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sleevegenie

LAP-BAND Patients
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Everything posted by sleevegenie

  1. hi demitrios, how are you doing? i wish i had seen this sooner, i had my sleeve done on 5/28 so i think we are surgery mates, i am amazed at how good i am doing,, how are you??/ i'm so glad that's over, and we can move on to the rest of our lives, if you like we can compare notes, take care, remember sip walk sip walk
  2. Hey Tif, can you believe it, i got my sleeve, i'm so happy, it all went so well, i'm exhausted, i love you, i'm going to bed !!!!

  3. sleevegenie

    ? about Aceves please..

    i am so jealous my bmi is less than 40 but i had to do the liquid pre-op and i hate it, i have lost 15 lbs in a week and a half, but my goodness, i'm starving, have to do two days clear wed and thurs and surgery is this friday morning, i would much rather have had your pre op orders, best of luck
  4. sleevegenie

    officially sleeved!

    congratulations, i'm having my surgery on Friday and just want to wake up and have them say ok all done, take care
  5. i am completely amazed, i have been in appeal for so long my insurance, anthem blue cross of california denied the sleeve saying they consider it experimental. i requested an independent medical review and i won, drs office called today to schedule and i have surgery in two weeks, holy moly, i am so relieved, i have been so worried and now i have to do the liquid pre op diet, doesn't sound like much fun, but i am there, will be going to the store tomorrow to stock up, so glad i didn't settle and do the bypass, i knew that this was definately the surgery for me, so i think i am still in shock and i cannot wait for this two weeks to pass, thank goodness they :thumbup::thumbup1::biggrin2::cool::wink0: scheduled it so soon,
  6. sleevegenie

    i won my appeal scheduled for 4/28

    hello, i didn't get approved by anthem blue cross they denied me, but in Cali we can appeal to the state, requested an independent medical review, which i did and won, but bmi over 40 is the rule or if you have co morbidities then bmi over 35, so i have had bmi over 35 for at least past 5 yrs, i also have co morbidities , i'm sure you can have the surgery if you pay for it yourself, but don't think insurance will without bmi over 35 for at least a couple of years, best of luck to you, ) jeani
  7. sleevegenie

    i won my appeal scheduled for 4/28

    i'm pretty sure that after this bariatric conference in june they will no longer be able to say it is unproven, that's just no longer true, but i'm not sure about the bmi, i would advise you to call and ask them, i thought it was bmi over 35 with co morbidities for 5 yrs. but i could be wrong, my problem was not that, mine was they say the sleeve is still experimental, and like i said, just no longer true, i won my appeal. best of luck to you,
  8. sleevegenie

    i won my appeal scheduled for 4/28

    i'm sorry, i'm a little confused, Aetna approves the sleeve, why were you declined? the letters i have are based on them saying it is still investigational,
  9. sleevegenie

    what i feared the most has happened:(

    if you send me your email address i would be happy to send it, i didn't win my appeal with anthem blue cross, in CA we have a state office that we can appeal to and they have three independent doctors review the case and this is how most of us won in CA if the independent medical review votes in your favor the insurance has to pay for it, not sure each state is the same, but pretty soon they will all be covering it,
  10. sleevegenie

    i won my appeal scheduled for 4/28

    lol, good point, thanks
  11. sleevegenie

    i won my appeal scheduled for 4/28

    what insurance do you have?? i live in CA and here if you are denied d/t experimental or maybe for any reason you can go to the state they have the dept of managed health care and you can request an independent medical review, they assign your case to 3 doctors who review your case, read your appeal letter and decide if the denial is fair or not, if the vote in your favor the insurance company has to pay for your surgery, i am so blessed, so happy but i think each state may have different laws, you should probably contact the state insurance commisioners office, best of luck, let me know if i can help in any way, i think really that they will all start covering it soon, they will probably outlaw the band and start doing the sleeve, much less problems, jeani
  12. hey you, the denial letter from anthem included a letter stating if denied because they say it is experimental then you can request and Immediate Medical Reiew, so i did and i won my IMR and my sleeve is scheduled for 5/28 i think i am still in shock, i started the liquid diet today which sucks but i can deal i just found out friday afternoon, still haven't gotten the letter yet but the doctor's office don't call to schedule until they KNOW it will be paid for, when did you get your sleeve, do you love it?? i am so happy right now but hungry, :o)

  13. oh goodie, i am so excited and happy and i wanted to share it with you, its my own fault, that stupid thing in the corner, i didn't realize that your notifications go there, yaeh!!!! less than 2 weeks, i can't wait!!! I'm hating this liquid diet, yuko, but i can deal, i'm just so HAPPY!!!! thank goodness for the IMR, oh good, i was so shocked when i didn't hear from you because i knew you would be so pleased, i'm glad you're there, it means a lot, YAHOO!!!!!!:thumbup::biggrin2::lol0:

  14. i thought the liver shrinking was for a fatty liver so i would have thought low fat, so is it low fat and low carb? low carb low sugar? i'm a little confused, i have to do my 2 week but just found out friday that i have a date on 5/28 so not even 2 weeks now,
  15. sleevegenie

    Denied!

    Hey Tify, i won my appeal, my surgery is 5/28 two weeks, can you believe it, i am so excited, i just wanted to thank you for being there for me, you have helped more than you know, i got a great letter together with help from people on OH and i am so happy i don't know what to do with myself, now i have to do the preop diet, what was your diet? one week? two?? low fat high protien or liquid?? omg two weeks, i thought she was gonna say how about july____ WOW
  16. hi, i just got my date 4/28 and i am wondering what your doctor's preop diet was if you don't mind sharing, i find it interesting that you can eat the night before??
  17. i turned 60 last month, i have anthem blue cross of california who denied the sleeve as investigational, i requested an independent medical review and the doctor's office called today to schedule, yeah, i knew the sleeve was the only one for me, too many problems with band/bypass, it seems like it took forever, but people are winning their appeals, and more companies are covering them, kaiser, united, aetna, and soon they all will because to say it is unproven is balony, best of luck
  18. sleevegenie

    Got my Date! NEXT WEEK!

    wow, that's great, your preop is only one day of clear fluids??? is that what he has all his patients do?? i'm just wondering, i have my date in two weeks, i'm a lightweight and he wants a two week liquid diet, congratulations to both of you, take care jeani
  19. Hi Tif, since you were the first person to ever welcome me on any of these formats i wanted you to be the first to hear my great news, my sleeve is scheduled for 5/28 OMG?? i'm still in shock, i got a call from the dr office and the gal said i'm calling to schedule your surgery!!!I'm so excited, you have been a big help even if you don't realize it, i enjoy reading all the posts and you have always provided a positive caring thought to throw into whatever the mix is, thank you omg :o)

  20. sleevegenie

    Scared and need some support!

    so sorry you are going through this, hopefully antibiotics will fix the problem and it sounds like your doctor is willing to help, thank God, take care, hoping everything works our well for you, still preop so no feedback to give just take care,
  21. congratulations, i'm jealous, hoping to get approved am currently in appeal, best of luck to you , take care
  22. 30 days, they had faxed me a copy of the denial letter to my job so when i got it i faxed them my appeal, which i had edited and now think is probably way too long, (6pages, well 5 and a piece of one) then when i got home and found the letter in the mail it said if denied d/t investigational i could skip appealing with them and go right to asking for an independent medical review so now i don't know what to do. i guess i'll wait and see what they say, all very frustrating and confusing, Please God it will all work out, thanks for caring, i appreciate it, take care

  23. Hi, i have arthritis and back problems so i need nsaids, i also have high b/pressure and elevated triglycerides, and have been borderline diabetic, i am about 39 -40 BMI i think when i had my first pre op with surgeon i was 39 have gained a couple of pounds since then, so i finally got my denial letter today and i faxed off my appeal, i really appreciate the prayers, thank you so much, very kind of you. So i will put up a good fight, doesn't seem fair that other people are offered this choice but i am not, take care

  24. sleevegenie

    what i feared the most has happened:(

    i was denied becasue Anthem blue cross of California still consider the sleeve investigational? so i am going to appeal with them, and if they deny my appeal i am going to take it to the State's insurance commisioner, so wish me luck and with God's help i will get my sleeve, please keep my updated with your progress, i'm so happy for you , but i'm a little green with envy over here, i want one too!!! )
  25. sleevegenie

    am i just setting my self up for dissapointment?

    Hey Tiff, well i'm sick with all this, i got a letter saying not a denial of service, contact Anthem blue cross utilization dept for decision about investigational called that dept 3 times told they dont deal with HMO go back to the HMO , hmo says appeal, so i appeal and on the 30 th day of appeal get told you havent'been denied so cannot appeal yet, what?? now i've been denied and have to appeal again, so i'm thinking of editing my appeal letter, can you send me the letters you mention in this message, i'd really appreciate it, trying not to let it get me down thanks

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