lotsofkids

you are hitting it on the head.....I deal with Insurance Companys all the time and many times.....I find and correct mistakes...whether human or computer generated. If you know your rights...it is easy to get things fixed. Do know your policy and your annual deductibles/copays and any other amounts that may be related to your procedure. They cannot charge YOU "over" what is in your contract. The negotiated amount between the Insurance and the provider can be significantly less than the billed amount and the provider must "write off" that difference. The provider is not allowed to bill the patient for this amount...if a provider did bill you for this...then bring it to their attention...that this is incorrectly billed and you have your EOB from the insurance and they must re-adjust your billing accordlingly. hold on to your wallet LOL diane BTW:....if the provider is not an in-network provider...then you may have to pay the difference of what is considered reasonable and customary charges for the particular billing. However, do not stop there....many times you can negotiate with the provider to accept the Insurance amount as is....or work on a discount of that amount...let's say meet in the middle and split the difference. Nothing is written in stone....and do speak directly with the physician....as they can be very understanding in these situations and if you speak directly with them...they might work something out in your favor. I tell my friends that do not have insurance....always make that known to the doctor and ask if he has a cash discount....they will usually take off 20% (and doc is still making more money on your visit than from his patients with insurance that might take 40-50% off his billed amount!)

Your new friend, Diane from Ohio will be thinking of you and wishing you well during the procedure..... : ) You're doing it at St V's right? Let me know....and hugs! diane

hey Julia....(((((welcome))))) smiles and hope to see ya around.....today is my first day posting and I was met with some of the nicest people on the block. smiles....diane : )

Glad to meet with you! I would love to follow your progress and hey...maybe we can really encourage each other....as I hope my surgery will be in the next couple of months.....after insurance and all appts go through. where are you situated....I am in Fairlawn....1/2 between Cleveland and Akron. thanks for the encouragement! hugs to ya....diane ; )

I am only a 35 bmi and being considered because of my strong apnea situation, I believe and Hope the insurance will come through in the end for me. (I am working with the docs at Cleveland Clinic) ht 5'7 wt 229 I would not want to do a surgery in another country as I would be very sceptical of the standards. Here in USA there are checks and balances....and well...let's face it....Lawsuits....to keep everyone in line! LOL hugs..diane : )

welcome from one newbie to another.....and WOW congrats! smiles....diane

I am not yet banded.....but jumped in today to the forum and was warmly received by many. I think I'm going to like it here : ) Hope to see ya around....smiles...diane

I'd like to think all my husband's achievements....and my boys high achievements have been facilitated by extreme support and unselfishness on my end (whether they realize that or not) You know the old adage...."behind every successful man is an exhausted woman" anyhow....I must take myself seriously....and work on my health...before it becomes worse! Yikes. thanks for all the support.....it need constant reminding like this....to keep me focused until I can eventually get them on board (I hope) The getting to the band surgery part is going to be like pulling teeth with my physician husband. But I figure it is better than the surgery for apnea...which is probably in my future if this wieght doesn't go down! smiles....diane

I have a bmi of 35 ....wt 229 ht/5' 7" and the apnea...and some Water retention around my heart (peri-cardial effusion) from the cronic apnea. Because it is the Cleveland clinic.....they do a lot of prescreening and preliminary insurance contact before they even schedule you for a dr's appointment...so I think I will be ok....but all will be clear on the 2/13 appointment. and thanks Dawg...for the support! smiles....(I really do need to run errands..but being here is more fun) diane

thanks Susan ....and hey how are you feeling...only being banded a month ago? ~when life throws you lemons.....throw 'em back~

thanks for jumping in.....((((Hugs)))) and don't worry about tough love from Decarla.....I welcome all opinions.....I am pretty tough to have survived a controling man for all these years. Now I am finally just trying to support ME. the fish dinner sounds great for me...but there would be a major uproar from all those hungry Men! I'd have to leave them the dinner with a note....and put myself somewhere else! I'd come back and probably find...no one ate it...they order pizza and sovled their dinner dilemma! LOL Delarla......I Love to meet and be around strong women like yourself......it is just that if you are not walking in the same type shoes....it is hard to realize how difficult it is to change the routines and habits of others! It'll take time...but I'm up for the challenge. (I need to step out for a bit...but I'll check back later) hugs all, diane : )

Delarla..... If I knew now what I didn't know as a young 22 yr old bride....my life would be different. You must set the tone very early in a relationship and then build from there. I was always willing to be flexible, work harder, sacrifice more, invest heavily in my husband and kids...but never taking out time for myself in any hobbies or just hanging out with girlfriends. I have good friends...but I don't spend much time doing things with them....we talk on the phones...but I feel I am always busy with things that need to get done in my house or for my kids. Months go by before we get together. Once this becomes the norm for almost 2 1/2 decades.....then how do you put things in reverse without major resentment. It is hard, that's why a slow and steady pace is probably the only way in my situation. Just like child rearing.....you must work hard in the early years to mold the good habits.......if you wait until they are rebellious teens to start teaching them....you have already missed the boat. That's my situation...from the begining, I didn't train my husband to be sensitive to my needs.....now I am trying to right the wrong....and it will be an uphill battle. BTW: he is a very good man and lives for his family....he just has had everything go HIS way for such a long time....and now I am realizing that it isn't a good set up me and my aspirations. Hugs....diane : )

Paula......I'll use that....but then they'll probably call me the giant sunflower of the garden! LOL I have 4 boys and one girl......my daughter heard me singing....and said....Mom...if you try out for American Idol...they will need to build a bigger stage! I darn near dropped my mouth...but I was laughing as she is only 10 yrs old! But this is what I am going through! The men in my house have even recruited my dear daughter into making Fat jokes! Photonut....that is hitting the nail on the head. They don't want to make any changes....because they like all the things mom provides in services and in good meals! Why should they welcome changes when they have it pretty good the way things are! But I will stand firm....or else they won't have a mom in ten years to poke fun of. hugs all, diane

that's encouraging.....and she really did so well with her wieght lose! Supporting family members....can really help! Big Congrats to you and your kids! Diane : )

Man...I just posted a huge reply and then lost it during the submission! Paula,.....no, my husband has no bad habits (except driving my crazy LOL) no smoking, drinking etc.... He is a very driven, in control person. He brags that his Breakfast is a cup of tea and a 1/2 yogurt only. He looks really good in his suits and sets a nice look. I probably should have mentioned that he is a physician. Although, we are not rolling in financial bliss. He drives a Honda accord and me...a 6yr old mini van. (he has always worked in academia not private practice) and with have three boys in college to support!!! (it is known that most docs are excentric or quirky...to have reached that level) He is no exception....obsessive compulsive in everything he does! A born perfectionist.....and "I" the lowly, falible "normal" one! Two of my boys are following dad...and are studying pre-med courses. Delarla....I certainly wish that I could pull off a Marge Simpson....but our dynamics have always been very traditional and I play the supporting role for the whole family. I think if I pulled an about-face....I would end up breaking my marriage (he'd think I was nuts!) But, yes, slowly and steadily, I need to make small steps and start weaning them towards less dependancy on my services (house secretary, errand runner for everybody...elaborate meals etc...) I am burnt out now. My husband expects me to consult him in pretty much everything and he also consults me. I bought an expensive $2000 eliptical machine and He pretty much blew the roof off as I did it on my own. He felt we could have gotten a cheap one at Sam's club if that's what I wanted. I stood firm in my choice and told him I could return it...but there's a 15% restocking fee! Our house is really all high-achievers. My third son in his senior year...made "All North East Ohio" in football and made it to State Championships for Wrestling. My other boys are equally accomplished in different venues/interests. My husband told me NOT to go to the seminar.....but he wasn't in town that week....and I WENT anyhow! He was upset that I didn't listen...but I told him this is my health and I want to get informed. He feels they are salesmen trying to sell a product and I will be harming myself with a foreign object placed in my body. He doesn't want me to keep my 2/13 appointment with the doctor....but I WILL keep that as well. It could get pretty dicey in my house...but I hope he will get on board. He keeps telling me he got literature showing that sleep apnea is more harmful to the heart than first thought. Duhhhh.....I feel like I have been hit by a truck every morning! I have the cpap machine...but I don't tolerate it well...and I am non-compliant. I am now in a vicious cycle...the more wieght...the worse the apnea...the worse the apnea...the more wieght I gain. Anyhow...Hopefully you guys will turn me into SUPER MARGE...but it needs wisdom and suble changes...so they won't realize I am finally taking charge of my needs! As for the Fat jokes....they are really meant in comedy....not to hurt me....but it certainly does. they are meant to encourage my losing weight....but it is not helping my situation at all...it only helps to make me more self-concious and uncomfortable with myself. Hubby set the tone...and now everyone jokes continuously about my size. The joking is about as out of control as is my wieght!!!! Ok guys....transform me into Super Marge! hugs...diane : )