droose

It appears to be resolved! I fought with appeals for 10 months to get approved for my surgery, the big hurdle was weight loss surgery wasn't included in my coverage. I won my final appeal because the surgery was my only viable option to properly repair my hiatal hernia.
I called insurance, they told me it was automatically rejected based on my coverage, they will process it again and it should be fine.

It appears to be resolved! I fought with appeals for 10 months to get approved for my surgery, the big hurdle was weight loss surgery wasn't included in my coverage. I won my final appeal because the surgery was my only viable option to properly repair my hiatal hernia.
I called insurance, they told me it was automatically rejected based on my coverage, they will process it again and it should be fine.

Had my surgery on 3/10/21, this getting my denial overturned on 3rd appeal.
I am now getting a bill for the full cost of anesthesia that states "we do not offer coverage for this type of sedation" . . .WHAT!?
I don't even know where to go from here, how can this be something new?

Had my surgery on 3/10/21, this getting my denial overturned on 3rd appeal.
I am now getting a bill for the full cost of anesthesia that states "we do not offer coverage for this type of sedation" . . .WHAT!?
I don't even know where to go from here, how can this be something new?

I was told we should get 48-64 oz. take care.

I’m new to this forum. I’m scheduled for a gastric bypass March 29. I also feel scared and excited. The scared part is because I’ve had a few major surgeries in the last 10 years with post op complications. So I have a little PTSD when it comes to major surgery.

My daughter and I are going together surgery is March 25 sooooo excited

How is everyone doing this morning? I had my sleeve surgery on Monday. Thought I would give an update this morning. First is I can only sleep about 6.5 hours in the bed. (6.5 hours is heaven for me) It just becomes uncomfortable but with little pain. I have been fortunate to not need any pain medicine at all. I have walked every time I even thought I felt a pain possibly coming on so everything you read about walking is so true. I have not been hungry at all. Not even a little bit. Yesterday, I was able to get in 45 grams of protein and 48 ounces of liquid and it was a struggle. Later last night around 9pm, I had chicken broth (not much protein) but it was different than "protein" shake so it tasted delicious to me. I am sharing my story because so many others before me shared theirs and it helped me have the courage to go through with the surgery. For the second morning in a row, I have started this day with Gatorade 2. It seems like a good base before diving into protein and liquid (even though it is a liquid). No medical reason so maybe its just better to say, I like the soothing taste in the morning, Best advice so far is follow exactly what your dr/dietician gave you as your plan. 2nd best advice is baby yourself because how the house looks or what you look like doesn't matter. This was major surgery so treat it as such. Yesterday, I reported a major face rash which did begin to go down my arms. The dr isn't 100% sure but I either am allergic to the antibiotic they gave me while in the hospital OR it could be the one shot they gave me as blood thinner. Either way, the steroids the dr called in yesterday have already cleared it up. Again, an example of how important it is to communicate with your dr with any questions. Wishing you all a great happy healing day! How is everyone else doing from this weeks surgery?

My surgery went really well, how is everyone who had surgery feeling?

I am doing the bypass for my Hiatal Hernia which caused GERD and Esophageal Spasms. Due to my weight the standard procedure is not an option. As my insurance coverage does not cover "weight loss surgery or medications" it was a 10 month multi appeal process to get my surgery approved.
I do hope your post surgery is going well! Mine is scheduled for March 10th.

After fighting insurance for 10 months my surgery is scheduled for March 10th. So excited!

Wow we’re all very close in surgery dates lets make sure to keep each other posted!

Hi, everyone, checking in.
Since the last time I was here:
I got engaged after a long term relationship. I mean, the agreement was always verbal but I got a ring recently...
NJ began doing elective surgeries again, so I'm hopeful. Alas, my second surgery date passed three days ago, so...
But I did go through with getting my psych eval with the online service and it went great! My doctor should have the report by Monday and the psychiatrist is refunding my money because the telehealth session is covered by Medicaid. I feel really good about it.
So I guess now I just have to wait to be rescheduled. I hope everything works out this time.

Hope they give you news soon! Gah the waiting makes me cringe!

Nothing yet! Turns out the ONLY thing they cannot accept from my other doc is the dietician visit. So June 1st I have that, rven submission. I’m hoping for a July date so by my bday I’ll be happy and losing! (September 4th)

Thanks
He comes highly. Yesterday I received a call that he "wrote a beautiful 4 page letter" and the appeal was submitted. I am relieved that the process has started moving again.

Thank you! They moved my appointment up, the surgeon and the team are amazing and they will accept the things i've done so far through this process. I'm really happy I found him! I'm happy they wrote your letter, keep us posted!!!!

Thanks
He comes highly. Yesterday I received a call that he "wrote a beautiful 4 page letter" and the appeal was submitted. I am relieved that the process has started moving again.

I feel your pain. I had a doctor that constantly wanted to test me for weed (I VOLUNTARILY told them about this). I smoke or use edibles to sleep, I attempted to get on meds but mirtazapine made me gain about 10lbs so I stopped. Anyway, I've found a couple good doctors i'm inquiring about. The first one is requiring that i do 4 months of dietician visits (my insurance requires ONE), so I'm iffy about them. I've set up appointments with another doctor who luckily will accept my documents so hopefully it goes well & things start rolling sooner. Hopefully we both will have our surgeries soon!

When my surgery was scheduled (would have been Wednesday), we knew it would be denied but my doctor and nutritionist were confident it would go through on appeal with the proper paperwork.
The denial came back, there was some delay getting information and giving the information to my Dr. before COVID put a hold on surgeries.
When I ask about the status I am told "it's on his desk" and "he needs to write up the information for submission" it has been 2 months with no progress.
All I want is for them to finish submitting everything so that when surgeries are allowed again (possibly as early as 2 weeks) I am ready.

I'm scheduled for mid May, haven't heard of changes yet. With the current situation they will need to keep all available beds and ventilators open I'm guessing until we see the curve going down.
It is extremely frustrating to be told we have to wait. I do pray you are able to get re scheduled as quickly as is possible.
I pray you and everyone stay healthy and safe from the virus.

I was supposed to be finishing up my 6-month required pre-op weight loss journey in April and submitting the documents for insurance approval, but now I don't know what to do because I was planning on having this surgery in May because I start back college again in August and I wanted to have the surgery over with so I don't have to wait another year to get it. I have a virtual doctor's appointment on Tuesday and I am so nervous about what she is going to say about the surgery date.

I had a recently retired surgeon tell me.... he expects that elective surgery will not be back in full production until at least Sept, 2020 and any hiccup at all will delay it till 2021.

I'd explain that to them - that you need it done prior to a 4/13 surgery. They were trying to do that with my sleep study (although this was five years ago - not during a pandemic), and I told them I had to have it done before my bariatric surgery, so they backed off and kept the date. I don't know if they will in your case, but it's worth a try.

Always here for you, I do understand. I am blessed enough that most people involved in my day to day life understand how real this is. I did loose 70 pounds once.... found it all and since have been completely unable to loose anything. The surgery was recommended to me as the best option for repairing my hiatal hernia/GERD/esophageal spasms. Once I did my homework I feel that it really is the best option for every aspect of my life.
As for the co worker, they haven't walked in your shoes.
Hang in there, our time will come!