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Yes, all my codes said gastric bypass, but it all worked out fine. Don't worry, have a great weekend and just call 'em Monday. :-)

Okay, I had my first appointment at Emory on October 23. My insurance requries a 3 month supervised diet. I go back to the surgeon on November 26, which is about a month after the first visit. That means one month is done with the diet, two more to go. That means at December 2x appointment, I will finish month two and January 2x appointment, I will finish month three. At that point, I should be able to send off insurance information and have surgery shortly after, sometime in February or early March.. BUT why are people telling me that a 3 month supervised diet actually means 4 months? And why did the front desk lady say that my supervised diet doesn't start until my second appointment?

I am so happy for you!!! At least one of us is headed there. I am still waiting and the insurance keeps moving the date that they have for it being turned in. doc faxed it the 27th november, they said they didn't get it until the 29th. they said 7 to 10 working days from then. Next they told me the nurse didn't start reviewing it until the third. but they still have no answer. it is driving me crazy. i have been on this horrible shake plan since the 3rd and don't think iam getting surgery this month, so i feel like i have wasted my time, except i am 2 lbs away from surgery weight....just frustrated, but i really am happy for you. what happens next for you?

I haven't been here in a few months but I had not given up on getting VSG surgery approved. I've written some posts which tell more of my story if anyone is interested and is going through the same thing: http://www.verticals...er-suggestions/ This has been such an emotionally draining time that I wanted to share that I have finally had SUCCESS and I thank all of those who encouraged me to keep trying. I will be having a Lapband removal and revision to Sleeve - Surgery date not scheduled yet since my surgeon's office said they have to see if any pre-tests will be required. I was originally denied by UHC in August stating that I had not met their requirements since I hadn't completed a 6 month pre-op physician supervised diet. I was, however, approved for the Lapband removal due to complications. I wanted both done at the same time and found the fact that they approved one and not the other completely illogical. My surgeon's office suggested I move forward to start a physician supervised program (since UHC says it specifically cannot be a Bariatric physician). I started seeing my primary care Dr. specifically for weight loss. I had recently moved to FL so had to find a primary care Dr. to begin with. So essentially I decided to go down both tracks - appeal the denial as well as work on the six months pre-op diet so, in my mind, worst case I would still qualify by March. However, I was still upset about the whole 'principle' - or lack of - principle of requiring someone who lived with the Lapband for so long to do another 6 month pre-op diet. I sent an appeal letter to UHC and received the most ridiculous response I have ever seen - let alone another denial. They had another Dr. review my case - someone supposedly with knowlege of bariatrics and his lame reason for denying me was that since I had failed with the Lapband I would just fail again with a Sleeve and then I would be asking for a gastric bypass - almost his exact words... no lie. This infuriated me and showed a total lack of knowledge on his part in my opinion. I mean, just like that, this Dr. who does not know me at all, has never even spoken to me, let alone examined me, decides that I am just a BIG failure!!! I was told the next level of appeal would go to my employer since my employer self insures the plan or something like that. In the meantime I continued to go for my monthly Primary Dr. visits and the first few months lost about 5 lbs then after the holidays gained that back and more. I forgot to mention that my Band was unfilled back in July and my appetite has been worse than ever let alone that I can now eat a whole lot more plus things I couldn't eat for years. It took me another month or so to finally write my second appeal letter which went to my employer. By the time I sent it off it had grown to 70 pages - 2 for the letter and the rest my prior letter, denials and other medical records. The first appeal letter was 4 pages of a letter and 30 pages of records but I went ahead and obtained more records in the interim from my podiatrist, etc. I didn't intend for this post to be so long - I guess I'm kind of venting along the way so forgive me for that. I finally received a letter from my Employer the other day stating that they, too, had had another surgeon review my case who had bariatric experience and this Dr. (bless him) completed validated my case - stated that both surgeries are absolutely medically necessary and that I was correct in pointing out that UHC's own Bariatric policy contradicted them denying me both times before. I choked up as I read his words - and just praised God for his answer to my prayers! I don't have a date yet - I am supposed to hear from the Nurse at my surgeon's office on Monday to go over my health questionnaire to see if I need any pre-tests for sleep apnea, etc. I am really healthy other than my morbid obesity and even when I had Lapband in 2006 only had to have a pulmonary test done aside from the routine blood, etc. So if all goes well I may still have the surgery by the end of the month or in March. All this to say that if you are going through the same type of thing - particularly with UHC - DON'T GIVE UP!!! I'm willing to share my letter with anyone interested - email me if you want a copy. It's sad that they make us go through all of this; upon reflection it has all the more strengthened my resolve, but will still really unnecessary. As my plans progress I'll post in other topics. Thanks. Susie

The depression is probably not caused by feeling hunger, since depression is defined as sadness, lethargy and loss of will that has no discernible cause. If it were as simple as stimuli, the 21 lbs you've lost in the past few weeks should have you elated and ecstatic! I had a sleeve, not a bypass but my hunger didn't disappear overnight. The liquids phases were especially tough as I was missing the satiety and chewing from eating proper foods. If you're feeling depressed, I would recommend talking to a mental health care professional about finding a therapist. No amount of "cheer up!" Is going to help with depression.

I too am sort of new. I joined about the time I had a lap band. Did well for a time then began having troubles finding the "Sweet spot". Then breast cancer and had my band deflated for fear of vomiting. I have been pretty discouraged and talked with my PCP who felt I had done as well as I can expect with the band. I have lost and gained the same 20 pounds now for months. We discussed the bypass and I am waiting to see if I will be accepted into the program. I am looking to give and get support and learning tip from those who have gone before me.

They said the insurance company codes it as the bypass.. It's enough to confuse the patient tho

My surgery is in Tuesday. There are quite a few women who have been very successful at my old job (on COBRA) so I'm still covered. My sister had the sleeve not too long ago and from what my mom says she doesn't sound like she has lost weight and may need surgery for scarring. She's been having issues with it. She lives in the Middle East. My doctor does less lap band now than the other procedures but is well known for all of these surgeries, so I'm not worried about that. He still is going to do the lap band for me, he says less are asking for the lap band. Just getting nervous about the negative things I see out there about complications. Oh and my mom had a gastric bypass years ago and now has osteoporosis since she doesn't absorb Calcium. I've got a small area of osteopenia of my lower spine which I'm taking calcium supplements and picked up upper body weights. I broke my knee 3 years ago and had to stop Impact exercise which stimulates bone growth. I swim, ride my bike a few miles and go to the gym. I just need not to be hungry. I've been eating less theses past few months also. Anyway. Just nervous. I'll do anything not to throw up that's the worst thing in the world for me. I know I can follow the instructions on how to eat what to eat and exercise. I'm a RN also.

My insurance had many requirements one which was a 6 month dietitian requirement to ensure I knew how to eat the right foods. I went thru so much testing and have finalized everything. I'm scheduled for November 28th. I just got approved last week. It's a long journey and you need to be ready for a life change. Go through everything you need to. I found out during the process that I had severe sleep apnea. I had no idea. Just knew I felt horrible all the time. Good luck with the process.

Congrats...could you pls tell me what u did to get approved?! I live in dallas tx btw...or could u give me any hints...pls i dont want the gastric bypass...why reroute my insides when i could just get a partial of my stomach removed ...

Yea i want to have a baby slso thats why i didnt get sleeve got bypass instead didnt want my stomach cut either You guys are correct about the sleeve not being reversible; however, I don't think it has a negative impact on becoming pregnant (providing you are willing to wait a year after the surgery to stabilize weight): http://www.ncbi.nlm.nih.gov/pubmed/23306797 http://www.marinahospital.com/blog/will-i-be-able-to-get-pregnant-after-gastric-sleeve-surgery Studies stated, "Barring very uncommon complications of surgery, this should eventually make it easier both to conceive and to carry a child to term with less risk of negative consequences."

So, I just went through gastric bypass on March 8th, the first week post op was just fine. However, after my 1 west post op, I have been noticing some breathing problems. I can't seem to catch my breath. I can't take a shower without having to sit down afterwards to breath or walk up a flight of stairs without my chest tightening and I have to sit down. This is not normal for me. I have no pain or fevers and I had some vitals checked and all my vitals look good and my oxygen was 98%. Has anyone else experienced this? Do you know what it is? Sent from my SM-G920V using the BariatricPal App

Last Friday the insurance coordinator said she submitted my request to Cigna and we would hear something Tuesday or Wednesday of this week. I called Cigna on Tuesday and they told me my request was pending clinical notes from the surgeon's office. I called the insurance coordinator and told her what Cigna has said. She said she would call Cigna. When I called Cigna on Wednesday the status was still pending clinical notes. I asked what clinical notes they needed and they proceeding to tell me it is all the paperwork we have been getting together to submit to insurance.Can you imagine my frustration at this point? Couldn't get the insurance coordinator by phone or email on Wednesday. Thursday, the insurance coordinator sent me an email that the paperwork had been faxed to the case nurse. When I called Cigna on Thursday they said it takes 2 business days to decide approval and denied. I call this morning and got a great C. S rep named Patti. She had gastric bypass in 1999 and understood my anxiety. We talked for over 20 minutes. She said the approval could come any time today up to 9PM. I was just wondering if the paperwork had be submitted with the request for surgery approval last Friday would I stil be waiting today?

I am new also, and am hoping to have surgery in november.

Hi I am new here and love all the support I see on this site. However I am very nervous. I have been reading the forums and online articles preparing for my surgery. Ordered shakes, Protein and Vitamins. My friend who had her surgery 8 months ago said I am too prepared. LOL I am not thinking so. I am so nervous today and my gastric bypass is tuesday morning. I am doing this for medical reasons and for the weight. I have severe reflux, hiatel hernia, gallstones sleep apnea and IBS. I am looking forward to feeling better after the recovery from these issues. Any support or suggestions are very much appreciated. Thanks Cynthia

I am very frustrated today. I went in for my consult at Weight Loss Surgical Center in KC last November in which they checked to see if my insurance would pay and I received a phone call saying they would pay but it had to be done at an acute care facility which they did not have but were in the process of building one. Fast forward to a month ago and I called to check on the facility and if it was completed & they had just done their 2nd surgery there so the ball starts rolling again....get phone call to set up another consult OR pre-op visit. I was on the fence whether to do it or not and after joining this group and reading the success stories I am 110% committed so left 2 messages to set up pre-op consult and the person that gets insurance clearance had been calling me WEEKLY to update me on Tricare's requirements that were being met each week SO I think as soon as the facility meets Tricare's requirement I am a go....NOPE....now I'm told that my BMI is under 40 and I do not have the 2 co-morbidities to qualify. WHAT!?!?! Talk about popping someone's bubble fast that was ready to get this going..........so now I wait as they try to gain clearance from Tricare. Why would they tell me last year that they would defniitely pay for it and now possibly NOT? They had the same requirements last year that they do today. Very disappointed & upset. Anyone else have to deal with Tricare? Do they pay for your fills as well? I have a $1,000.00 family deductible which I met last year from being in the hospital twice and if I could have had this done before Oct 1st I would not have had to pay a dime! But my health is worth the $1000.00 at least and I just want to do this and I think if I'm denied I will really fall in to a deeper depression...I don't want to have to eat until my BMI is over 40 to get the surgery so I may be left of my own. I lost 84# once before but its all back and then some. They think my thyroid issues will count so they are going to run it by Tricare. Thanks for letting me vent and if anyone has Tricare just wondering how they were getting them to pay for your surgery!

I don't think there's any time frame. I just got my letter of referral to a surgeon for surgery from my PCM in November. I didn't see him or talk to him again until I needed a letter from him saying I was physically ok for surgery until February, and that was the only two times he was involved. Every other time it was the surgeon or tricare itself. I think the only time you have a specific time frame is once you have approval from tricare. I got approval on Feb 28 and had to have surgery by May 28.

There's been some patients that had part of the hospital bills from complications covered by insurance, but others have had complete exclusion of any complication bills being paid by insurance that do not cover the initial procedure. It seems it's all in how the hospital bills the charges, and how the doctor handles the complications. It's a tough situation to be in as I would not want bypass, and I would have self-paid for my revision if insurance would not have come through for me.

I thought about this, I think I would go with the gastric bypass. I am afraid to continue with the medical conditions associated with obesity, I fear a heart attack in the next 6 years.

Hello friends i got my surgery date for my bypass surgery for november 27th they gave me a 3 week liver shrink diet to do but it doesnt look bad!! Praying i can do it Sent from my LG-M210 using BariatricPal mobile app

Thanks so much for the replies, it is nice to know that there are people willing to help you when you are faced with a situtation that will potentially change your life. I live and work for a contract rehab company in Western KY, however I have Anthem BCBS of Alabama. I have had many dealings with them as I have had several trips to the ER for kidney stones and ovarian cysts. They have been wonderful in paying those claims. In the past couple of years I have been hospitalized for my overian cysts, had lithotripsy for my stones, and underwent a hysterectomy. I am so thankful to have medical/health insurance at all, but have really been disappointed with their help in this matter. Again, they have told me that through the proper guidlines gastric bypass would be covered. I have attended seminars, met with my doctor of choice, and completed some of the initial testing and have been seeing a dietition on a regular basis. For now I have put the remainder of the procedures on hold. Just passing time hoping things may change with my insurance.

Just wondering if any Australian people have recently submitted applications to APRA for release of super funds. I put my application in on 12 August and still haven't got a response. I have now started to phone every day. Had a small glitch this week with some wording but resubmitted the relevant letter yesterday and after speaking to them today it hasn't reached my file yet. Just wondering once APRA approve how quickly will they provide information to super fund for release of funds. My surgery is in 3 weeks (4 November) and I'm starting to stress that the money won't be through in time.:thumbup:

Hi, my name is Melissa im 31yrs old and live in Victoria, Australia. I started this new jorney on november 07 had all my appointments through Boxhill hospital my surgeon was Dr Moore :cursing: i was then placed on the waiting list for 18 months then finally got the call i was banded on the 1/6/09 and has lost 7kgs since my op:thumbup: it was the best decision i have made. just wanted to introduce myself and say hi and wouldnt mind hearing your stories as ive only just started and sometimes the will power isnt there and sometimes abit:confused: thanks

11/2/2007 I still continue to struggle with my weight. I am not getting that full filling like I think I should. I haven't had my first fill yet. I will be having that on November 15. I am just tired of being over weight. Not being able to look or feel comfortable shopping for clothes for myself. I looked at myself in the mirror and I can see why my husband doesn't want to have anything to do with me. My arms are just huge acutally every part of my body is. I hope soon that I won't have such a low self esteem. I am thankful that God allowed me to have the surgery. I just get really lonely and sad. But I just have to have aith in God the Father and know that He is there with me all the way.

Yesterday was the start of a new journey for me. A client/gastric bypass paitent asked...." When do you stop being a patient and start being a normal person again?" My first answer is that you are always a patient. From a Dr point of view that may be correct. There are many out there that either the band does not take in thier body or eventually some need to have it taken out. I hold a stand so that thes people may have some support to make sure they need no other surgeries, My Life Is My Message. I no longer hold any liquid inside my band, making my stomech normal again. My goal is to maintain my wieght, Concur any new stuggels with this journey. If this can help one person out there, Its worth every step. A great thanks to all of the supportive people out there. Remember One Step At A Time! Be patient with your self. Most of all LOVE YOU! BE YOU! Tiffany C