3kidsmom

Hello, I just received my insurance approval, after over a year of fighting! Surgery September 9 in ABQ NM. I'm also very excited, this has been a long time coming.

I should have done that before, I've attended WW and another doctor monitored diet program with weekly diet logs, etc. I assumed (incorrectly) the 6 monthly visits with my doc monitoring diet and exercise and the psych eval would be sufficient. I do not have any co-morbidity, and this is another reason Lovelace said it is not medically necessary. I think its a bunch of BS I still may be able to dig up my old diet logs and appeal through my employer. Thanks for the info

terri0826, No luck! I have not appealed to my employer yet, which would be the last step. I am still contemplating another appeal. The main hang up was that according to Lovelace I have not made substantial efforts to lose 20 lbs or 10% of my weight and surgery is not medically necessary. I think this entire insurance thing is a racket!

Thank you HappyMom and Mimo: I am reviewing the appeal process through my employer (office of personnel management) which is the last step. Good to know the surgery for self pay is cheaper in Texas. May have to go that route. This insurance bureaucracy is so stupid! Yes Henry has been great, and he said Dr. Smith was meeting or going to meet with the medical director for Lovelace HMO. Hopefully we can get some results.

How exciting for you that have had the surgery with Dr. Smith. Unfortunately, my insurance company Lovelace HMO has denied me, I appealed and they denied again. I am working with Henry at the hospital, but this is absolutely ridiculous! I am so disgusted with the insurance company right now.

Good for you. I was hoping for the February date, but doesn't look like that will happen. What is the March surgery date, do you know? Have you attended the support group meetings? They are pretty good.

Dr. Smith is now coming to Albuquerque to do lap-band surgery once a month. I have had my appointment and attended one of the support group meetings and everything I hear about him is GREAT! Esp the fact that he is a patient himself.