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Irishflower79

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Irishflower79    183

Irishflower79
Posted

This makes me so mad!! You hang in there and don't give up!

Thank you! I have two more weigh ins then will be resubmitted for Ins. I was so happy and ready now I'm depressed and sad and I don't come on here as much, because seeing everyone so happy they got approved and a date. I am very happy everyone is moving forward just feel like I'm stuck and won't be moving on to a healthier me. I'm afraid even after I do the now required 6mo weigh ins they will find another reason to deny me.

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Cocoabean    430

Cocoabean
Posted

Were you told of the change of requirements before your weigh in? If you were in street clothes and you weren't told, perhaps you can have a do-over and be weighed in a gown. If your insurance changed their requirments mid-stream, it seems to me you should have been informed of that.

A letter to your state's insurance commission might not be out of the question either.

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Cocoabean    430

Cocoabean
Posted

Thank you! I have two more weigh ins then will be resubmitted for Ins. I was so happy and ready now I'm depressed and sad and I don't come on here as much, because seeing everyone so happy they got approved and a date. I am very happy everyone is moving forward just feel like I'm stuck and won't be moving on to a healthier me. I'm afraid even after I do the now required 6mo weigh ins they will find another reason to deny me.

Don't be depressed! (no, I am not telling you to pull yourself up, I know depression doesn't work that way) Fight them and win! Then be here to help others who need to fight! I was denied at first, so I got to know the appeals process very well back then. I used that experence here to help others with their appeals. Things have changed in the nearly 6 years since I went through it, but now you can use your knowledge to help others. It stinks that you are having to learn it, but use it to help others.

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Irishflower79    183

Irishflower79
Posted

Were you told of the change of requirements before your weigh in? If you were in street clothes and you weren't told' date=' perhaps you can have a do-over and be weighed in a gown. If your insurance changed their requirments mid-stream, it seems to me you should have been informed of that.

A letter to your state's insurance commission might not be out of the question either.[/quote']

They changed their rules aug 13. My last weigh in was aug 19.

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angelabgray    17

angelabgray
Posted

I had the same feeling before surgery, reading about all the happy people on the site. It was such a waiting game with the insurance and doctor's office anyway - none of this happens quickly for anyone! One thing I did while waiting was to sort of pretend that I'd already been banded. Like, what would I be doing differently now if I had my band? Eat smaller meals, get more Protein, chew well, etc. Even though I didn't lose much doing this, it got me in the mindset and every pound I lost pre-band is just as good as the ones I've lost since surgery. I think we start to see actually "getting" the band as the day everything starts, when really, so much of this is a mental game that starts well before surgery. Just keep your chin up and keep doing the things that will put you on the road to your goal, then when you get the band it will be like icing on the (metaphorical) cake!

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Irishflower79    183

Irishflower79
Posted

Finally!

It's official I get my band Nov 8!

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kphoping    47

kphoping
Posted

Congrats!

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Leena    108

Leena
Posted

Congrats on getting through with Aetna!

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Irishflower79    183

Irishflower79
Posted

Thank you! True Results had to appeal on my behalf and they did that on Sept 24. I never heard anything so went for my second last weigh in on Oct 21 and when I got home and checked the mail there was the approval letter they sent on Oct 9. Why it took 12 days for me to receive it?!

I am just happy I did receive the letter and now I have the proof, and I want to frame that letter let me tell you! :)

I bugged the heck out of the front office people trying to get an official date set! I did it though! :) two weeks from tomorrow and I will be on "the other side!"

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Essence33    90

Essence33
Posted

Sorry, that happened to you. Hopefully they'll approve you sooner then later. Hang in there and try and be optimistic.

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Essence33    90

Essence33
Posted

Phone acting stupid. I just seen the ready of the post. Congrats!! Happy your approve. :)

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.

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