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approved after 2 denials!

KSTUZ

By KSTUZ, in Insurance & Financing

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Bobbe Schu    53

Bobbe Schu
Posted

I wish you a very speedy recovery and good GOOD health!!!!

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peteyrulz    82

peteyrulz
Posted

Thanks so much! I am sure the Ls will be successful for you. Kerp in touch!

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aslcertified    86

aslcertified
Posted

oh wow I found the perfect forum, I am working with lindstrom as well. I hired them jan 2016 to help with my case to overturn my denial, but just last week they denied my appeal but lindstrom is not giving up without a fight they are an awesome team. The reason they are saying my surgery was denied bec of net weight gain 1.5 lbs and my surgery was not scheduled within 6 months of initial date. we questioned them over and over again , " when was I suppose to have scheduled the surgery if you already denied right after the 3 month pre-op requirement" ?. all Aetna could do is read my policy to us 20 times UGHHH! . I was so hurt and disgusted by this I could not believe it and I was going over it in my head about everything asking myself, where could things have went wrong? no way 1.5 lbs gained would be such a big deal bec you cant calculate 1.5 lbs as a major weight gain. So many factors can cause a 1.5 gain. clothes , time of month anything etc....... at this point , I was confused and I started to do a little digging on my own today 7/27/16. so, I called my dr office and asked what were my weigh in's which I should have been monitoring and keeping track of everything from insurance coverage to all my weigh in info.
/initial start date 6/2015 240 , 7/2015 245 , 8/2015 242, finial weigh in 9/2015 239.5 .. MY MOUTH DROPPED! ok so where is this 1.5lb weight gain they are talking about, what was the real reason for denial???? so I am thinking the ball dropped with someone or am I missing something here ? has anyone experienced this before?

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Amurillo04    109

Amurillo04
Posted (edited)

C

Edited by Amurillo04

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KSTUZ    438

KSTUZ
Posted

Received call from Aetna and I am now approved for surgery !!!!! ????????????????

Sent from my iPhone using the BariatricPal App

Congrats!! That's the best news! They are amazing and wish you the best of luck!

post-220851-14717250970098_thumb.jpg post-220851-14717250970098_thumb.jpg

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aslcertified    86

aslcertified
Posted

Omg! You look awesome!!! Thank you for the encouragement. Were you nervous before the surgery , How was the first few weeks? @@KSTUZ

Sent from my iPhone using the BariatricPal App

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aslcertified    86

aslcertified
Posted

I am now thinking of a surgery date and the holidays are approaching so maybe End of December or just make the sacrifice and do it end of September , first week of October so it will not be so hard for me during the holidays with family. I just don't know !!!

@@KSTUZ

Sent from my iPhone using the BariatricPal App

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KSTUZ    438

KSTUZ
Posted

Omg! You look awesome!!! Thank you for the encouragement. Were you nervous before the surgery , How was the first few weeks? @@KSTUZ

Sent from my iPhone using the BariatricPal App

Terrified, but it has been the best thing I've ever done.

Just remember this, first few months while your on liquid , purée and soft foods...u will be able to eat ANYTHING you want in a few months. Do not eat what your not supposed too and risk hurting yourself. I kept telling myself this is only temporary. And it was. I'm over a year and a half out.

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KSTUZ    438

KSTUZ
Posted

I am now thinking of a surgery date and the holidays are approaching so maybe End of December or just make the sacrifice and do it end of September , first week of October so it will not be so hard for me during the holidays with family. I just don't know !!!

@@KSTUZ

Sent from my iPhone using the BariatricPal App

I was terrified. But excited!!

I had mine done Jan 5th.

It was the soonest I could get it done.

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aslcertified    86

aslcertified
Posted

Jan is a great month to start and I have 6 months to have this done from yesterday date. Per my advocate , do not have it done at the turn of the year to risk the chance of my ins policy changing and it be excluded Bec I was thinking Jan as the perfect time.

Oh well I guess I have to do what I have to do.

Sent from my iPhone using the BariatricPal App

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aslcertified    86

aslcertified
Posted

Yes I am terrified of the what if's but I must stay positive. I was not so concerned when it was getting denied and trying to fight it Bec it was like i was pushing it off to give me more time to really think about it and now it is actually about to happen , I'm like omg !! This is really going to happen.

Sent from my iPhone using the BariatricPal App

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      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

      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

        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

      CaseyP1011

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

      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!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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