Chantrella

1 hour ago, Hopefulin2021 said:

I drink at least 3 Protein Shakes 4 oz of lean meat 2 servings of vegetable and 64 ounces of sugar free drinks I just drink Water though. I also have some sugar free Jello and sugar free popsicles. Days 1-3 were hard and I barely had energy day 4 I’m feeling good, more energy.

I rather this than what I’m on! ☹️. Wish I could have some meat and veggies

1 hour ago, Hopefulin2021 said:

Wow only in the 3’s? How many calories are in your Protein Shakes? Well also I can eat a little meat and vegetables. I was feeling light headed day 1 day 2 was a little better, today is day 3 and I don’t wake up starving so that’s a good thing. I lost 3lbs already so I’m happy about that.

They want me to follow this

AM-Protein Shake-160calories

Lunch- Broth-5calories

Lunch-protein bar-200calories

Snack- sugar free jello-5 calories

Dinner-Broth-5calories

my daily Protein intake is 59

On 2/15/2021 at 4:23 PM, Grahamco said:

I have BCBS federal basic. Can you tell me how much out of pocket you are paying? Just for the surgery and hospital stay? Not all the other appts

I am only paying 300 everything else is 100% covered. I met my 300 deductible but I haven’t met my oop max of 3000 yet, but the way my job has it set up I only pay 300.00. I have insurance through my employer.

Update for everyone my coordinator called me today to ask if I knew how much I had to pay for surgery at my pre-op. I told her yes 10% of the procedure since so am in coinsurance phase. She told me that didn’t sound right and to call the hospital they would know for sure. So the hospital said I have the best insurance because all I pay is 300.00 everything else is covered. A little lost I called my insurance asked to speak to someone high up and they too confirmed only 300.00. Like wow! I haven’t even met my out of pocket yet. So thankful I decided to get the more expensive policy for 20 extra bucks a month.

34 minutes ago, catwoman7 said:

I know you didn't ask me this, but yes, that's how it works with most insurance companies - although yours may be different. You could always call them and ask - then you'd know for sure.

Yup, I called them I pay 10% until I reach my oop max. Thank you that really helps me figure out how much I will be paying on the 1st.

On 2/6/2021 at 1:19 PM, Uomograsso said:

The total you should have to pay is you deductible plus your out of pocket maximum i.e.

$600 deductible + $1200 oop max = $1800

If you have met your deductible, you only need to pay up to your oop maximum, but usually after you have met your deductible, you pay a percentage such as 10% or 20% of any bill until you meet your oop max, i.e.

$12,000 hosp bill × 10% = $1200 which meets your oop max. Any bill after this would be paid 100% by insurance as long as providers are in network.

Yes I have met my deductible, but not my oop max just yet. I think I understand you. I am still in my coinsurance phase so I would be paying 10% of my surgery total?

22 minutes ago, GradyCat said:

My deductible was met, but I still had an out-of-pocket maximum to meet, which was $1200.

When did they let you know how much you had to pay?Was it before you went to the hospital or the day you went to the hospital? My pre op appointment is March 1st my surgery is March 3rd. I still have claims processing on my insurance so I’m not sure what my out of pocket will be because the claims haven’t been fully processed yet.

12 minutes ago, bufbills said:

If your deductible is already met, and your maximum out of pocket is as well, you should be good to go. Just call your insurance company.

I called them that’s why I’m so confused one person said this and another person said something totally different. My out of pocket isn’t reached yet unfortunately it’s a new year. Would’ve been nice if I could’ve had the surgery last year lol.

I am having bypass surgery March 3rd through insurance approval and when my coordinator called to schedule my consents. She said I didn’t have to pay a deposit to my surgeon because my deductible was met. When the scheduler called to schedule my appointment and pre op paperwork appoint for 2 days before surgery she did not mention I would have to pay anything. I just don’t want to get to the hospital and they want 4,000.

4 minutes ago, Hopefulin2021 said:

Make them check while you’re on the phone . When I called after insurance confirmed I got approved they said they hadn’t received it yet. I was like can you double check and low and behold it was there .

She called me Sunday to schedule my pre consents appointment for Thursday. I was so shocked she called me on a Sunday. I received my approval letter in the mail Monday. Might’ve been in there since Saturday but I don’t check my mail everyday, lol

Sounds like you feel like I do after I eat something I'm not suppose to. I'm type 2. My blood sugars have always been controlled until Jan 2020. One of the first signs I knew it had went out of wack was a yeast infection I couldn't shake and constant sleepiness. Checked my sugar over 500. Made a dr appointment was put on insulin. Thats when I started looking into gastric bypass.

On 1/6/2021 at 11:42 AM, Hopefulin2021 said:

After what seems like a million years I finally got my approval!!! I am ecstatic and overjoyed! Now that it is really happening I can’t lie I am kind of nervous because I never had a surgery besides a c-section almost 20 years ago lol I am waiting to speak with the nurse so I can pick a date but I know it will be sometime in February omg!!!! Any helpful tips and tricks will be highly appreciated!

congratulations!!!!

On 12/18/2020 at 11:21 PM, Hopefulin2021 said:

Omg I know you were so annoyed!! I would have been pissed but luckily it all worked out!

Yes, I was very! She told me today they will be calling in Jan to schedule my scope. Ready to get this ball rolling. Tired of having a hard time doing things because of my weight.

They seemed like they were on it! My patient advocate was MIA October- the second week of December and she’s asking me if I did stuff. Well if she would’ve returned my calls and been on getting my records from the people they sent me to she would know all my stuff is done.

14 hours ago, Hopefulin2021 said:

Wow my psych eval was done right in the same hospital along with all of my other tests. You had to go somewhere outside of the hospital? I have a meeting with my surgeon next Tuesday I guess it’s to sign consents abs stuff and then they’ll send everything to my insurance company

Have you done your EGD? I’m currently waiting on that. Seem that it will be after New Years.

3 minutes ago, RTL1234 said:

I asked about this because I’m on an insulin pump and had the same issue after my csection, and this time they said it will probably happen again. My endo said it can be stress related to major surgery. So they don’t mind any rising at the initial few months. It usually settles back out.

Are you type 1? I am type 2.

30 minutes ago, Starwarsandcupcakes said:

I haven’t had an a1c since August the week before my revision but when I had my revision surgery I was on 4hr blood sugar checks in the hospital because my post op level sugar level was over 200! It was confusing because I’m not diabetic and all of my a1c draws have been within normal limits.

Oh wow my sugars are well controlled I would hate for them to go up after this surgery. Now im really thinking.

4 minutes ago, Hopefulin2021 said:

Wow my psych eval was done right in the same hospital along with all of my other tests. You had to go somewhere outside of the hospital? I have a meeting with my surgeon next Tuesday I guess it’s to sign consents abs stuff and then they’ll send everything to my insurance company

Yup, they gave me a list of psychiatrist to call at my first appointment. I'm going to go to their main office today because I paid out of pocket for that evaluation and for them not to send my evaluation or return my calls is holding up the process.

On 12/15/2020 at 12:27 PM, Hopefulin2021 said:

Hi did you ever get in contact with anyone? I’m kinda where you are now, I finished everything and I just want to know what happens next.

Yes, my patient advocate reached out Monday. Now I am waiting on them to send my psychological evaluation. I took it November 11th and my surgeon still hasn't received my results. I've been calling the place I got it done leaving messages to be called back everyday. Everyone seems very unorganized to be in the medical field.

Wow. Im a diabetic thats why I'm getting bypass.

7 hours ago, DeeTee said:

Hi, I was wondering if anyone has experience Anthem BCBS claim denial for the 2 day hospital stay after the R-N-Y? Surgery was paid but, they are denying the $60K “Room and Board” for the 2 day inpatient stay afterwards. Ugh... I am so sick right now! Any words of wisdom right now would be appreciated.

Hello, was the surgery done at a blue distinction facility? My cousin got approved for surgery but hers wasn't done at a supporting facility and she was stuck with a bill for the same thing as you, but I feel that's faulty on the insurance.

On 12/15/2020 at 12:27 PM, Hopefulin2021 said:

Hi did you ever get in contact with anyone? I’m kinda where you are now, I finished everything and I just want to know what happens next.

Yes, my patient advocate reached out Monday. Now I am waiting on them to send my psychological evaluation. I took it November 11th and my surgeon still hasn't received my results. I've been calling the place I got it done leaving messages to be called back everyday. Everyone seems very unorganized to be in the medical field.

14 hours ago, stridesforabetterme2020 said:

They wouldnt approve me bc my job underwrote it out of the policy ;(

Wow, did they not call and verify if you had bariatric surgery in your policy before speaking with you?

On 12/12/2020 at 7:53 AM, Hopefulin2021 said:

Wow it only took a month? I had to have test, bloodwork, a psych eval, and 6 nutritional classes. I finished everything and I have one more class left on Monday. I am hoping it won’t take forever and a day to get approved I am so ready for this. Did you get the surgery?

I have them I started my journey October 1st 2020. I originally need 6 visits, psych evaluation, 1 dietitian visit, bloodwork, and medical clearance, but a week after my first visit it went down to three visits because I am a diabetic. I completed all my requirements before my last visit on 12/10 now it’s just the waiting game.

I wish this was me

Just now, Jaelzion said:

Hm, is there a main number you can call and speak to someone else? Or can you email? It's possible that she's on extended leave or doesn't have access to her normal work phone during COVID-19.

I will call the office tomorrow to see if they received all of my required documents. Thank you, im trying to get the show on the road.