ThinnerMe2015

I am waiting for the papers are being submitted and waiting for approval so then I can have my psych eval, and meet with a surgeon. I declare the wait on the paper work and approval is torture, but what can we do, nothing but wait and be patient, although the patient part is not that easy, I wish I can remove it all from my mind until the answer comes in, that will be less stressful

I have Medicare as my Primary and Medicaid (United Health Care) as my Secondary, so your telling me you can just go to a surgeons office and start the process of seeing him and go to psych eval, and all that and surgery without Medicare's approval, I don't know that makes me nervous to think that will fly without in the end you ending up with huge medical bills for not getting some kind of authorization. I have Medicare but right now my referral coordinator is working on my paper work to submit it to Medicare and Medicaid, so look like in Michigan you need some sort of pre-authorization

I have United Health Care as well, but now I also have Medicare, I started my journey May 2013, and was under United Health Care, then this year October 1st Medicare kicked in so now Medicare I was told is my Primary and United Health Care is my Secondary, so I am kind in limbo right now as well. The coordinator is working on my referral to be submitted to the insurance companies, so I am just sitting back and playing the waiting game right now. With United I had to do 1 year of supervised dietitian meetings, I am in Michigan don't know if that makes a difference, but yeah they required a year of it I actually did 16 months total. Medicare didn't require any I found out, so if I get approved I then will be set up with appt to take psych eval and meet with surgeon.....Fingers Crossed

Thank you ready I will do just that, start to prepare myself so the new changes won't be such a system shock. I appreciate the feed back, yeah I've decided to just sit back and stop stressing and let the coordinator do her job and wait to here something, because stressing won't make it any quicker, just hard on me for nothing. I will stay positive everything will come back in my favor, that's all I can do, well good luck to you to with your process

It is co confusing for me at times because I have 2 Insurance carriers and when I started I had just the one, but now I have 2 and the new one is now my Primary, and I get so confused. I have been meeting with my Dr. and Dietitian, and have finished that requirement. No the referral coordinator is sending paper work into insurance I don't know if that's for surgery approval, or just approval to see psych dr. I am getting overwhelmed, I need to find my zen and just relax and hope al turn out good, I am getting to anxious, I am losing my patience too, and I know dealing with insurance companies, these things take time, it's not gonna happen over night, now the thing is getting that thought to stay in my brain, and just relax...Lol

See I've done the dietitian meeting already and went to a seminar yesterday and they said they will schedule appt in about 2 weeks to meet with the surgeon, but I think if I go ahead that way I may be stuck with a bill cause it's like I am moving on my own. I have a referral cordinator working on referrals for me so I guess I need to go through them to make sure ALL my procedures will be covered. So I am waiting now for her to submit paper work to my insurance. I still have to have a psych evaluation, and meet with a surgeon, I guess that will happen next upon approval..... I Guess !!!

Thanks for the reply Zebra I appreciate it, yeah it look like it all come down ti your insurance

Thank You SuzeMuze Yes It Helps A Lot

Do the order you go see the dietitian, Psych Dr, & Surgeon vary according to which particular insurance you may have? I've noticed some people have taken their psych eval before meeting with surgeon, and some have met with their surgeon, before even being approved. I am really confused by that. Tell me do the surgeon submit the paper work to the insurance company to see if they'll pay for it, or do your Primary physician's office/Referral Department submit it? As for me the referral department is submitting paper work so I can see a Psych Dr. and I guess to see a surgeon as well. Can you tell me do the insurance company approve you before sending you for the Psych eval, and surgeon appointment? I need info please, lots and lots of info......

Oh wow so sorry you've had such a rough time Kim, I sure hope your recovery road has gotten more smooth by now. I am yet to have the surgery so can't help you there, but I am sorry that you are in that 1% category

Thanks Tina, I will keep you posted on my progress and when I get to that point of having my psych test I will make sure to come on and let you know how it went and so forth

Thanks Judyr, I appreciate the info....

Thanks Jonathan, I appreciate the feed back

Wow congrats, December 1st is my birthday I wish I was having mine then it would be a wonderful birthday gift...Lol,I pray you have a successful surgery and a smooth recovery

Wow good luck I hope all goes well and your recovery be easy. As for the waiting yeah it is horrible, I guess because I am excited and ready for a change and start the new chapter of my life, so I do have to sit back and take a deep breath and relax. I hope and pray all goes well for me too, as for getting approved, I've done everything I was suppose to up to this point, so I can only wait on them to continue with after giving approval to go and have my psych evaluation, and meet with a surgeon, I don't know why but from reading a lot of people's journeys, I feel like I am doing mine backwards, a lot of people have already met with their surgeon and say the surgeon be the one to submit the paper work to the insurance, but I have a referral cordinator subitting paper work, is that right?

Oh wow that was quick. Lucky you, I hope all went well for you, and your recovery is going smooth... Thanks for the response, every bit helps. I see your in Michigan I am too. I am in Saginaw, if you don't mind me asking did you go through Medicare or Medicaid (United Health Care)? I have them both Medicare being my Primary, but when I started I just had Medicaid (United Health Care), then I was also given Medicare October 1,2014... Oops sorry looking at the wrong info your not in Michigan...Sorry

Wow SuzeMuze your situation sounds like mine. It seem like were going down the same path. I just finished with the dietitian in September , I met with my Physician and told her I was done, and the dietician that I saw in the same office said I was done. She told me to tell my Dr. to turn it in because they would probably move faster for her. So now the referral cordinator is turning something in to my insurance company, can you tell me is that the request to cover the surgery or a referral just for the Psych Dr. Will the answer what they send back from the referral will that be my answer of approval, or just approval to see the psych dr.?

I haven't even met with a surgeon, I guess some insurances have a different order. I've read alot the surgeon submitted the paper work, but I have a referral cordinator sending paper work in to the insurance company is that the same? It seems as though I am waiting approval after her sending in the referral when I finish my 12 months of dietitian meeting, actually it was 16 months for me, so do you think they are waiting for approval for surgery from what she sending in or just approval to see a Psych Doctor? I am anxious to talk to a surgeon, but I guess I have to wait for approval before I can see a surgeon or a psych doctor.

So from the time you started how long did it take you to get to the point of getting your surgery date? If you don't mind me asking which insurance did you go through?

Oh Ok I found out today they don't require it, although I've done 16 months and done with it now because when I started I had just medicaid and they required a year actually, and now I also have Medicare as my Primary and Medicaid is my Secondary I am waiting on a answer as well so I can continue on to see a Psych Dr. and a surgeon

Congrats and Good Luck to you

You had final weigh in and the Surgeon is sending in the paper work? How did you get to see a surgeon already and just completed the weigh ins?

I think they denied you because you hadn't done the 6 months of nutritional meeting alone, I don't think it had nothing to do with gaining 2 lbs. That would make no sense, maybe once you've completed the 6 months of meetings it will be a different outcome. I mean people gain weight all the time I hardly doubt the 2lb weight gain played a factor in their decision

Is anyone going through Medicare or Medicaid or both I have both, but Medicare is my Primary, and Medicaid is my Secondary. Does anyone if Medicare require a 6 or 12 month dietitian meeting. What are any other requirements they have?

How long did the whole process take for you to get to this point?