SeattleLady

I understand back and forth with the insurance company. Personally, I am hopeful that my new doctor will take the $50,000 plus of testing I have done since April. I am currently waiting on an answer to this very question.

It doesn't make sense to start over.

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Ok. It is devastating. ((hugs)). So grieve for a few hours, then get on top of it. Find out the offices that your insurance covers that are IOQ. Call their office and schedule an appointment this month (do NOT let 30 days lapse from the date of your last RD appointment), so that the clock keeps ticking in you moving the ball toward the goal line.
Explain to the new doc's office that you have had probs with insurance and your present program not being an IOQ and you don't want to start all over! See if they can help slip you in. Then make sure you get your complete medical records from the bariatric surgeon, the RD, the psych, the sleep study, the EGD and take it to the new doc.
I would think they'd want to fast track you in their office cuz you are Ca-CHING! Ready to give em the money without the 3-6 month hassle of earning it up front.

OMG- I have Aetna too. They sent paperwork to my Bariatric Drs. Office and everything. This red head will really be pissed if they pull that s**t on me. They are the Worst and I can’t stand Aetna already. Thanks for your post!

I love this response.

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There are so many Aetna plans. Aetna underwrites plans for companies and they vary so much. I have Aetna and nothing I experienced would pertain to her situation.
I agree with Fluffy, grab your records and find a surgeon they will accept ASAP.
Best of luck.

In baseball terms, you are a "dying quail". An unexpected gift of an opportunity to "score". A bariatric patient who is ready to fall into their lap and have surgery without a 3-6month "sales time line" to wait for the $$$. Any doc can fit another surgery into their schedule for the month, especially if they are a private insurance situation where they actually get paid. So that makes you "HIGHLY DATEABLE". Most surgeons would fall all over themselves at the opportunity you present to them. So be sure you present and explain it that way to the receptionist/nurse/office manager/bariatric coordinator--whomever you have to jack with to get what you want at the new office! But the important thing to know is that time is valuable and the clock is ticking. I'd personally go pick up your records and take them with you in hands. That way no one can say they got lost.

sorry to hear about this. This sucks and is devastating. I cannot imagine going through this process AFTER checking and they deny you. Insurance companies are ass holes!

I understand back and forth with the insurance company. Personally, I am hopeful that my new doctor will take the $50,000 plus of testing I have done since April. I am currently waiting on an answer to this very question.

It doesn't make sense to start over.

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Thank you....very good suggestions. Just need to process all of this..

I have to get this off of my chest. I'm not super active posting but have read a lot. Here is my story. I have terrific Aetna insurance. I originally wanted to go to the mayo clinic for my surgery but I found out that AETNA needs a facility to be an institute of Quality (IOQ) So mayo clinic wouldn't take me on. Even though I called Aetna and have a letter saying it doesn't need to be an IOQ. Fast forward I found another surgeon, who is not an IOQ but a Center of excellence. They checked with Aetna and said I was covered and signed me up for their program in April. The past four months i've gone through all the steps, the psychologist, chest xrays , upper GI, Cardiac clearance and radiological stress trest, 3 nutrition appointments and weigh ins 60 miles away. 3 check ins with my PCP for weigh ins... oh and my back was thrown out in the middle of this.
I completed all steps and the advocate states today I was denied because they are not in institute of quality but a center of excellence. What?? We checked on this. Then she starts to give me other hospital names. wait..no......WTF. I'm sort of mad at my surgeons office but also Aetna. They said it doesn't matter what they said in writing, they won't cover me because my doctor is not an IOQ. I'm devastated and frankly wish I would have gone to mexico to begin with. I've already spend more money out of pocket than the surgery would be in mexico. nonsense.

needed to vent

I am winning. I will get my date by October 2019.

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I am approved. Waiting on a date!

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What awesome news!

Ok, the only thing I did not understand? I am approved? If I agree to start over. Like no previous testing, surgeries and wait for an undetermined time.

So, no clue how long this is going to take. I feel excited and mad at the same time.

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Ok, the only thing I did not understand? I am approved? If I agree to start over. Like no previous testing, surgeries and wait for an undetermined time.

So, no clue how long this is going to take. I feel excited and mad at the same time.

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I am approved. Waiting on a date!

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In 5'9" and stated at 371. Six months later I'm at 250. I had the Rouen Y. Check my posts for progress pics.

Me either and I have the Most Cranky Crabby RNY in history, so if my Endoscopist, my gastroenterologist or surgeon didn't tell me, you should be totally cool. And Precious Pouch won't even tolerate Decaf coffee, cottage cheese and bananas, my life is directed by my mini-egg shaped bundle of Gastric tissue and PP is the Empress and Tyrant of Everything. Today she is quiet but when PP isn't Happy, ain't nobody going to be Happy!

I love this place. We share real information and experiences. My first bariatric surgeon was a real "jerk." He lied and provided fear base healthcare; Like, "don't drink out of straws." I am so happy you all are doing well and receiving curing treatments.

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I had VSG 8/27/13, my RnY was 6/4/19 (so I can only give you about a 3 month update)

1. None, it’s been great.
2. My weight loss has been percentage wise better than my sleeve.

I was 322 when I was sleeved, had a low of 242 with that. I was 248 with my RnY and am currently 213. At the 3 month mark I had lost around 24% of my excess body weight with the sleeve. I am around 38% down of my excess body weight with my RnY. (From my heaviest to now including both surgeries I am down 65% of my EBW)

I lose 2-4# a week. My restriction is better than I had with the sleeve. I have no real intolerances. I had bad stomach cramps when I tried tuna and haven’t tried that again but otherwise I eat fresh fruits and veggies, meats, dairy etc.

3. Mine was done for GERD and it seems to be gone. I cut to half on my protonix post op and should come off it in a couple weeks at my next appt.

4. None. I’m very happy. Any issues I have are in my head (fixating on the scale stuff like that. It’s hard to slow down and enjoy the journey.

I was revised 10/31/18 for severe GERD. I was about 20# from goal weight at that point.
1 - complications - one of my incisions got infected, but it's the same risk for any surgery.
2 - I lost most of the remaining 20# over the next 4 months but found it very difficult because I had much less restriction with RnY than I had with the sleeve. (My sleeve was VERY restrictive and I liked that). My surgeon says that "revised" RnYs are not as restrictive as those done on a "virgin" stomach. I also found it very hard to redo all the post-op food phases because I had just "been there-done that." (My sleeve was Feb. 2018.) After the sleeve, I had never progressed past soup/stews so I had never gotten to the real "lean protein" stage. I can now eat regular meats.
3 - GERD - Yes, the procedure fixed my reflux issues.
4 - No regrets. I was on the maximum prescription-strength omeprazole, 2x/day plus TUMS as needed. I couldn't keep waking up at night with acid up my nose and in my mouth. It was going to destroy my teeth and esophagus. Gotta play the hand you're dealt, right?

Thanks Alex, this is a great place to share and support eachother.


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We've received many many requests over the years to add a revision forum. Your wish has now been granted!

That’s the plan going forward I do pre op testing in the morning 😊.

Yes, that is what I found too! Longterm use of PPI's are not good for your body.

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