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Denied...frustrated!



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I got a call last month from my dr. office saying I was approved...brought me in for my pre op appointment. Later that day I was called and told that No that they hadn't gotten the approval and that I might have to do the 6 month I can change program (tufts). it's been two weeks and they kept asking for more and more paperwork, which my dr. office kept sending them last night they denied me. missing clinical paperwork missing! My dr. office calls and tells me that she's working with someone and that she is going to resubmit it with the missing stuff. I call and as questions ( I hate waiting!) and the insurance woman tells me that no a denial is a denial and that my Dr. can call in and speak to the medical director one-on-one and perhaps that would be better than an actual appeal. My dr. is now on vacation till the 9th! UGH i'm so upset and frustrated right now! who is tell me the truth? did they not send the paperwork? did the insurance co mess up?? I just want my approval!!!

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I am SO sorry! It is so hard waiting. It will happen for you. Just keep doing what the doctor says and I know it is hard, just be patient. :)

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I got a call last month from my dr. office saying I was approved...brought me in for my pre op appointment. Later that day I was called and told that No that they hadn't gotten the approval and that I might have to do the 6 month I can change program (tufts). it's been two weeks and they kept asking for more and more paperwork, which my dr. office kept sending them last night they denied me. missing clinical paperwork missing! My dr. office calls and tells me that she's working with someone and that she is going to resubmit it with the missing stuff. I call and as questions ( I hate waiting!) and the insurance woman tells me that no a denial is a denial and that my Dr. can call in and speak to the medical director one-on-one and perhaps that would be better than an actual appeal. My dr. is now on vacation till the 9th! UGH i'm so upset and frustrated right now! who is tell me the truth? did they not send the paperwork? did the insurance co mess up?? I just want my approval!!!

Hi,

Were you denied becuase you didnt do the I can Change program with Tufts (i have them). I know from talking to the place I am going and with Tufts that they will NOT approve you until you finish this program and its 6 months long. If you havent done the program then that would be the missing documentation as they provide a "graduation" letter at the end and this needs to be submitted with the paperwork the doctor submits. Im done with my program next month and i cant wait!! Now i just need to get my surgery date. Im sorry your so frustrated but have you called Tufts directly? Wishing you luck!!

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I was told by tufts that I didn't need to do it because I already had surgery and the band failed. I hate all this waiting. Its not healthy

Sent from my DROID RAZR using VST

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The dr. Office just ca,,led and she got the approval!! she re-faxed what they were looking for and they approved me!!! Now just waiting on a surgery date!!! August/September/October.. I don't care I just want my date!!! Onederland here I come!!!

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The dr. Office just ca' date=',led and she got the approval!! she re-faxed what they were looking for and they approved me!!! Now just waiting on a surgery date!!! August/September/October.. I don't care I just want my date!!! Onederland here I come!!![/quote']

Awesome!

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That was fast! Congrats!

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Congrats!!

Sent from my SPH-D710 using VST

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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