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Everything posted by lindas0809
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a thread that had me thinking....
I agree completely!! Several Dr.'s have tried to tell me to have RNY - I try to explain that that would be too easy for me and I still wouldn't have to confront my food issues. I work with several women who have had RNY and eat like a bag of pretzels and M&M's all day(and are very thin). I can do that now with no surgery!
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Intro
Hi Mary - Welcome to the group! How are things in NC? - I grew up in High Point and miss it a lot sometimes. I know in reading the posts sometimes it seems like people see they Dr. and have surgery a month later, but I don't think that's really true for a majority of people. I know I started last summer (going to my PCP for documented diet), got approved by Aetna a few weeks ago, but probably won't get a date until June. It is frustrating when you are ready and no one else seems to have the urgency you do. Just use the time to get prepared (stock up on Protein shakes:tongue_smilie:) and be as healthy as you can for surgery. Good Luck! Linda
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Frustrated beyond Belief
Hi! This journey is nothing but frustrating for most of us- believe me we can all relate in some respect. I have Aetna and was approved about a week ago with no problems. I did go to my PCP - her notes were what I weighed, a review of my food logs and just generally our discussion of next steps. I also had a letter of medical necessity from her which my surgeon said was one of the most important things. if I were you I would talk to my PCP and see if they can update your files(not falsify or anything) - I'm sure that you actually did talk about your diet when you were going every month, so they just need to document it accurately. I hope all goes well for you - keep us posted.
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What does 3 mo. Behavior Mod Program mean?
It sounds like maybe you have Aetna - I know they had three month multidisciplinary option. If that's the case then they want you to have a more intense three diet & exercise program VS. just diet. I know my surgeon had an in house class that fulfilled this requirement. I thought about it but it was extra money I couldn't afford and I was already four months in with my PCP. It's definately a great option but make sure it's well documented. i would ask your surgeon if they have classes or know of any that fulfill the requirement. Good Luck!
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Needing some serious Aetna advice!
I was just approved by Aetna last week and was approved with a 6 month diet history, psych eval, nutritional eval and a letter of medical neccesity from my Dr. Originally I was told I needed the two year history and finally got it from my old Dr., but my Surgeon coordinator turned in my packet before I gave it to her. I was really worried that they would deny me because of that but obviously I had no problems(maybe I'm so big they just know I couldn't have been below a 40 BMI in the last two years). One suggestion I would make is to call the precertification number on your insurance card - that's who told me I was approved. They seemed more helpful than just calling the general number. Good Luck- keep us posted!!! Linda
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Cigna's Hoops
Hi! This is weird because I just went through this with aetna they make a big deal about a two year weight history on their requirement list and my office coordinator told me to get it also. Anyway, I finally got my last stuff done and was going to send in my weight history, but the office had already submitted my paperwork without it. I had the case number and was going to fax it in myself because I was so worried, but Aetna approved it before I could. I would suggest getting to the office(and keep a copy for yourself)- I would rather have them turn in extra documentation then to have to go back and have an appeal. Good Luck !!
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Liquids in; liquids out
Hi Guys! I have not had surgery yet (hopefully May), but I did go through an issue with an issue with heart palpitations a few years ago. I don't know if it's at all relevant, but after EKG's and a heart monitor and lots of blood tests, they decide it was just anxiety attacks. I had never had them before, but it was basically from cumulative stress that had been building up at the time. Is it possible that all the post surgery stress may be building up with IBS problems and contributing to the heart issues? Good Luck!!
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Anyone Change Hospitals/Drs?
Hi Everyone, I've been going through the approval process since last September with my hospital. I saw my surgeon last October and completed all my insurance documents and appointments March 3rd. The last thing I completed was a support group at the hospital, where I found out that my Dr. is pregnant and going on leave in May (they didn't mention this in October), they are now booking her surgeries in July!!! I am very upset and their reaction is basically you waited this long what's a few more months. They supposedly turned my stuff into insurance last week (although I can't get any confirmation from the financial coordinator- she doesn't respond to email or vm). :thumbup: I feel like I'm in a Catch-22 because they have all my insurance information, but I am very frustrated with the whole program (Johns Hopkins Bayview) and would like to go to another hospital. But if I go to another hospital and have to start over will it be July anyway? Has anyone had a similar situation? Talk me down...:smile: Thanks, Linda
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Hi From Maryland-
Hi Marcy! I live in Maryland also (Elkridge) and I'm currently in the program at JHU Bayview. I have not had surgery yet - my packet was just turned in for insurance approval. Please feel free to contact me with any questions you have. Good Luck! Linda
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Confused....
I feel your pain- I finally finished my 6 month and evals with the hopes of getting it to my insurance this week and having surgery in April. I found last Friday that my Dr. is going on maternity leave and they aren't scheduling any more surgeries for her until July!! OMG- they didn't even tell me she was pregnant(she wasn't showing when I saw her last). I am totally confused and depressed. I'm toying with switching Drs., but I'm not sure yet - they just turned in my insurance so I'll wait to see what comes of that before making any decisions. I know none of this helps you, but thought I'd let you know you're not alone in this confusing mess. Good luck!
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April Bandsters
Hi! I think I will be an April bandster(as much as I would like to be in March). All my insurance stuff should be turned in this week(fingers crossed), so hopefully with approval I'll get a late March early April date. I'd love to hear how you are doing along the the way. Good Luck! Linda
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My name is Jen and I'm addicted to...
Hi Jen, I feel the same way and I'm not even banded yet. I noticed that you are in Ellicott City, I live nearby in Elkridge and was wondering where you had your surgery? I am in the process at JHU Bayview - they are good, but definately push RNY over lap band. Any feedback you could give me would be great. Thanks, Linda
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Anyone Start with a BMI of 50+?
Heath1840 - I do have diabetes, which is why my DR. would prefer me to go RNY, but insurance wise I should be OK with either. Good Luck!
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Anyone Start with a BMI of 50+?
Thanks Nat! I hope you get approved soon! Fingers Crossed.
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Anyone Start with a BMI of 50+?
Nancy, Good to hear from you. I'm am hoping for a January date also(fingers crossed), so hopefully we can keep in touch. This site has been great.
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Anyone Start with a BMI of 50+?
Thanks so much everyone!!:thumbdown: I know the Dr. was just trying to be tough with me to give me realistic expectations, but it did throw me for a loop. I will definately check out the forum for high BMIer's. I really did just need a pep talk! Thanks again, Linda
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Anyone Start with a BMI of 50+?
Hi! I'm new to the forum and just had my first surgical consult yesterday. My Dr. was very sceptical of me having the surgery with a BMI of 49. She wants me to go the RNY route, but I just don't want to have it done for many reasons. I am kind of down and confused after the consult and was wondering if anyone out there had higher BMI success stories they could share. Thanks!