through an external review where Aetna's decision was overturned. Aetna can be very difficult to deal with but don't give up that's what they want.
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Frustrated over Insurance Denial
dede0314 replied to rccbrandon's topic in Gastric Sleeve Surgery Forums
I had LINDSTROM OBESITY ADVOCACY-WWW.WLSAPPEALS.COM help me with my appeal. Maybe you can give them a call to see if they can provide any information. They'll let you know if they can help or not if anything they might be able to at least give you a little knowledge. -
Frustrated over Insurance Denial
dede0314 replied to rccbrandon's topic in Gastric Sleeve Surgery Forums
I don't have blue cross but I did have to go through appeals with my insurance company. I actually had to go through an external review appeal and the denial got reversed. All I can say is don't give up and get all the information you can about their appeal process and why they are denying you. -
Should I be worried?
dede0314 replied to deanna2178's topic in POST-Operation Weight Loss Surgery Q&A
Yes.... Just cause you can doesn't mean you should. I believe I was still on 1/4 cup of food then. Did they give you a packet with guidelines on how much food you should be eating during each stage? -
4/18 201.5 Hopefully next weigh in I'll be in Onederland Thanks
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My doctor gave me the okay to have alcohol, but honestly I can't take it. It makes me sick and I end up throwing up even just having one drink makes me sick.
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Do they have a bulletin you can print out? Maybe you can ask someone to send you the information so you have it on paper.
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Submitted to Aetna Ins for Revision Surgery
dede0314 replied to PSUCookie's topic in Revision Weight Loss Surgery Forums (NEW!)
Any update ? Sent from my iPad using the BariatricPal App -
EXERCISE CHALLENGE 3! WITH SPREADSHEET!
dede0314 replied to Rebeccaabrooks86's topic in Gastric Sleeve Surgery Forums
0 for last week.. How far am I behind sorry I was out of the country. -
The last time I got on a plane is August I could barely fit the seat belt. I had to suck it in I was embarrassed. Just got on a plane last week and had no problems
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Congratulations!! I am currently at 90 pounds lost. I'm so excited to hit the 100 pound mark plus it will put me in onderland and I seriously can't remember the last time I weighed less than 200 pounds.
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4/11- 205