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Band Removal Approved; BYPASS DENIED!

Bobbe Schu

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armywife79    123

armywife79
Posted

Hey PinkP, I'm so glad to hear your on your way and your not going to be hassled by insurance anymore! I wish I had known about the advocates much earlier on in my situation too but, they really came through in a big way for me! I would use them again in a heartbeat if I ever get another denial. You never know what I may need down the road. If I ever ask for revision I have the feeling I would be in the same boat again. When it comes to WLS, these companies seem to have no issues being out right discriminatory towards us. Lindstrom is really involved with lobbying for new laws regarding our surgical needs. Since obesity is such a nation wide issue, they really do need to amend the laws. Bobbe, let us all know how it goes, I have my fingers crossed for you!

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Cdominguez    26

Cdominguez
Posted

I did the Dr's Diet for 6 months and was approved the program is called Dr's diet hope they have it in your state good luck! ????

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Bobbe Schu    53

Bobbe Schu
Posted

Still waiting. Appeal was filed with UHC 10 days ago. The waiting is KILLING me.

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armywife79    123

armywife79
Posted

I know! They have 30 days to reply and the sure do take the 30! At least your in the home stretch!

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Bobbe Schu    53

Bobbe Schu
Posted

That's exactly what Kelley told me this morning. They really like to make one suffer!

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Pinkgirl1234    761

Pinkgirl1234
Posted

Whenever you feel a flare up see your dr.....document everything.

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Bobbe Schu    53

Bobbe Schu
Posted

DENIED AGAIN! ANOTHER APPEAL! Kelley wasn't surprised. It seems my records were reviewed by a PLASTIC SURGEON!!! Duh!!!

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betrthnever    107

betrthnever
Posted

Bobbi, is this with the weight loss advocates?

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Bobbe Schu    53

Bobbe Schu
Posted (edited)

Bobbi, is this with the weight loss advocates?

Yes. But now we move to the next step. I will not give up, nor will the Lindstroms! So happy to have them in my corner. Without them I would not have pursued this--wouldn't have known I had the choice.

Edited by Bobbe Schu

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betrthnever    107

betrthnever
Posted

I was just approved!! I'm so happy!

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betrthnever    107

betrthnever
Posted

Bobbi, is this with the weight loss advocates?

Yes. But now we move to the next step. I will not give up, nor will the Lindstroms! So happy to have them in my corner. Without them I would not have pursued this--wouldn't have known I had the choice.

maybe its the third time is a charm thing. I wouldn't give up either. I was prepared to contact the Lindstrom group if I wasn't approved.

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Bobbe Schu    53

Bobbe Schu
Posted

Bobbi, is this with the weight loss advocates?

Yes. But now we move to the next step. I will not give up, nor will the Lindstroms! So happy to have them in my corner. Without them I would not have pursued this--wouldn't have known I had the choice.
maybe its the third time is a charm thing. I wouldn't give up either. I was prepared to contact the Lindstrom group if I wasn't approved.
Congratulations! I am so very happy for you! Do you have a date yet?

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Pinkgirl1234    761

Pinkgirl1234
Posted

This is ridiculous!What is your insurance again?

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betrthnever    107

betrthnever
Posted

Bobbi, is this with the weight loss advocates?

Yes. But now we move to the next step. I will not give up, nor will the Lindstroms! So happy to have them in my corner. Without them I would not have pursued this--wouldn't have known I had the choice.
maybe its the third time is a charm thing. I wouldn't give up either. I was prepared to contact the Lindstrom group if I wasn't approved.
Congratulations! I am so very happy for you! Do you have a date yet?

Not yet...I have to talk it over with my SO tonight. We are getting married in December and I'm a little worried about how the surgery might effect my wedding (or how I might feel at my wedding time)

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amaral1407    11

amaral1407
Posted

Hello

I was denied at first for the sleeve revision but was approved for the lapband removal for not having 6 months of nutrional visits. My doctor did a peer to peer conference with the insurance and was approved immediately. I had surgery on 08/31. He sent in all the information on first surgery had the 6 months of nutrional visits and that everytime I went to get a fill or unfill I spoke to nutrionist. Hope that helps!!!! Not sure why people have to hire and advocate cause this is what we are paying our doctors to do. Or at least I found an amazing Bariatric team that did all the leg work for me

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Go To Topic Listing Gastric Bypass Surgery Forums

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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. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
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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
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      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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