Catherine Gray

Ive been waiting since 12/23 to find out. After several mis-communications with BCBS ( who might I add is horrible! !!!), I finally was told today im approved!!!! Surgery is 2/24/15!!!! I start my diet nect Tuesday!

I'm going through the same thing. I was sleeved almost 6 weeks ago. Most people in my office think I just had gall bladder surgery (which I did). My boss and two co-workers whom I trust know that I also had the sleeve. People are starting to notice that I've lost a bunch of weight, so I'm just telling them I am exercising more, avoiding carbs and generally trying to eat less. You don't owe anyone an explanation. What you've been telling them is just fine!

Girl not to get preachy on you but what the f**k were you thinking?? You are not even a month out? Cheddar beer Soup sounds like a stomach bomb on a regular stomach let alone a new sleeved one. And a sugar drink? Yeah that stuff would be a recipe for the squirts....

Reality check, most likely the Mexico surgeons are worse which is why they are in Mexico and Not in the US where there are higher standards. I wonder every time I see so many Dr. (fill in the blank) in Mexico and wonder who is really posting them.
Get Real - don't be cheap on your health and get it done right. I have heard many horror stories form Mexico
Hear it Newbies save the extra couple of bucks to do the surgery right.

So the saying is true... you get what you pay for. It blows my mind when people take short cuts with their healthcare. Most people won't bat an eye to pay 17,000 for a new car, but they only want to pay 5,000 for a sleeve. :banghead:

Ive been waiting since 12/23 to find out. After several mis-communications with BCBS ( who might I add is horrible! !!!), I finally was told today im approved!!!! Surgery is 2/24/15!!!! I start my diet nect Tuesday!

I'm about 5 months out and the experience and results have been fantastic, no more CPAP, no more meds, walking without pain, and I don't need to shop in the big mans section anymore. Life is good and getting better. But me and my sleeve are still getting used to one another, I usually feel some restriction and stop, but if I eat too fast or go over the line.......ooooowwwwwwww. I get really really uncomfortable and regret the hell out it for at least a half hour. As awful as I feel, I hope that feeling is permanent because I WILL get it sooner or later and I appreciate and cherish this new friend (tough love I guess). Has anyone else experienced that feeling? Does it last?

Ive been waiting since 12/23 to find out. After several mis-communications with BCBS ( who might I add is horrible! !!!), I finally was told today im approved!!!! Surgery is 2/24/15!!!! I start my diet nect Tuesday!

Ive been waiting since 12/23 to find out. After several mis-communications with BCBS ( who might I add is horrible! !!!), I finally was told today im approved!!!! Surgery is 2/24/15!!!! I start my diet nect Tuesday!

Catherine, I see that your surgeon is Dr. Boynton. He was my surgeon and he's awesome! Chris is amazing as well. I have nothing but good things to say about them!

Please, please double-check this with your insurance company. In all my years in the medical support field, I have NEVER seen it work this way. Perhaps your insurance DOES work this way. In my experience though, if the primary denies, the secondary will ALSO deny because the primary denied.
Your insurance MIGHT have a clause that says if your primary denies for not being covered on the plan, they will pay as if they were primary.
I would not only call my secondary, but I would probably record the call.

Congrats! ! I know your so nervous! Praying for a safe surgery and speedy recovery!

I have horizon NJ as well. I saw Diane Palmer through kennedy in Stratford. I had no out of pocket expense. It was covered 100%
Diane T. Palmer, MSN, Apn
856-566-6459
Just call and tell them you need a psych clearance. Shes very nice. Yiu may have to call a few times to get answer. Hope that helps

Congratulations! !! So excited for you!

I can totally agree with you. Ive always been heavier but since 2010 its gotten way out of hand. I weigh 316, and 5'9. I have seen myself in the mirror and like man I suck it in, or angle myself.
Well for xmas my daughter got a tablet. I was on the phone and she started taking pics. Later on she told me to come see. I was mortifies! Who was that in those pictures?!?! Where had she been hiding all these years. Its amazing how deceiving we can be to ourselves.
So glad im moving forward with the sleeve.

They told me it takes 24-48 hrs to upload into the system. All I need is the denial letter ????

I'm calling as we speak. I'm giving them until monday to receive it.

Called insurance again and they have still not received my claim. Called the program and there are no notes saying the claim had been sent. The insurance person Kelly, has not returned my phone call of last week and Doreen who is the admin for the program said she would talk to Kelly and see what the hold up is. This is so frustrating. It is almost 3 weeks since my last NUT visit and the program has not even submitted my paperwork. I am about to become that squeaky wheel!

Not good. Makes me wonder what else do they procrastinate on.

Catharine Gray...good for you for your persistence. Holidays are rough on everyone! Lots of stuff gets overlooked!

Happened to me, too. I waited online with my insurance while the doctor faxed it. The person who received it called me back within the hour to let me know it was approved.

Ugg, that is terrible! Hopefully they sent it today, and your insurance will review and approve it really quickly.

I can totally agree with you. Ive always been heavier but since 2010 its gotten way out of hand. I weigh 316, and 5'9. I have seen myself in the mirror and like man I suck it in, or angle myself.
Well for xmas my daughter got a tablet. I was on the phone and she started taking pics. Later on she told me to come see. I was mortifies! Who was that in those pictures?!?! Where had she been hiding all these years. Its amazing how deceiving we can be to ourselves.
So glad im moving forward with the sleeve.

I've been working in medical administration for over 15 years. I have NEVER had a secondary insurance that will "just pay" if you bill them (not saying they don't exist, just that I've never seen it)... although I've never worked with Horizon NJ Health.
Generally, the secondary follows the decisions of the primary unless you get something different in writing. So if your primary insurance does not cover a procedure, your secondary has two options: follow along with the denial or cover as if they were primary.
I would never counsel anyone on my team to perform a procedure without a written authorization/approval from the secondary in your situation. The likelihood that we would get paid for it would be slim.

You totally need the seminar and stuff. It is a life changing decision and you really need to be educated on how you will manage your new life. Not an easy instant solution at all.