Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I apologize in advance for what is about to become a novel.

So, some of you may have seen on other posts where I am/was having issues with my insurance company and the uncertainty of when I could actually have my surgery due to odd verbiage in my policy. I called UHC tonight to get names and dates of when I called back in October for my HR rep who has been working with our UHC rep to find out the specifics. That was the ONLY purpose in my call tonight. While on the phone with Patricia, my new best friend, she told me that she wanted to call Clinical Services just to check on the status of my file that I thought SHOULD have been submitted this week. I waited for a few minutes for her to return to the line.

When she came back, she made a statement and told me to write a Case # down, so I did as I was instructed. And paused. After a few seconds of silence, she asked if I was still there. Once my mind wrapped around what she said, I asked "Did you just tell me that I was approved for surgery? I am approved to have the Gastric Bypass? That case # you just read to me is my proof of approval?" To which she responded with "Yes!" Of course, this then prompted the flood gates to swing wide open and allow the tears to fall.

A little back story to help you better understand where I am coming from- I would have to say that my life (27 years young) has been challenging. I don't want pity, because as tough as the trials have been, they truly have made me stronger. They have made me ME! And I'm grateful. My sister was killed in a car accident when I was 8. There was an 18 year gap between us as she was from my father's first marriage. But my mom was basically her mom and played a huge role in her growing up. I never viewed her as a half sibling. She was a single mom of a 3 year old at the time. So, we adopted her son the day she left this Earth and I went from being the baby and 1 of 2 girls out of 3 children, to the middle child and only girl. It was a huge adjustment that I struggled with. My grandfather passed that same year a long with my father having his first heart attack months after. Fast forward a few years, I became involved with a guy who was emotionally, mentally AND sexually (yes- it's possible even if you're in a relationship with the person) abusive. I was 14 and truly believed that the behavior I received from him was due to my own mistakes. I was brainwashed and blind to the severity of the situation. Throw in two more heart attacks for my daddy and open heart surgery for 5 bypasses during this time as well. Children are very impressionable at that age, and it has taken me 13 years to forgive myself for sticking with him for 2 1/2 years. From that relationship, I dove into another one with a guy who was great at first. And then the physical abuse presented. I loved him. I NEEDED him..or so I thought. After all, he was the one who helped me move past my previous relationship. Finally, after a year and a half of hell with him, things ended. These two relationships, all before I was 19 did a huge number on my self confidence and damaged me emotionally.

And then I met my husband. My saving grace. We have been married for 8 years. Things have been tough. We have experienced every hardship imaginable with the exception of infidelity. The biggest challenge being our inability to conceive due to my PCOS. I have wanted to be a mommy for so long and this surgery is my last hope at becoming one.

But the straw that broke the camel's back and contributed to my weight gain began back in 2011 when my daddy was diagnosed with Bladder Cancer. We quickly learned that his diagnosis and prognosis were not promising as the cancer had already metastasized to his bones and his spine/ribcage/shoulder blades were covered in cancer. I literally watched him wither away for an entire year before he passed. I helped Mama as we became his caretakers when he became too weak to care for himself. He passed away 10 days shy of his 1 year anniversary from being diagnosed. On January 18th 2012, I lost my safe haven. And a part of myself. I have ALWAYS been a daddy's girl and did not handle his death very well.

So I tell you that all, to tell you this- I truly did not expect to receive approval. Not on the first attempt or without having to put up a fight first. I have had the cards stacked against me what seems like majority of my life, and believed this would be a similar situation. To hear Patricia confirm my approval....I am in utter shock. I have read a multitude of post on here where people are posting their approvals and surgery dates and while I have been so happy for them, a part of me felt envy. Because I didn't think I was ever going to be THAT person. THIS person. I am so stinkin excited that I don't even know what to do with myself!!

Share this post


Link to post
Share on other sites

Thank you, @@Inner Surfer Girl ! I am ecstatic!!! I can't wait to get the show on the road. :) I'll gladly sit by WHOEVER on the loser's bench. I'm not picky! ;)

Edited by sassyfrass23

Share this post


Link to post
Share on other sites

I'm super happy and excited for you!!!

Congratulations!

????

Now to see how soon you can get on the surgery schedule!!

Start that pre op diet NOW girl!!!

Share this post


Link to post
Share on other sites

Congratulations and good luck on your surgery. One word of caution.

After I was approved and even had a letter from my insurance company stating I was accepted for surgery, I received a notice that indicated I still needed an additional approval. It turns out that I not only needed approval for the surgery but I also needed approval for the number of days I was to be hospitalized after surgery. I found this very confusing because how would the hospital know how long I needed to be in the hospital until after the surgery, since complications could extend my stay. I contacted the surgery team. They told me that it was just a formality and not to worry. I didn't and it was a non-problem.

Share this post


Link to post
Share on other sites

Congratulations! I see brighter days ahead!!

Share this post


Link to post
Share on other sites

Thank you, @@Nurse_Lenora ! I am meeting a friend who had the sleeve by the same surgeon to do my shopping for food, Vitamins, etc! I'll definitely start ASAP! My surgeon told me in January that if my surgery was approved before my February appointment to call in to move it up. So I'll be calling tomorrow morning and hopefully be on the books for March! :D

Thank you for sharing that @@James Marusek . I'll definitely talk with my benefits coordinator about that tomorrow. With the bypass, I have to FOR SURE stay 2 nights. Unless complications arise and require me to stay longer. I'll see if they've already submitted for that approval or when they will.

Congratulations! I see brighter days ahead!!

As do I!! Finally :) thank you!

Share this post


Link to post
Share on other sites

@@sassyfrass23 - Congrats!! It is the beginning for a new life for you!

For what it's worth, I had bypass and only stayed in the hospital one night (barely 24 hours), so unless your surgeon is just very very cautious, you could get to go home after only 1 night!

Share this post


Link to post
Share on other sites

You know, I had a rough start myself. Some up's and many downs. The great thing about life is it does get better. We know better, we do better. What an amazing gift the universe has bestowed upon you! Good luck and enjoy the gift! You deserve it!

Share this post


Link to post
Share on other sites

Thank you @@MsB7 and @@Daisee68 !

My surgeon requires his RNY patients to stay two nights :( he won't budge!

And thank you @@because I feel very blessed to have this opportunity. And as excited I am, my heart hurts for those who want this but don't have it as a feasible option. I don't know what I would have done had insurance denied or not even offered coverage. So so thankful.

Edited by sassyfrass23

Share this post


Link to post
Share on other sites

@"sassyfrass23" I am so excited for you!!! So what's your next step?? Just to schedule the surgery??

Yes ma'am! I'll have another appointment this month, hopefully next week and will be told when to start my 2 week pre-op diet!!

Thank you!!

Share this post


Link to post
Share on other sites

@"sassyfrass23" I am so excited for you!!! So what's your next step?? Just to schedule the surgery??

Yes ma'am! I'll have another appointment this month, hopefully next week and will be told when to start my 2 week pre-op diet!!

Thank you!!

That's exciting!!! So you will probably have surged in March!!

Share this post


Link to post
Share on other sites

I'm am so happy like crazy for YOU!!! I've been following your dilemma and was hoping it would work out. ????!! You've had so much grief, I bet the pre op diet will just fly by and soon it will be !!*THE BIG DAY*!! I'm sending you a big hug ????

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      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! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      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 
      · 0 replies
      1. This update has no replies.
    • 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. 
       
      · 0 replies
      1. This update has no replies.
    • 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.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×