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A big disappointment.



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I finally got the phone call i have been waiting for from the financial reviewer yesterday about the insurance companies decision. I GOT DENIED....WTH.... Seriously how is that even possible. Come to find out my last health care provider didn't schedule me for a full 6 months weight management it was 5 1/2 months.... really. And they said i gained 4.5 ponds then. Plus now my insurance company ( Priority Partners) started a month ago where your required to keep a food log and exercise log.... i was never told this when i was doing all the requirements. So i balled like a baby because this means i will have to start the process and tests all over again. What the insurance company fails to give a crap about is that i have a large ventral hernia that has been causing me pain and health problems since i had a c-section with.my lil girl 2 1/2 years ago. Yet now i will have to wait another 6-8 months for WLS and then another 6-8 months after that for the hernia surgery. Im Soooo frustrated i just want to crawl in a hole and give up. This isn't fair that i have to stay in pain and suffer longer because my old doctor don't know how to freaking Count.

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Do what my mother and I did. We call our insurance to see why we got denied

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Most insurance companies have an appeals process. I would call.

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I can relate to your frustration and pain. I have been battling with my insurance company for a while now. I originally started for a bypass in 2010. Did all of the requirements to meet for the surgery and was denied the first time due to being underweight. Even though, I was applying for the surgery not for weight loss totally, but for other health issues. I did call my Dr.’s office back at the time and had them do an appeal which was eventually approved. However, since the approval the military has changed insurance companies from Tricare to United Health care and I am starting all over again. I am hoping that it will go a bit fast since my health has taken a very nasty turn. Try for an appeal process if the office does them first before you try another 6 months program. However, in the meantime make a point to record your meals, exercise , or any other requirements they need. Find out if they need other diagnostics as well such as a sleep study, EGD, etc…. Don’t give up, this is a bump in the road and you can get past this just stay determined. Best of luck! :D

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I wouldn't have to do the EKG or sleep study and blood work again. My new doc just did EKG n redid my labs and the sleep study I did back in feb of this year and was diagnosed with Severe Sleep Apnea. I did call the insurance company to find out about the appeal process and gave my doctor all the information because he is the one that is required to appeal in writting. Anyway the insurance requires logs but don't have a clue how to obtain them to fill them out. I think that's just another stupid loop hole for another denial. But I'm really frustrated.

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So does anyone know of how to do a blog and post their journey on like fb or something like that

You can do a video blog and chronicle it on youtube. That's what I'm doing. I don't know much about computers but do know how to work my camera phone lol. Best of luck to you.

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Appeal. Have your doctor involved in the appeal. He can write a letter on your behalf. If you can get more than one doctor to do it, even better.

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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.
      · 0 replies
      1. This update has no replies.
    • 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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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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