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I am so discouraged. My surgery was denied. It's scheduled for a week tomorrow. (Dec 17) I am hoping the doctors office some how gets this approved but I am so upset. I've already a week into my liquid diet and down 12 lbs and 7 inches and all I want in my life is to continue this path and I'm going to be so devastated if if doesn't get approved. I need to have surgery before Jan 1st because my out of pocket is met so there will be no money out of pocket for me. I can't afford it next year my OOP is 3750 and I'm getting married in October. I just don't have the money. I'm so heartbroken. Sorry for the complaining. I just needed to vent to people who understand.

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Was there a reason it was denied? I'm self pay so I guess I never thought of being denied as an option as long as I passed all the Tests and lost the pre surgery weight...

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Ooooh i feel you. I need mine this year for oop reasons as well.my surgery is Monday. If i got denied right now after being on pre op for 10 days id easy life a maniac for my sadness but stay strong and fight girl you've come toooo far.

Ooooh i feel you. I need mine this year for oop reasons as well.my surgery is Monday. If i got denied right now after being on pre op for 10 days id eat like a maniac for my sadness but stay strong and fight girl you've come toooo far.

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Was there a reason it was denied? I'm self pay so I guess I never thought of being denied as an option as long as I passed all the Tests and lost the pre surgery weight...

According to my insurance that they didn't get any of the needed information. Like pcp approval, nutritionist visits, and whatever else I forget but my surgeons office said they sent everything in. So I am just so confused and upset.

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Ooooh i feel you. I need mine this year for oop reasons as well.my surgery is Monday. If i got denied right now after being on pre op for 10 days id easy life a maniac for my sadness but stay strong and fight girl you've come toooo far.

Ooooh i feel you. I need mine this year for oop reasons as well.my surgery is Monday. If i got denied right now after being on pre op for 10 days id eat like a maniac for my sadness but stay strong and fight girl you've come toooo far.[/quote

That's how I'm feeling right now. I literally just want to shove my face with a Big Mac bc I am so frustrated. I am not enjoying these shakes but I am doing so well on them , but all I can think of is that there is no point anymore. I'm hoping when I speak with the insurance coordinator tomorrow she has some game plan. She needs to work for her money now. I did everything I needed, so now she needs a to get it approved

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Don't be discouraged. I was denied right after completing everything the insurance company wanted me to do. They forced me to have 2 additional nutrition visits and then gave me 30 days to have it done. My physician's office worked hard on my behalf and helped me get those appointments in. I'm now approved but my insurance now said I must get it done in this calendar year and they told me that only 2 weeks ago. I felt discouraged because my surgery date is January 13th. Just stay on track and don't worry too much. It will work out for you.

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Just a bit of a rant, I keep reading people post over and over again how they can't afford the surgery if they have to pay out of pocket. Let's get real for a second. Such claims are patently false. Thousands of people go to Mexico each year and pay for their own surgery. Countless others do self-pay in the states. Not everyone is wealthy yet the majority of people who are dedicated to the surgery will find a way to pay for it if they must. I managed to raise enough for my surgery in Tijuana without having a steady income. You can do it as well just change your mind set and don't let obstacles stop you. If all your avenues are denied then you can save enough money to have your surgery out of pocket.

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Just a bit of a rant, I keep reading people post over and over again how they can't afford the surgery if they have to pay out of pocket. Let's get real for a second. Such claims are patently false. Thousands of people go to Mexico each year and pay for their own surgery. Countless others do self-pay in the states. Not everyone is wealthy yet the majority of people who are dedicated to the surgery will find a way to pay for it if they must. I managed to raise enough for my surgery in Tijuana without having a steady income. You can do it as well just change your mind set and don't let obstacles stop you. If all your avenues are denied then you can save enough money to have your surgery out of pocket.

Normally I don't engage in conflicting opinions because everyone has their own but felt I needed to share the other side of yours. In today's economy there are many people who live pay check to pay check. A few thousand dollars doesn't come easy in today's world unfortunately. The frustration for people to think they'll have insurance coverage then realize they don't and be faced with the prospect of raising this money on their own is overwhelming and frankly they have the right to be sad and frustrated. Your way isn't always possible. I like your thought, it's just not always viable. Especially not in a quicker time frame which most are aiming for.

Edited by HopeandAgony

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Was there a reason it was denied? I'm self pay so I guess I never thought of being denied as an option as long as I passed all the Tests and lost the pre surgery weight...

According to my insurance that they didn't get any of the needed information. Like pcp approval, nutritionist visits, and whatever else I forget but my surgeons office said they sent everything in. So I am just so confused and upset.

Same thing happened to me. Doctors office didn't make sure everything was received and it wasn't so I waited two weeks and was denied. Then had to resubmit and wait 30 more days on an appeal. Thankfully this all happened to me back in October -November and I got approved December 2. I feel your pain there's nothing in the world worse than trying so hard to make a positive change then being shot down on a technicality!! Praying it works out for you!!

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Just a bit of a rant, I keep reading people post over and over again how they can't afford the surgery if they have to pay out of pocket. Let's get real for a second. Such claims are patently false. Thousands of people go to Mexico each year and pay for their own surgery. Countless others do self-pay in the states. Not everyone is wealthy yet the majority of people who are dedicated to the surgery will find a way to pay for it if they must. I managed to raise enough for my surgery in Tijuana without having a steady income. You can do it as well just change your mind set and don't let obstacles stop you. If all your avenues are denied then you can save enough money to have your surgery out of pocket.

I am quite aware people go to mexico every year to get this surgery done. And that surgery still costs more than my OOP. There are many sides to things and you don't know my whole life story. So to insinuate that because I can't afford it next year that I'm not committed is rude and unnecessary. If you need to know I am on disability right now due to having a revision of my cervical fusion . So I cannot work and I don't get paid my full paycheck being on disability with my job. I am on my last legs with my job since they want me back to work and I can't being I am in a neck brace and can't move my neck. I am STILL paying off a medical bill from January which applied to my OOP because I had a lot of problems due to my neck before we found out the issues. I am getting married in October out of the country so I need to pay for a destination wedding. I could ask my parents for the money but I am 28 years old and I am trying to be an adult, and this was just rude. You do not know my story or why I wouldn't be able to afford. I commend anyone who does self pay. But I myself cannot when I am going to be starting a new life with someone. Thanks for your input.

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For the record....I have a GREAT paying job and I am good at budgeting but if my insurance denied me, I would never be able to afford this with my mortgage, student loans, car payment, etc.

Everyone's situation is different. Hope everything got worked out @@kdelrosso

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Thanks for the support everyone ❤️❤️❤️it finally got approved yesterday so my surgery is on Thursday and I am so excited to start this new journey !!!!

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Congrats!!

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Thanks for the support everyone ❤️❤️❤️it finally got approved yesterday so my surgery is on Thursday and I am so excited to start this new journey !!!!

Awesome! Good luck to you!

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Congrats!!!!

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    • Aunty Mamo

      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. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
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    • 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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    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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