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Good And Bad News Today!



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Where to start...

The Good: I called my insurance company today and found out that my surgery would be covered 100% as long as I jump through their hoops and at a local hospital! My best friend is having to travel over an hour away for hers because of her insurance. I have the name of my surgeon, 2 seminars set up (they are for 2 different hospitals, I want to see the differences of opinion) and a list of support groups. My insurance company is mailing me all the information about their requirments and I printed a booklet that has to be filled out and returned to my surgeon before the first appointment.

The BAD:

I am uninsured. They said that it looked like a paperwork mis-hap on their end, but that I may have to wait a full 30 day billing cycle before they can add me back to my policy. Ugh. So I have all the tools that I need and now I can't make the first consultation. I have the first appointment with the dietitian. Oh well. This will give me a few extra weeks to go through all the paperwork and get a head start on it :)

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More bad. The surgeons office just told me that they don't do the sleeve procedure. I feel like I am back at square one again.

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Do what ever you have to do to do it, FIGHT FIGHT FIGHT, don't let the insurance company win, I had to fight mine for 12 months than my companies CEO and HR pushed it through for me.

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Keep trying.. Don't give up!!!!! You will get the sleeve!!!

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Whatever it takes, its so worth it!! Even if you have to wait. Don't give up. B)

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The insurance company is making you wait 30 days to add you back because of THEIR error? That is a problem. When your insurance is back in effect, can you go to another surgeon who performs the surgery?

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Don't give up!! I had a lot of issues with insurance as well, but I didn't give up and I ended up getting the surgery in March. Keep moving forward!!

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After all the research and digging today I am exahusted. I learned though that I can have it done at the same hospital that my bestie is having it done at, over an hour away...ugh. I have to call there tomorrow and see about going to one of their seminars and to see if I can go to the support groups in my area as opposed to driving all the way out there all the time. Hopefully better news tomorrow, or Wednesday since I have Wednesday morning off work :) Fingers crossed! It really sucks that the dr here will only do the bypass. Just because I am a cow doesn't mean I want to be butchered.

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    • 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.
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    • 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! 🤣
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    • 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 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
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