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Oh my... Insurance submitted!!

SillyWillyMommy

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SillyWillyMommy    2

SillyWillyMommy
Posted

Eeeks... I'm so much more excited than I thought I would be... I am anticipating this SOO much... My doc just told me she submitted my case to the insurance company... and if I get approved, my date would be May 16th... However, she did mention that I shouldn't completely count on it, because they often get rejections on the first submission... but almost ALWAYS get approved the second time.

YAY!!!

:clap2: :clap2:

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musicalmomma    1

musicalmomma
Posted

Eeeks... I'm so much more excited than I thought I would be... I am anticipating this SOO much... My doc just told me she submitted my case to the insurance company... and if I get approved, my date would be May 16th... However, she did mention that I shouldn't completely count on it, because they often get rejections on the first submission... but almost ALWAYS get approved the second time.

YAY!!!

:clap2: :clap2:

I know exactly how you're feeling!!!! They sent my file in on the 13th and on the 23rd it was approved!!!! I couldn't believe it!!!! I don't get my date until the scheduling nurse calls me and they said that can take up to a week because there are 10 patients ahead of me. But Dang! It's a GREAT feeling!!!! Keep us posted!!!!!

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faithmd    14

faithmd
Posted

How awesome for everyone!!!

I just saw my PCP today and weighed in, and I'm below what my insurance company wanted me to be!!! WOOHOO!!!! So now I just wait for my PCP to send her office note with the proof of my new weight to the surgeon, and for them to fax it in to the insurance company. I've already talked to my case manager this morning and she says she'll be looking for it in the next couple of days. I was denied the first go-round because I hadn't lost enough weight, but I dropped almost 18# this month.

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faithmd    14

faithmd
Posted

Awww, thanks. But the last week or so all I've been eating is slimfast low-carb shakes and chopped fresh veggies and salads. So I'm sure to gain a little once I bump from my now nearly 800-900 calories a day back to my approx 1500-1700 a day. I had to make 335 by today, in order to get approved, so I had to do something drastic.

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SillyWillyMommy    2

SillyWillyMommy
Posted

Hey Thanks, Drew's Lou... and Faith.. it doesn't matter WHAT the motivation was.. you still rocked it, girl :-) Way to go... So, did you make it to your goal, 335?? I still totally cannot get how someone can tell someone that they are too big for weight loss surgery... That's like saying your cholesterol is too high to be treated. Duh.

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faithmd    14

faithmd
Posted

Hey Thanks, Drew's Lou... and Faith.. it doesn't matter WHAT the motivation was.. you still rocked it, girl :-) Way to go... So, did you make it to your goal, 335?? I still totally cannot get how someone can tell someone that they are too big for weight loss surgery... That's like saying your cholesterol is too high to be treated. Duh.

I was 330.4 when I stepped on the scale this morning at my PCP's. WooHoo!

I get the fact that the insurance company wants you to lose something on your MD supervised diet to show that you can follow orders, but... My ins co requires a 12 month MD program and 5% loss of your excess weight. Which for me would have been about 9#. My starting weight was 344, but over the course of the year I got sick and was off work and on meds that made me very sedentary for almost five months. Well, I gained lots of weight. My ins co said that the letter my cardiologist and the letter my PCP wrote (both saying that it wasn't my fault and that I am losing now that I'm fixed) were not convincing enough and that I had to lose all I gained, plus the original 9#. I had gained to 371, so I had to lose back to the 344, then the additional (original) 9#. I applied last month at 348 (down from the high of 371, but still up from the original 344) and was denied. So for the last week I have been drinking one or two SF low carb shakes or EASAdvantEdge drinks or Atkins drinks and eating salads and chopped veggies and 1/2 cup of cottage cheese a day. It wasn't awful, but I wanted to slather some A-1 sauce on the arm of anyone close to me and start gnawing. So now that I've "weighed in" and it's official, I'm heading to Outback! I'm on my way right now. Though I will not be having a potato, probably only one little piece of bread, if any, and no dessert. I just want a big slab of meat! :rolleyes:

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faithmd    14

faithmd
Posted

Okay, maybe a little of a Bloomin' Onion! But honestly I've changed my eating habits so much that the "bad stuff" doesn't really interest me anymore! (Never thought I'd say that!)

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SillyWillyMommy    2

SillyWillyMommy
Posted

I just called my insurance company........... and I've been approved!!!! I'll be having my surgery on May 16!! I am so excited, I am jumping up and down as we speak!!!!!!

....and congrats on meeting your goal, Faith!

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faithmd    14

faithmd
Posted

I just called my insurance company........... and I've been approved!!!! I'll be having my surgery on May 16!! I am so excited, I am jumping up and down as we speak!!!!!!

....and congrats on meeting your goal, Faith!

Thanks and...

:wow2: :) :welldone: :lol: :waytogo: WOOHOO!!!!!!!!

HOORAY!!!!!!

I can't wait to hear myself!

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MEW    0

MEW
Posted

CONGRATULATIONS to both Faith and SillyWilly!!!!

I'm just as excited for the both of you as I was for myself when I got my approval!!

(My surgery date is May 23!!)

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

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    • Eve411

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      April Surgery
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      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
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    • KeeWee

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      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 
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    • Aunty Mamo

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      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. 
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    • 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
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      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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