skinny_minnie_wannabe

I have BCBS IL and they have been pretty awesome. I call every day haha. I'm having major issues with insurance but the issue is my insurance coordinator. I'm not even going to get into that one. Anyways, it's been a week since my paperwork was submitted. My only issue is the indefinite timeline. One person told me it would take 72 hrs, one 5 days, one 5-7, one 5-10, one said one month. I wish the issue was addressed accurately. I'm very anxious! Good luck! Hopefully we will both have an easy approval!

I was encouraged for gastric sleeve initially and found out that it can worsen GERD so I decided that gastric bypass would be more suitable. So I got a call last week saying that I had an abnormality in my EKG (mind you this was done a long time ago and my prior surgeon saw nothing) and I was told that I WOULDN'T need a clearance. My doctor's office said it was urgent. I called my weight loss surgeon's office today and I asked exactly what the issue was. Apparently I DO need a clearance. She was super snide with me and told me she had already told me what I needed to do and basically told me that I should have scheduled my appointment. I'm so fed up! I hope that everyone gets their situations cleared up. What a difficult journey!

My paperwork was submitted to BCBS IL last Thursday. I am def on pins and needles. I understand how you feel. My BMI was 39.9 with high cholesterol, asthma, and GERD. I'm hoping and praying! Waiting is the hardest part.

Thank you so much for your response! I'm sorry about your situation. Insurance companies can be cruel. It is a money making business. I don't think people should be denied for many reasons. It is terrible when people end up with other issues. This issues could get worse and cause other health complications. It doesn't make sense to me when they don't pay for things that could rectify problems before they get worse. You will be in my prayers. Take care

Thank you Idlewood and congrats on your recent surgery!

You can and will do it! Congrats on your hard work!

I've learned that the journey is hard but you have to keep pushing even when you feel like you can't anymore. It is about our health and life. Nothing is more important than being healthy.

Oh btw, if you are having gas pain, I heard that gas-x melting strips are awesome.

I think you will too! Good luck!

My journey has been a nightmare but I'm trying to stay positive. I started in April. I had all of the testing required, blood work, x-ray, endoscopic testing, psych eval, ect. I did all of my weight visits as well. My surgery was scheduled for November. Unfortunately, my insurance prevented coverage so they rescheduled for December because I would have a new policy. Mid November I went to the surgeon and found out that the surgeons were leaving the practice/hospital. I was notified that I could go to Pittsburgh. I live in Erie so it's a drive but I didn't care. I then got a call and their was no doctor in Pitt that did sleeve which was what the doctor recommended. So, I went to another hospital. I figured I would have a surgery date scheduled. Nope. They make sure that you have official authorization through your insurance before they will schedule you. I told the office that I needed my surgery at least in the beginning of January. I have school and my husband needs to get off of work. They said they would be diligent and speedy. I then found out that the surgeon wanted me to have a catheter down my throat before he would allow them to submit it all to insurance. I went to the testing and couldn't tolerate the test. I waiting a whole week before the insurance coordinator submitted my claim. She told me she sent it sooner but she got my name mixed up with another patient. She assured me that she submitted it last Saturday. I called BCBS IL yesterday and they never received the documents. Turns out that she submitted it to my old insurance. I had to tell her my requirements for submission and everything. Welp, it is officially in the review and I'm on pins and needles. I genuinely believe that this has all happened for a reason and that God has a plan. It has been terrible though. I wouldn't wish this on anyone. I need this surgery. We all do and it seems that people don't understand our deep sense of urgency. It will work out though!! I hope that other people have a more smooth process.

My journey has been a nightmare but I'm trying to stay positive. I started in April. I had all of the testing required, blood work, x-ray, endoscopic testing, psych eval, ect. I did all of my weight visits as well. My surgery was scheduled for November. Unfortunately, my insurance prevented coverage so they rescheduled for December because I would have a new policy. Mid November I went to the surgeon and found out that the surgeons were leaving the practice/hospital. I was notified that I could go to Pittsburgh. I live in Erie so it's a drive but I didn't care. I then got a call and their was no doctor in Pitt that did sleeve which was what the doctor recommended. So, I went to another hospital. I figured I would have a surgery date scheduled. Nope. They make sure that you have official authorization through your insurance before they will schedule you. I told the office that I needed my surgery at least in the beginning of January. I have school and my husband needs to get off of work. They said they would be diligent and speedy. I then found out that the surgeon wanted me to have a catheter down my throat before he would allow them to submit it all to insurance. I went to the testing and couldn't tolerate the test. I waiting a whole week before the insurance coordinator submitted my claim. She told me she sent it sooner but she got my name mixed up with another patient. She assured me that she submitted it last Saturday. I called BCBS IL yesterday and they never received the documents. Turns out that she submitted it to my old insurance. I had to tell her my requirements for submission and everything. Welp, it is officially in the review and I'm on pins and needles. I genuinely believe that this has all happened for a reason and that God has a plan. It has been terrible though. I wouldn't wish this on anyone. I need this surgery. We all do and it seems that people don't understand our deep sense of urgency. It will work out though!! I hope that other people have a more smooth process.

I think it's so important to count our blessings. We all have had so many difficulties. It is awesome to have such an opportunity that is life changing. It can be challenging and sometimes it is hard to think positive. I'm waiting for surgery approval and negative thoughts hit me. I try to push all the negativity away. Everything will work out. Congrats on your surgery! Take care.

You can have sex when you are comfortable enough to do so. They say to be very gentle though and not to do anything too wild haha. Also it is important that you use birth control because you become very fertile after surgery. My doctor recommended not to plan pregnancy until at least 18 months past surgery date. Generally, I think it's about a year at least. If you become pregnant earlier, it can cause complications.

Congrats!!

I finally got a hold of the insurance coordinator. She sent in my documents Saturday. I asked her about the 5 year weight documentation and she didn't even question that before submitting it. Shouldn't she know these things? Anyways, I'm tracking down my weight documentation today and hoping for the best. It is insane to me because the decision to get this type of surgery is life changing. It can be very nerve racking and some of the health professionals don't understand the urgency that we feel. Good luck with your pre-op tests! I'll say a little prayer for you.

Thank you for the reply. Good luck to you as well. That is good that they have everything they need to make a decision. I'm searching around for the documents myself because the coordinator is never in her office. It is so frustrating but I want it and I will take the initiative to get things going. Please keep me updated. Have a good night.

It has been a week since I attempted to get my information submitted to the insurance company. I was under the impression that my case was submitted but the insurance coordinator mixed me up with another person. How does that happen?? Anyways, I have called the insurance company and doctors office nearly every day to check on the status. Friday it still wasn't submitted. It is so frustrating because I started the process about 8 months ago. I did the 6 months, all of the testing, psych eval, you name it. My surgery was scheduled for November but my insurance at the time wouldn't cover it. It was rescheduled for December. At the end of November I was notified that the surgeons were leaving. Basically I was SOL. So I contacted another surgeon in my area and transferred. I told them the importance of having my surgery in December because I have a winter break from school and my husband has a week off from work. I was told that they couldn't schedule me until insurance officially approved me. How frustrating! I feel overwhelmed because I am not at 40 BMI and I only have high cholesterol and GERD. I'm expecting appeals. I'm nervous about being denied. Every thought one could have, I have had it. I'm chalking it up to my anxiety disorder but I think that many people go through this. Is anyone else going through this hell? I have BCBS IL. Has anyone dealt or is dealing with them? Needing some encouragement and prayers would help as well

Lol @Michael Jackson. Congrats! I understand your anxiety. Everything will go well. Good luck!

Congrats!!! You look gorgeous!

I transferred doctors and I had all of my documentation handed to me. I was being nosy. Thank you for the advice

Congrats! I'm currently waiting for my insurance to authorize my surgery. The office won't schedule until approval which has been difficult for me to deal with. I commend you for quitting smoking. You have your eye on the prize! I hope that you have a smooth surgery and good recovery. New year...brand new you! Take Care

I understand your frustration all to well. I began everything about 9 months ago. I did all of my testing a-z. I was scheduled for November but had an insurance issue. It was scheduled again for this month. A month before my scheduled surgery date I was notified that the surgeons were leaving. Basically I was out of luck. I transferred to another hospital. They were supposed to send my information in Monday. I made an emphasis on the fact that I had my surgery scheduled according to school break and my husbands schedule. They STILL haven't sent the information in and they will not schedule my surgery until they get a definite yes from the insurance. I'm so frustrated and I'm trying to have patience. I'm waiting for the possibility that I will have to appeal as well because I started out at 39.5 BMI and I have high cholesterol and GERD but no other qualifying commodities. I'm so frustrated. I think that we all go through these feelings because it is a loooonngg process. It is demanding and can be emotionally draining. We all want a release from our conditions and it often seems that our sense of urgency isn't on the same level as every one else. I guess things happen as they will. Keep strong girl! Hopefully we will both get our surgeries approved. Take care

I am currently waiting for my insurance to pre-auth my surgery. I had a psych eval which was done at the place where I have been going for years. I had never met the psychiatrist before. All seemed well until I was able to review my exam and he said that I had bulimia. This was not brought up during the eval. He had access to my medical records and I have a past history. It is no longer an issue. I have a policy through BCBS IL and they specify that they will not cover WLS with an eating disorder. Has anyone gone through this? Will I have the right to appeal the decision despite this requirement?

Wow! Terrible grammar. You will have to excuse me ha.

It is funny (not literally) because I was just putting my clothes away and then I read this post. I'm currently waiting for my insurance approval and I'm a nervous wreck. I'm on an emotional roller-coaster. I'm trying to maintain faith that things will work out. When I start doubting things, I say "it will work out." Anyway, back to the clothes haha. I was putting my clothes away and thinking what am I going to wear once I lose weight?? Then I started to reflect on my clothes collection. Like you, I lost weight with some dedication. My depression and poor habits brought it back. (I also have been diagnosed with bipolar) I noticed that I have been in a "sweat pant rut." I was using them to workout. Now I sit around in them. It is very counterproductive. I realize that clothes can signify our our journeys in life. For us yo-yoers, we have gone up and down in sizes. Clothes remain dormant "just in case." I came to the point where I threw it all out accept for one pair of size 12s. I haven't worn them in about 7 years. I'm rambling now lol. As women I think we understand the depression of not fitting into clothes. I can't think of anything more empowering than taking those size 12s off of the shelf and fitting into them. I think that our situations make us enjoy the small things once again. Good luck!!