dstgirl11

Thanks for words of encouragement. Ever since I've been going to this center, the nurse has mostly been negative. I will continue to eat, drink and stay active like it was stated in their manuel.

Thanks for the posts. I had surgery July 11th and lost pretty good the first week and a little the second week. By the third week, my period came on and I had Water weight gain. My surgeon totally freaked me out. He berated me and made me feel like such a failure. I have followed all the recommendations and even went down a size. Now that my period is off, my weight has dropped a few pounds. I am doing drinking Protein Shakes, water, and taking about 6000 steps about five times a week. I know this is a process but I am literally scared to death to go back to my surgeon and not lost like he wants me to. You all have confirm that these things happen, but I am so afraid to return to his office in three weeks without a huge amount of weight loss.

I hope this is helpful, but I had a mentor. My sister had surgery in December and she became by backbone when I wanted to give up. She would call or text and ask how I was feeling and offer suggestions. If she wasn't available, another friend that had surgery two years ago and is very successful was my backup. In other words, try obtaining a buddy to assist you when you are getting ready to start your pre-op diet that will hold you accountable.

Actually it was one of my comobilities along with hp to getting me approved for the surgery. I use a cpap machine and just had surgery on the 11th.

The surgeon office called a week ahead to schedule my preadmission appointmment. The appt was on a Thursday (July 6) and my surgery was that next Tuesday (July 11). The surgeon office also called the day before to remind me about the surgery the next day.

Just when I was thinking of self-pay, my approval came through. If I can help in any way, please do not hesitate to ask. Best wishes.

11 hours ago, BGrundee said:

I wish there was a template I can follow so I know how to write my truths as professionally as possible without being all over the place.

If you go to www.obesitycoverage.com and look across the top, click on the heading Insurance Coverage. Then, click scroll down until you reach the seventh heading under sample letter of appeals. Hope this helps.

I have BCBS of Alabama and I did live chats (so I can print out the conservations) and ask was my paperwork receive from the surgeon office and what was the status. One conversation, the representative said "no, it was in the wrong place". She fix the problem. Then after another week, I called back and was told everything was in place and waiting on a decision from the review team. After two chats, my surgeon called and said I was approved. Good luck.

I have BCBS of Alabama and had a 40 bmi and two comorbilities (hp and sleep apnea). I was still denied. So, I had to get a letter from my PCP and send in pictures. After about six weeks of no replys, I started a one-on-one chat sessions (2 total). After my last chat session, I was approved. Hope this help.

Mine is Tueday also, in AL.

Welcome. I'm from Alabama, too. My surgery is 7/11. I'm nervous and excited and I believe it is normal and I believe that is common for everyone. You Got This!!!

My sister started getting the shakes from Insure in January when she had her surgery. Unfortunely, when I tried last week they said Alabama had not renewed there contract at the present time. I was so disappointed because the insurance company paid for it and it came directly to your front door. Hopefully, the contract is renewed before my surgery date. Good luck!

Like you I was supposed to lose and/or not gain. I was so nervous. Well, I did gain 4 pounds and was a nervous wreck that they would cancelled my surgery. The surgeon wasn't pleased but he assigned me a surgery date and gave me my pre-op plan. It will work out for the best. Good luck!

1 minute ago, Shannon2123 said:

Thank you it does. I have 18lbs more to loose and im just struggling at this point, but I can do it. I apperciate your response so much.

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My sister got sleeved in December so I call and ask for help with food and what can I do and what I can't do. I think it is good when you have buddies that you can count on. Good luck. We can do this together.

I was denied and successful approved by getting a medical necessity letter from my PCP and calling (2 times) and doing online chats (2) with the insurance company. After my last chat session, I was approved.

8 hours ago, Shannon2123 said:

Im having trouble losing the set amount of weight. Im not going to give up, but sometimes I doubt myself. How did you stay focus on losing the weight before surgery?

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I have an app (myplate) on my phone that a person can set for the number of calories (mine is 1000). I track everything I eat. For instance, one I enter the premier shake by scanning the bar code, it can find it and substract from my total. Then, I track my lunch and dinner and anything in between. Also, my fitness tracker is connected so it automatically add my exercise. In this manner, I know everything I have eaten and can stay on track. Hope this helps.

Surgery July 11th. Start pre-op diet, June 26th. Nervous and excited!!!

I also have BCBS of AL and I started this process in 2016. I had to get 6 months of weight check-ins at thetot hospital's clinic. Each weigh-in had to be signed by a doctor and faxed to the surgeon. I did have two co-mobilities (sleep apnea and high blood pressure). In November of 2016, my paperwork was submitted and after three weeks I was denied. The insurance company want three years of documented weight from PCP (2013,2014, and 2015). The surgeon office had 2014, 2015, and 2016. Well, I didn't have 2013 because my PCP moved her practice and I did not find another doctor that year. So, I went with their second choice of dated photos from 2013 and a letter of medical necessity from my PCP. The insurance held my paperwork for a month without making a decision. So, I started calling them and doing live chats. Still nothing. Finally, my last live chat did the trick and two weeks later, I was approved.

Montgomery, Alabama

Congratulations!!

I totally agree with you. My paperwork was in limbo at the insurance for weeks before I decided to advocate for myself. I called and did live chats (paper trail) to see what was the status of my surgery. Finally, the last contact with the insurance company, I was called by the surgeon office and approved. It was hard work but well worth it.

6 minutes ago, ChaosUnlimited said:

Ugh. Frustrating. I called my insurance a bunch of times to check the status, you should call them and see where it's at.

Last Fall I was denied, but resubmitted my paperwork this past Winter. I did a live chat several times to let them know that I was serious about obtaining this surgery. Keep the pressure on.

On 4/9/2017 at 6:32 PM, Alex Brecher said:

Some patients need to jump through hoops to get weight loss surgery. You are especially bound to the requirements if you are hoping for reimbursement from your health insurance plan or if your chosen surgeon has strict requirements. A long weight loss diet or liquid diet are some of the better known requirements, and others include a sleep study, cardio testing, lab testing, and psychiatric evaluations. The purpose is to make sure you are dedicated to weight loss surgery success and properly prepared for it.

However, these requirements are not just annoying for some patients. They may actually be counterproductive! In fact, a recent study showed that having more requirements leads to patients deciding not to get surgery. This means people who need it might be left out of bariatric surgery.

What do you think about pre-op requirements? Are they helpful? Were you required to have a long pre-op diet and go through a variety of tests? Did you think they were useful, or a barrier? Would you consider going self-pay just to avoid the hoops? Share your thoughts here!

After completing six-months of weight-loss check-ins, a 1400 calorie diet a day, submitting 3 years of medical records from a PCP, I was denied. The insurance company need a medical records from my PCP that I did not have because my doctor moved her practice. So, the insurance company told me to send in a letter of medical necessity and dated photos from the year I was missing. I did that and they stalled and stalled and stalled. After I kept calling them, they finally approved my surgery since I guess they couldn't find another excuse to deny me. I really was looking for a way to self-pay because the process was very tedious and heart beaking.

I am an educator so I scheduled my surgery in the month of June. On the other hand, my sister's WLS date was given to her.

I have questioned myself over and over again. All I can think about is the cokes I love to drink and the great food I will missed. Then, I realized this is my only chance because I am middle age and want to do so many things. I have diet before and always gained the weight back doubled, so I just put my negative thoughts on the back burner and pushed through the doubts. You can do this. Good Luck!