GingersnapMI

I have not yet received any bills for the two issues I'm about to discuss, just the EOBs (Explanation of Benefits). For non-US readers, this is a notice that an insurance company must send the patient whenever the insurance has received a bill. It explains to the patient about the bill: the medical provider, the service rendered to the patient, the charge from the medical provider, how much of that charge will be covered by insurance, and how much the patient can expect to self-pay.
My original surgery date was delayed/changed due to the hospital's COVID-related closure to elective procedures. I therefore ended up having surgery about 6 weeks after my original date. I just received the EOB relating to the hospital's $55,000 charge. The EOB states the charge has been denied due to "preauthorization was not obtained". I went through all the paperwork I've collected since my journey began and found the preauthorization approval notice for the original date of surgery... but it seems I never got a preauthorization approval notice for the new surgery date. Naturally, the surgeon's office has several people whose job it is to get insurance approvals/preauthorizations prior to surgery... I'm worried that the person handling my case dropped the ball...
The second billing issue concerns an EOB that shows I will owe $900 for the nurse anesthetist's bill ($500 deductible plus 50% copay). The anesthesiologist's bill was covered at 100%, but the issue is that his assistant (the nurse anesthetist) apparently doesn't participate with my insurance so I'd be responsible for the high out-of-network charges! Naturally, I as the patient only get to pick my surgeon... I don't get to pick the anesthesiologist or the nurse anesthetist or any of the nurses, for that matter. Again, the team used for my procedure is something that my surgeon's office and the hospital should have put together properly.
I called my surgeon's office a week ago and was transferred to the insurance specialist's voicemail. I've not received a call back. I'll try again tomorrow (Monday) but I'm worried... should I be?
I know a lot of people here have had their surgery dates moved around due to COVID, so this can't be the first time this issue has come up...?
I'd appreciate advice and opinions. Thank you!

Interesting... I'm single and thoughts like yours have crept into my mind, too. I'd think something like, "He must be one of those 'chubby chasers' so he must be a weirdo." Of course, it really should be no more "weird" for men to enjoy chubby bodies than to enjoy slim bodies... the whole slim is best thing is social conditioning. But despite knowing that, I still couldn't get my head to accept that a "normal" man would enjoy my admittedly more-than-just-chubby body.

Interesting... I'm single and thoughts like yours have crept into my mind, too. I'd think something like, "He must be one of those 'chubby chasers' so he must be a weirdo." Of course, it really should be no more "weird" for men to enjoy chubby bodies than to enjoy slim bodies... the whole slim is best thing is social conditioning. But despite knowing that, I still couldn't get my head to accept that a "normal" man would enjoy my admittedly more-than-just-chubby body.

UPDATE:
I called the number on the $900+ bill I had by now received from the nurse anesthetist's office. They told me to call my insurance.
I called my insurance and the wonderful lady on the phone stated that since I had my surgery in a participating hospital with a participating surgeon, all other bills should have been processed as in-network, even if the particular surgical team member (the nurse anesthetist, in my case) isn't actually in-network. She stated that it looked like several different people at the insurance company had handled the charges related to my surgery and the person who handled the nurse anesthetist charge had not "realized" that the charge was related to an approved procedure in an approved hospital. (Someone wasn't being thorough in the performance of his/her duties!)
The proper pre-authorization had been obtained and all charges will be, hopefully, processed/re-processed correctly and paid as expected.
I'm so glad that I know just enough about medical billing and insurance to be able to tell when something doesn't look right, and sometimes even be able to figure out why and therefore be able to argue it effectively. I pity the people who simply pay any bill they receive. I don't think a year goes by without me having to straighten something out concerning medical billing... and I've had several different insurances over the years so it's not just one or two particular insurance companies that are the problem.

oh my gosh, you're insurance took you for the scariest Halloween ride of your life! Im so glad its solved!! [emoji3060][emoji3060]

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UPDATE:
I called the number on the $900+ bill I had by now received from the nurse anesthetist's office. They told me to call my insurance.
I called my insurance and the wonderful lady on the phone stated that since I had my surgery in a participating hospital with a participating surgeon, all other bills should have been processed as in-network, even if the particular surgical team member (the nurse anesthetist, in my case) isn't actually in-network. She stated that it looked like several different people at the insurance company had handled the charges related to my surgery and the person who handled the nurse anesthetist charge had not "realized" that the charge was related to an approved procedure in an approved hospital. (Someone wasn't being thorough in the performance of his/her duties!)
The proper pre-authorization had been obtained and all charges will be, hopefully, processed/re-processed correctly and paid as expected.
I'm so glad that I know just enough about medical billing and insurance to be able to tell when something doesn't look right, and sometimes even be able to figure out why and therefore be able to argue it effectively. I pity the people who simply pay any bill they receive. I don't think a year goes by without me having to straighten something out concerning medical billing... and I've had several different insurances over the years so it's not just one or two particular insurance companies that are the problem.

Ditto!
I chose RNY bypass over sleeve due to:
1) RNY gives slightly better results, statistically, and seems to be more commonly recommended for my age group (I'm 58).
2) I'm a twenty-year GERD sufferer, even when at lower weights. The sleeve can cause/increase GERD symptoms (you will find a fair amount of people here who had revision surgeries from sleeve to bypass due to GERD). I also had an older sibling who was a long-time GERD sufferer and ended up dying at age 61 of esophageal cancer. I decided to take no chances.
3) Bypass is reversible, sleeve is not. (Though there are very few instances when a reversal would actually be needed/done.)
4) I actually wanted the possibility of dumping as a "reminder" to stay on course with proper eating over the years to come.
5) RNY procedure bypasses some of the small intestine which causes mild malabsorption of nutrients/calories. This means that lifetime Vitamin use is absolutely necessary (which is also recommended for sleeve recipients) but it also means that occasional digressions from proper eating won't be as detrimental to overall results.

WOW, congrats on your fantastic success!
1) Yes! But they never last more that a minute or two for me.
2) Your center of gravity has probably changed and I'd think that you will naturally adjust over time to a smoother stride.
3) When something becomes so big that others say I'm "swimming in it", I will buy one or two items in the new size. Luckily, I wear scrubs to work and they're pretty forgiving when it comes to fit... they're expected to be loose/boxy. But for non-work wear, I'll buy one new pair of jeans now and then when I really need to until I reach my goal weight. The tops I wear are pretty forgiving, too.

I actually weighed MORE the first week after surgery than I did before the surgery! They give you A LOT of fluids in your IV to keep you hydrated and this often shows up as pounds gained. But the weight DID start to come off eventually, don't lose heart!

Yes, something similar (almost exact) happened to me. I contacted my insurance company, not the hospital, and was able to hash it out. (Insurance failed to check a box or something and denied.)

The first is likely nothing to worry much about, but to stay on top of - with COVID around I'm sure this is a common thing (though TinDE is right in that these things are usually pre-approved for some period of time, as delays happen. It is likely a matter of box checking and the surgeon's insurance coordinator needs to get with the insurance company to get the correct box checked on their forms so that their computer can do its job. It may even be routine enough that they don't even bother changing the pre-auth date rather than doing it retroactively. Again,, not likely a big deal, but it is their problem to work out - that's what they get paid to do.
On the second issue, this is one of the semi-legit "scams" in the medical world, where we get these trail of bills from out of network "providers" we never heard of. Kick this back to the anesthesiologist (why does he need a nurse assistant for a simple bypass job?) More and more various hospital workers, seemingly down to the floor sweepers, who used to be covered under a general surgical or anesthesia charge seem entitled to charge you insurance separately
My wife had an orthopedic surgery a couple of years ago and we got an EOB from a surgical nurse charging more than $16k (over double the surgeon's fee - for a half day job) of which the insurance paid $300.. We couldn't get any response from her billing service (an RN needing a billing service?) so we asked the surgeon about it in a follow up appointment (she must be damned good to bill double your rates!) and he texted her while we were there and the excess charge was removed by the time we got home. These underlings have an incentive these days to try to get away with what they can, but ultimately, they don't want to cross their boss - the guy who specifies their services.
Similarly, on a shoulder job I had, the insurance rejected the claim for a PA surgeon's assistant, claiming it wasn't necessary for that surgery; the surgeon told me "we'll take care of it", and they did.
In short, let the relevant providers know of the problem and let them take care of it before panicking, If it doesn't resolve within 2-3 months, then panic.
As a final note, let your surgeon know of any of these problems, as he is the ultimate boss, (or at least higher up the food chain). He may feign disinterest, (there's nothing I can do about that...) but anything that impacts the public perception of his practice is in his interest. He can't technically tell the anesthesiologist how to run his practice, but he does have influence over using his practice, so it may just be a mention over lunch ("Hey Bill, your nurse is hassling my patients again - have her knock it off...")

I have not yet received any bills for the two issues I'm about to discuss, just the EOBs (Explanation of Benefits). For non-US readers, this is a notice that an insurance company must send the patient whenever the insurance has received a bill. It explains to the patient about the bill: the medical provider, the service rendered to the patient, the charge from the medical provider, how much of that charge will be covered by insurance, and how much the patient can expect to self-pay.
My original surgery date was delayed/changed due to the hospital's COVID-related closure to elective procedures. I therefore ended up having surgery about 6 weeks after my original date. I just received the EOB relating to the hospital's $55,000 charge. The EOB states the charge has been denied due to "preauthorization was not obtained". I went through all the paperwork I've collected since my journey began and found the preauthorization approval notice for the original date of surgery... but it seems I never got a preauthorization approval notice for the new surgery date. Naturally, the surgeon's office has several people whose job it is to get insurance approvals/preauthorizations prior to surgery... I'm worried that the person handling my case dropped the ball...
The second billing issue concerns an EOB that shows I will owe $900 for the nurse anesthetist's bill ($500 deductible plus 50% copay). The anesthesiologist's bill was covered at 100%, but the issue is that his assistant (the nurse anesthetist) apparently doesn't participate with my insurance so I'd be responsible for the high out-of-network charges! Naturally, I as the patient only get to pick my surgeon... I don't get to pick the anesthesiologist or the nurse anesthetist or any of the nurses, for that matter. Again, the team used for my procedure is something that my surgeon's office and the hospital should have put together properly.
I called my surgeon's office a week ago and was transferred to the insurance specialist's voicemail. I've not received a call back. I'll try again tomorrow (Monday) but I'm worried... should I be?
I know a lot of people here have had their surgery dates moved around due to COVID, so this can't be the first time this issue has come up...?
I'd appreciate advice and opinions. Thank you!

Hang in there!
I became food-obsessed immediately post-op. The liquid diet was torture... but it was all head hunger and I knew it. I felt sad about the loss of my old lifestyle.
I did ask my doctor if I could begin puree at ten days instead of 14 and he agreed. That helped decrease the sudden obsession with cooking videos tremendously.
I'm nearly 8 weeks post-op now and I feel great. My only regret is that I didn't do this sooner!

Hang in there!
I became food-obsessed immediately post-op. The liquid diet was torture... but it was all head hunger and I knew it. I felt sad about the loss of my old lifestyle.
I did ask my doctor if I could begin puree at ten days instead of 14 and he agreed. That helped decrease the sudden obsession with cooking videos tremendously.
I'm nearly 8 weeks post-op now and I feel great. My only regret is that I didn't do this sooner!

Yup, well said!

Welcome!
My story: I had been an excessively skinny child and teenager but during my 20s I became more "normal" weight-wise. I was always able to eat anything and any amount that I wanted, thereby developing some pretty bad eating habits.
Time marched on, I had three kids and found myself continually hovering at 30-40 pounds overweight during my 30s. Add menopause in my mid-40s and I became continually 60-80 pounds overweight. Throughout these years, I was able to diet off significant weight several times but it always came back, plus more.
In my 50s I became continually 100 pounds overweight. I'm in my late-50s now and what tipped me over into considering and doing WLS (I'm one week post-op RNY) was my 83yo mother. She, like everyone else in my family, is considerably overweight. She needs daily care and assistance with everything. I looked at her and thought, "That'll be me in another 25 years". Being elderly is never a piece of cake but being obese and elderly is a truly difficult challenge. Mom could do so much more for herself is she weren't 100 pounds overweight. 😞

I can very much relate to your feelings of being overweight and getting older and not being able to care for myself. I have had those exact thoughts and frankly they drive me to get healthy. I feel for your mom.

Thank you for the encouragement! My program requires we drink 96oz/day for the rest of our lives 😳. During the first two weeks we are supposed to get 48oz of the 96 from electrolytes. Protein Shakes are allowed but they don’t county toward your 96oz/day, so you can imagine how that would just add on to the constant non stop sipping alllll day. It’s miserable so I don’t even bother with anything that doesn’t count toward my 96oz/day. Week 3 is when they want us to start meeting protein goals with soft foods. I do feel better today. I’m so glad every day is getting better for you!

Welcome!
My story: I had been an excessively skinny child and teenager but during my 20s I became more "normal" weight-wise. I was always able to eat anything and any amount that I wanted, thereby developing some pretty bad eating habits.
Time marched on, I had three kids and found myself continually hovering at 30-40 pounds overweight during my 30s. Add menopause in my mid-40s and I became continually 60-80 pounds overweight. Throughout these years, I was able to diet off significant weight several times but it always came back, plus more.
In my 50s I became continually 100 pounds overweight. I'm in my late-50s now and what tipped me over into considering and doing WLS (I'm one week post-op RNY) was my 83yo mother. She, like everyone else in my family, is considerably overweight. She needs daily care and assistance with everything. I looked at her and thought, "That'll be me in another 25 years". Being elderly is never a piece of cake but being obese and elderly is a truly difficult challenge. Mom could do so much more for herself is she weren't 100 pounds overweight. 😞

I'm one week post-op, too, my RNY with hiatal hernia repair was May 11.
I must say that the first two days after surgery were some of the worst I've ever been through and I've had other surgeries as well, though this is my first abdominal surgery. I really hadn't expected it to be quite so painful and difficult. That said, every day since has seen major improvement. 🙂
I had horrible diarrhea on the day that I switched from clear to full liquids (day 4) so I went back to mostly clear and decided to take it slower.
Question for you... Are you drinking any clear Protein Drinks, if you're not doing the shakes? Propel may have electrolytes but it has NO Protein. The chicken broth you mention does have protein but it doesn't sound like you're taking in much, you want to reach at least 60g per day. I've been drinking protein water that I found at Costco: Protein20. Each bottle contains 20g protein. Their are other protein waters on the market, too.
Congrats on your 8 pounds lost since your day of surgery! I weighed in at 246 the morning of, and today I am 244. BUT, I know I gained at least six pounds at the hospital due to all the fluids they pumped into me so I'm telling myself not to be discouraged.
I hope it gets better for you quickly!

I'm one week post-op, too, my RNY with hiatal hernia repair was May 11.
I must say that the first two days after surgery were some of the worst I've ever been through and I've had other surgeries as well, though this is my first abdominal surgery. I really hadn't expected it to be quite so painful and difficult. That said, every day since has seen major improvement. 🙂
I had horrible diarrhea on the day that I switched from clear to full liquids (day 4) so I went back to mostly clear and decided to take it slower.
Question for you... Are you drinking any clear Protein Drinks, if you're not doing the shakes? Propel may have electrolytes but it has NO Protein. The chicken broth you mention does have protein but it doesn't sound like you're taking in much, you want to reach at least 60g per day. I've been drinking protein water that I found at Costco: Protein20. Each bottle contains 20g protein. Their are other protein waters on the market, too.
Congrats on your 8 pounds lost since your day of surgery! I weighed in at 246 the morning of, and today I am 244. BUT, I know I gained at least six pounds at the hospital due to all the fluids they pumped into me so I'm telling myself not to be discouraged.
I hope it gets better for you quickly!

Welcome!
My story: I had been an excessively skinny child and teenager but during my 20s I became more "normal" weight-wise. I was always able to eat anything and any amount that I wanted, thereby developing some pretty bad eating habits.
Time marched on, I had three kids and found myself continually hovering at 30-40 pounds overweight during my 30s. Add menopause in my mid-40s and I became continually 60-80 pounds overweight. Throughout these years, I was able to diet off significant weight several times but it always came back, plus more.
In my 50s I became continually 100 pounds overweight. I'm in my late-50s now and what tipped me over into considering and doing WLS (I'm one week post-op RNY) was my 83yo mother. She, like everyone else in my family, is considerably overweight. She needs daily care and assistance with everything. I looked at her and thought, "That'll be me in another 25 years". Being elderly is never a piece of cake but being obese and elderly is a truly difficult challenge. Mom could do so much more for herself is she weren't 100 pounds overweight. 😞

Welcome!
My story: I had been an excessively skinny child and teenager but during my 20s I became more "normal" weight-wise. I was always able to eat anything and any amount that I wanted, thereby developing some pretty bad eating habits.
Time marched on, I had three kids and found myself continually hovering at 30-40 pounds overweight during my 30s. Add menopause in my mid-40s and I became continually 60-80 pounds overweight. Throughout these years, I was able to diet off significant weight several times but it always came back, plus more.
In my 50s I became continually 100 pounds overweight. I'm in my late-50s now and what tipped me over into considering and doing WLS (I'm one week post-op RNY) was my 83yo mother. She, like everyone else in my family, is considerably overweight. She needs daily care and assistance with everything. I looked at her and thought, "That'll be me in another 25 years". Being elderly is never a piece of cake but being obese and elderly is a truly difficult challenge. Mom could do so much more for herself is she weren't 100 pounds overweight. 😞

Hi Everyone,
I’m officially 6 weeks post gastric bypass and I’m feeling great!
Starting weight pre-liquid diet was 305lbs. After 3 week liquid diet on day of surgery I weighed in at 277lbs. Today, I’m sitting at 243lbs! I was on the post op liquid diet for 2 weeks then semi-solid for 1 week. 4th week out I started on full solids and have kept everything down. I’ve had pizza, subs, burgers, hotdogs, steak, pork, ribs, wings etc and have never felt nauseous or thrown anything back up. Of course I can only have bites/ounces at a time but it’s great to be back on regular food! With the doctors blessing I golfed 4.5 weeks out and got in 13 holes before it hurt to much to finish, but finished a full round of 18 the next week. Even rode my bike 6km yesterday with the kids....which is who I did this journey in the first place!
I’ve had type 2 diabetes for 5 years and have stopped taking meds about 3 weeks ago (doctors suggested) as my resting sugars have not gone over 6.5 in weeks.
I’ve read lots of posts on here steering inquiring people the wrong way with horror stories of months/years of not eating regular food and/or not being able to do physical activities months/years post op. My answer is listen to your doctor and your body and do what’s best for you. Everyone is different and the post op experiences are going to be vastly different.
Thanks and looking forward to more weight loss and more physical activities with my kids!
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