JennAsVSG

@@JennAsVSG Don't give up!!! What insurance do you have? Have you spoken to a Care Manager? Are they denying the sleep study because it was coded incorrectly on the prior authorization request? I can't believe you've had to pay for all that you have! Your insurance sounds useless! Fight for your benefits!

@@JennAsVSG I'm sorry that your insurance if you such a hard time. I too have private insurance and I only had to pay for my pysc visit. Maybe in January you can try to look for another insurance company? For now if you feel like the best bet is to get serious and lose it yourself then power to you and good luck:)
Sent from my iPhone using the BariatricPal App

I don't even snore, so it was a huge surprise for me!
Sent from my iPhone using the BariatricPal App

Thanks for the ray of hope!!! I will for sure let you know how it goes
Sent from my iPhone using the BariatricPal App

No I didn't know until after my sleep study. I'm a snorer as well. The surgeon didn't think I was going to have sleep apnea because he said my neck wasn't very big and how I had answered the questions he asked. But he was Wrong!! I did & I was also so excited to have it. So I totally understand praying for it....i did the same thing LOL. I pretty much figured that night of my sleep study. I had a split study so when they came in the second half of the night to put a CPAP on me I kinda figured I must have had it. But even after I got the CPAP and we resubmitted to insurance I was a nervous wreck until I new 100% it was approved. So I will pray they send you for a CPAP after the study!! Good luck & keep us posted!!!

I was approved today!
Sent from my iPhone using the BariatricPal App
And no I had no idea I had sleep apnea
Sent from my iPhone using the BariatricPal App

Good for you in making a wise and sometimes tough decision. I look forward to hearing about your journey. You're right that this board could use some low BMI perspective. My BMI was 36.2 so higher than yours but on the lower side too. Sleeved last week and doing darned well so far!
Good luck!

Many many people get approved after being denied first and usually peer to peer works very well in that case. I really hope you get approved. Let us know.
Sent from my iPhone using the BariatricPal App

My 7/16 appointment is an informational meeting and then a 1:1 with the surgeon. It's not a hospital, but a Bariatric Clinic. I am taking comfort in that, because this is the stuff they specialize in. I don't have to get any referrals or see my primary care physician, so I'm hoping that if this doctor finds something for me (and I'm hoping that's the kind of thing they'd do with someone so close but yet so far away) and deems in medically necessary, that my insurance will comply.
Good luck on this last hoop of yours. I hope it all works out for you.

@@kaoson2 I did get approved with the peer to peer review! I had my surgery 11/30/15, band to RNY revision. I've lost 47lbs so far. It's a daily struggle, but worth it so far!
Sent from my iPhone using the BariatricPal App

Thank you to everyone that shared ideas and that shared your concerns. I am so grateful. This week has been so emotional, crazy, and just hard. After last Friday when I found out that surgery wasn't going to happen to for me on Monday which was my surgery date. I was crushed. I was just broken. I cheated all weekend and had pizza, burger and fries, and of course chocolate!!! Monday morning I showered before work and said to myself the money to pay down my deductible wasn't going to pay itself. I called to see if I could get back on the calendar for surgery on the last possible date Monday, June 27th. I did!!!! Then, I gathered a plan and spoke with friends, family and coworkers to see if I could get donations and/or loans. I sold some clothes and home goods that I haven't ever used. Long story short by mid week I knew that $2000 wasn't going to happen so I called my surgeon's office on Friday morning to see if I could pay half and work a payment plan for the other half later. The receptionist stated that she couldn't authorize it and there was no on in the office that could and that her supervisor was in NY. She said she would call and let me know but couldn't make any promises. I was a nervous wreck waiting...so she finally called around 1:30 and said yes!! They accepted!!!! My surgery will be Monday June 27th. I literally started shaking I was so happy. I had a friend drive me because I had to pay at the office because I had cash and it's about an hour away. I made it! I paid it! I'm so happy and excited!! It was meant to be!!
Sent from my iPhone using the BariatricPal App

These pics are NOT easy to share because I have No make-up on and tons of loose skin and wrinkles, hence the the Yikes in my title! All that being said, I couldn't be happier and healthier. Last Summer I was wearing a size 22 swimsuit and the one I have on in the pic is a size 10, so YAY! Having had gastric bypass has truly saved my life. I was a slow but steady loser (can't exercise much due to a chronic nerve condition) and only have a few more pounds to go. These last 10 lbs. are the hardest. Being obese for 30 years took it's toll on me but I'm so happy now that I refuse to dwell in the past. Advice for those just starting out ... Take "Before" pics and measure yourself!!! Here are my stats:
54 years young
5' 2" tall
HW 285
SW 260
CW 138
GW 130
Inches Lost
chest: 12"
above waist: 21"
waist (@@belly button): 18"
below waist (apron): 19"
hips: 15"
thighs: 8"
knees: 3"
arms: 6"

TODAY I HAD MY SURGERY AND IM HURTING LIKE HELL !!!! TODAY ACTUAL START MY NEW LIFE #REBIRTH
Sent from my SM-G928V using the BariatricPal App

I had a follow up with the surgeon's office today. They submitted my info to insurance last week seeking authorization. 2 hours before my appointment, they got the call that I was approved! I really thought they might have to fight a little. My BMI is 40, but they required 5 years of obesity. I've been a yo yo dieter since I was like 9 years old. When I looked over my 5 year history with the doctors office, there were years I was in a decent range and then years I wasn't. She said it went through smoothly though.
I have thought about surgery many times over the past 15 years, but I always decide against it. In November of last year, I decided enough was enough, it was time to pursue. I felt so discouraged though when they said I had to wait six months and do the supervised diet. My first appointment wasn't until January. The six months wasn't too bad. I was wishy washy a bit during that time. Do I really need to go this route? Is it too extreme? Will it even work for me? And it gave me enough time to come to a firm decision that this is the right move. I only recently told my husband about it. He probably thinks the process went very quickly.
They gave me a surgery date of July 20th today. However, I think I need to change it and go the following week if they can. I'm supposed to go away that weekend and I doubt I'd be up for that. I'm considering cancelling our trip instead. I'll see what my husband says tonight.
I really am excited! I can't believe my life is about to change! I get to be ME again and break out of this awful prison shell of a body!!!

Good luck. I'm heading there now
Sent from my iPhone using the BariatricPal App

At hospital waiting for them to call my name I am so nervous and so excited all at the same time. Looking forward to this journey to good health
Sent from my iPhone

@@JennAsVSG Have faith! I've heard several folks have really good results when the surgeon does a peer to peer review.....that's when your surgeon actually talks with a doctor who works for the insurance company......Most any time I've heard folks on here that had the peer to peer they were approved.
I suggest waiting for your surgeon to get back from vacation and let him do the peer to peer first.....then if it's denied file an appeal.
I'll keep my fingers crossed for you!!

So sorry to hear that you got denied but like the last post said she wrote a letter that'll be a good thing to do try to get your mom or significant other to write one for you and just tell them how depressed you are living like this and list some things that'll make your life better if you we're to have this surgery. The Dr office can submit it for you they do listen and usually approves. Hope this helps, wishing you the best.

You can appeal their decision. My first attempt at WLS was in 2011. My insurance denied me, but I wrote a letter and they approved it. Then I changed my mind about the surgery at that time I think things have changed and they are really much more strict, but it's always possible. It would be completely ridiculous if you had to gain weight to be approved. My current insurance company denied me when I tried to bypass the full 6 month workup based on my history, but as soon as I met their required 6 months waiting period, they approved me within 24 hours. Good luck, I'm sure you must be so frustrated!

Wow. That really sucks. I'm worried that they may deny me, too. I go for my last weigh in July 1st. My MD keeps asking me if I'm sure my BMI is high enough to need surgery. (I think I'm around 37)
My insurance requires a 6 month medically supervised weight loss effort and 2 co-morbidities. I'm like you and on my last stages. Had to pay out of pocket for psych evaluation as well as other things that my insurance would not cover.
I've read on here where some have submitted an appeal...have you thought of doing that?

I hope they approve after the peer to peer! Stay strong!

From what I've read, I think the docs are pretty good at pushing the insurance companies a bit to get them to approve. I've heard the patient can call them and push too.
I know the process is hard enough, you don't need the insurance company getting in the way. Good luck!!!