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Medicare.. Finally my paperwork is being submitted this week



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So I made an appointment with my surgeon to discuss WHY was it taking so long for Medicare to approve or give the GREEN light for the Gastric Sleeve. His response was " Here can you read this", It was an email from the head of the insurance dept at the hospital from about a month ago. It stated that MEDICARE was still NOT approving the sleeve in PA. So I returned it and continued to inform him that how is it that they were the only hospital in PHILADELPHIA that was not processing patients because that I had an appointment tomorrow with another surgeon and he has reasurred me that he can submit to medicare. Funny how being your own advocate can move mountains, I had not even gotten home 10 min when the insurance secretary from the surgeons office was calling me to inform me that my papers where going to be submitted.. Then 2 mins later the surgron himself called to reassure me that he would personally submit them if he had to.. NOW I know you guys know I'm jumping in my skin with exitement BUT then again I'm here thinking WHY?? Did it have to go to those extremes for an individual to do the JOB she was hired to do which is HELP patients with this already stressful choice. I am EXTREMELY happy that I wasn't pushed to go to another surgeon and start the process all over again not to mention having to pay for the test that were not covered by medicare. So I close with this, BE YOUR OWN ADVOCATE WHEN IT COMES TO YOUR HEALTH... :) Smooches and hope to be on the losers bench very soon...

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BE YOUR OWN ADVOCATE WHEN IT COMES TO YOUR HEALTH..

babygirl

what a great statement - very true!!!!

good for you on pushing the envelope :)

you are right, if "you" don't fight for "you" - who will :o

dr. comment "here can you read this!!) doesn't sound very nice of him to say :(

hope you get a surgery date soon :)

good luck

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Babygirl: I have Medicarecomplet SecureHorizon/Medicare and been calling them for weeks (not covered,not covered,not covered) then one day they said covered I called the doctors office no not covered but but but they they called not covered I call insurance next day yes your covered ,call again yes your covered....call back to the drs office ok I will call right call back they told her no, shecall me says she can send it in if I request but dosent recomend it . I say send it 1/23/13 sent 1/25/13 Drs office gets ok.... surgery Febuary 6, 10:00 AM I dont hold the Drs office at fault we have 2 differnt lines we call and each had there own anwser....DEBI on my way ! ! !

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I think my ins co is trying to kill me off instead of save me. They have me jumping thru so many hoops that's its becoming stressful! Completed all reqs and 6mo nut visits. Paperwork gets denied bcause dr is no longer in network. (how is that when the office verified my ins b4 I started) Now they act like its so hard to find a dr in network that will cover. They keep giving me the run around. But I promise you guys 1 thing....I will not give up! I will find a surgeon on my own! And I will keep my Feb 20 surgery date!

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Sandy did you hear yet call insurance

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OMG.. I HAVE MY SURGERY DATE... PRAISE GOD!! Feb 25th.. I'm so excited right now!!!!

Sent from my SPH-D710 using VST

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Where are you having your surgery in Philadelphia?

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Einstein Bariatrics @ the Elkins Park Hospital on Township Rd..

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I work at UPenn, on the bariatrc unit. Small world.

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I was approved within three days, you should contract the surgeons office or medicare..

Sent from my SPH-D710 using VST

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CALL YOUR INSURANCE....you don't need to wait call everyday.

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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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        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.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        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
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