ahb08

Hi there huskergirl...ok i have read before on this website how other people who were approved with aetna, and there was no need for an exercise therapist/supervised watch.....and since i was approved without that, its true...basically here it was u need to do..and this goes for anyone with aetna....find a doctor's office and or a surgeon who has an office of their own who solely focuses on bariatric surgeries, b/c insurance companies like when u go to physicians offices who handle those, b/c usually they already have dietician's and nurse practitioners at their practive that could have the quals of a regular doctor who can be the one that notes how ur doing during the 3 or 6 month regimen and they are experienced on how to word everything on each of ur visits (documentation seems to be the key in these approvals)...the 6 month thing specifically says something about supervised exercising (but i have seen people get approved just with notations of the doc notating the patient is exercising), but the 3 month one is solely on preparing for the surgery (if u can find a place in ur area who is focused on bariatric care only then the 3 month plan would be acceptable b/c u went straight to the source, instead of going to ur regular pcp for the monthly visits and him just referring you to a surgeon later.)

By the sound of it ur insurance company put that "waiver" agreement, just so u couldnt even try to take them to court to have it appealed. Unfortunately your insurance's or employer's (whichever) legal people made sure that they covered their butts...when it comes to their policy holder's even having a chance on trying to appeal restricted health care procedures.....the only thing i could think of is to try to get insurance on your own, and or go out of the country to have the procedure done alot cheaper.....,

i know how u feeling i just got approved today...and i keep asking myself if this is for real?...and i keep looking at myself in the mirror telling myself i will not be the same 6 months from now....now that i got my approved call....im really preparing my mind for this...im gonna really start slightly getting a head start on my pre op diet...which does alow me to eat solids, and lean meats and fish....just extremely small amounts...so lets go ahead and get to it rmanns00!!

i was approved earlier today, and it was less than 24 for the approval...who is ur insurance with?

anything with terms saying ur have met the "precertified or pre notification" requirments means u are approved in health insurance lingo. U stated a rep at UHC confirmed that with u, so u are approved through them. UHC doesnt require all those monthly hoops like all the other insurances....they are the easiest if u were already at the bmi of 40 or more from the get go.

i was getting a little depressed to...im not yet banded...im still waiting on insurance approval...but i still want the band....just think about it like this...like someone said earlier the band will be with us longer than just 6 mnths and its our own little personal trainer.....after the show they will be in the same boat as us....which is SELF DISCIPLINE and WILL power. oh yeah...how do their bills get paid if they're on the show...?? or is the show throwing them like 5-6g's a month just for being on the show.....?? cuz if i had to miss out of work with no pay or my bills not gettin paid i wouldnt go on there anyway!!!

well from what im grasping in this post and a personal friend who has dealt with slippage...i basically need to immediately get an unfill anytime i feel like im getting sick or ill that promotes any kind of coughing, or heavy mucus like effects....b/c i know that when u have mucus and a lot of it tends to sit on top of the band and build up which causes the cough...so im gonna try to see if i become alert in time to forecast a sickness like food poisoning or the flu. Its lookin like the band not only needs to be deflated when pregnant to allow good nourishment for the baby but it needs to deflated during ill times to let our bodies fight off the illness allowing open passage ways to dispose or cough out mucus, etc.

if u go to my profile, and look under my statistics, and look at posts by ahb08 u should find a post i commented it has "phentermine" in the title...which is the generic of adipex.

even though u have been eating bad stuff from time to time..are u still seeing the weight come off consistently??? if u are then maybe ur eating the bad stuff in moderation...which is what we are supposed to eventually learn with the band...right?? and from what it looks like u been droppin what....10lbs a month or something??? or did u loose a lump sum amount in one mnth? either way ur doing good...i know this is hard..i havent got my band yet, but im already setting myself for the rough times....but yes i agree with u..u probably need to kick ur butt back on track, but if ur loosing while eating a not so healthy meal, i would continue to eat those foods, BUT only in moderation...like once a week or something...i see on ur ticker u got 36 lbs more to go..so im projecting u will get to it...before year end....i bet u!! lol before u know it, it will be october and you'll be pushing 160 lbs....

is ur bmi below 40 for u to be concerned about having a co morb in order to be approved by insurance? If its not under 40 then a co morb isnt required.

oh ok..thanks for the feedback!

U only need to go to nutritional visits 3x's during that 90 day period, and u need to see the specialized physician for bariatric surgery 4'xs (which consult visit is included in those 4 visits), as far as a psych, it states on the aetna website that its only needed if the patient has had PAST PYSCHOLOGICAL PROBLEMS....i dont have any so if it wasnt required by my surgeon i just didnt do it at all...now keep in mind im still waiting for my charts to be submitted to insurance.....so they might pull the psych visit on me...but it clearly states the need for a psych visit on the aetna website. So im still praying to god this goes smoothly!!!

The bottom line with JPMC is they cover WLS period. The tricky stuff comes with the type of insurance u have and what insurance company u have coverage with...as all of us banking workers know..jpmc is number 1 on the banking scale...so they are all over the U.S. with that being said each state is contracted with different insurance companies....so as far as the requirements are to be approved, u need to contact ur designated insurance carrier and find out what their requirements are to be precertified (approved) for the procedure to be paid by them. I was originally employed with Bear Stearns....had awesome insurance with United health care (they didnt require any monthly pre op diet before surgery approval), then when the JMPC/Bear merge happened It changed to AETNA. I recently left the company and I'm now with CITIBANK, and im still with AETNA so my pre op diet requirements stayed the same. Good Luck to ya!

Woooohooooo yayyyy!!!! Congratulations!!!

AMEN girl!!! i sooo can relate to ur list of things u cant wait to do!!!!! i cant wait till i get my band!!! i havent worn a dress that was above my ankles since 1995!!!! yes...i was 10 then...i was already self conscious of myself at that age!!! im 23 now and i want to live like one! good luck dear!!