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Denied by BCBS TN

OBXhappy

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OBXhappy    28

OBXhappy
Posted

BBweightlossjourne my apologies. I tried to read your message on my phone and somehow deleted it before I even had the chance to read it. So sorry!

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Zoes.Realm    190

Zoes.Realm
Posted

I am so sorry that you are having so much trouble with this process. I went through a smaller version of the struggle. It took 2 denials and an appeal. Stating everything from I had not excepting the necessary lifestyle changes to i was not mentally stable. I believe that the insurance companies pick random people to push the limits with. Just an option. But you will get there, you are working very hard for what you want.

Sent from my SM-G925P using the BariatricPal App

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OutsideMatchInside    10,166

OutsideMatchInside
Posted

What is your BMI? You don't have any of your information filled out. Are you around 40 BMI?

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OBXhappy    28

OBXhappy
Posted

I am so sorry that you are having so much trouble with this process. I went through a smaller version of the struggle. It took 2 denials and an appeal. Stating everything from I had not excepting the necessary lifestyle changes to i was not mentally stable. I believe that the insurance companies pick random people to push the limits with. Just an option. But you will get there, you are working very hard for what you want.

Sent from my SM-G925P using the BariatricPal App

I can't imaging going through 2 denials and an appeal. It's such a roller coaster. I really thought my surgery would be in March and now here I am still working at getting approved. I'm not going to give up on it. I figure this gives me time to start losing some of my weight so I'm ahead of the game.

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OBXhappy    28

OBXhappy
Posted

What is your BMI? You don't have any of your information filled out. Are you around 40 BMI?

I'm at exactly 40 and I have a comorbidity so I could actually lose a bit and should still be okay. Truthfully, I'd love to lose it and keep it off without the surgery. Through experience I'm pretty sure that won't happen.

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OBXhappy    28

OBXhappy
Posted

What is your BMI? You don't have any of your information filled out. Are you around 40 BMI?

Wow! OutsideMatchInside. I just saw your weight loss. That is fantastic. You must feel fantastic about your success in such a short time.

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Zoes.Realm    190

Zoes.Realm
Posted

I am so sorry that you are having so much trouble with this process. I went through a smaller version of the struggle. It took 2 denials and an appeal. Stating everything from I had not excepting the necessary lifestyle changes to i was not mentally stable. I believe that the insurance companies pick random people to push the limits with. Just an option. But you will get there, you are working very hard for what you want.

Sent from my SM-G925P using the BariatricPal App

I can't imaging going through 2 denials and an appeal. It's such a roller coaster. I really thought my surgery would be in March and now here I am still working at getting approved. I'm not going to give up on it. I figure this gives me time to start losing some of my weight so I'm ahead of the game.
I know how that is, I thought my surgery was going to be last August but it did not happen until March 16th. It gave me even more time to make sure this is what I wanted. There is always a reason for everything that happens. You will get your approval when you least except it and it will be when it's the best possible time. Keep me updated.

Sent from my SM-G925P using the BariatricPal App

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OBXhappy    28

OBXhappy
Posted

I am so sorry that you are having so much trouble with this process. I went through a smaller version of the struggle. It took 2 denials and an appeal. Stating everything from I had not excepting the necessary lifestyle changes to i was not mentally stable. I believe that the insurance companies pick random people to push the limits with. Just an option. But you will get there, you are working very hard for what you want.

Sent from my SM-G925P using the BariatricPal App

I can't imaging going through 2 denials and an appeal. It's such a roller coaster. I really thought my surgery would be in March and now here I am still working at getting approved. I'm not going to give up on it. I figure this gives me time to start losing some of my weight so I'm ahead of the game.
I know how that is, I thought my surgery was going to be last August but it did not happen until March 16th. It gave me even more time to make sure this is what I wanted. There is always a reason for everything that happens. You will get your approval when you least except it and it will be when it's the best possible time. Keep me updated.

Sent from my SM-G925P using the BariatricPal App

When I started this process back in July I couldn't understand when people said the 6 month wait was a good thing. I was prepared and wanted it NOW. I can't say that I felt the 6 months of nutrition appointments were helpful but, for some odd reason since the denial I've accepted that it is going to happen it will just not be on my time schedule. In the past week since the denial I've eaten healthier than I did during the whole nutrition experience. For some reason that stressed me out and I'm a stress eater.

Thank you for your comments. It is appreciated.

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FocusOnMeNow    599

FocusOnMeNow
Posted

1) collect and send in your own paperwork if stuff is missing 2) get on medically supervised diet for 6 months 3) you must have weighed in higher at some doctors appointments sometime in the past OR just finance your surgery and get on with it. I had no choice and honestly you all go through hell trying to get insurance to cover it. And yes I will own one less car in my life and the car I currently have will have to last me another 5 years, but it's worth it. It's the best thing I ever did. Also is your current doctor a bariatric surgeon or some other kind of doc? Bariatric surgeons offices are usually very good about the paper work because they only get paid right if the paperwork is right. Good luck[emoji4]

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OBXhappy    28

OBXhappy
Posted

@@FocusOnMeNow I've already been through the 6 months of nutrition visits. I don't have the patience for insurance appeals, and yet the thought of self pay angers me. Like most people I pay a large amount of money for insurance. I've hired an attorney to do the appeals process for me. It isn't a guaranteed positive result, but I'm sure their success with an appeal will be much greater than my efforts at one would have been.

Your results are fantastic and perhaps I will end up being self pay. I will fight the insurance battle first before I make that decision.

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OBXhappy    28

OBXhappy
Posted

Isn't it said that with WLS you are expected to lose 60% to 90% of excess weight? But you seeking to lose 25 pounds?

Sent from my iPhone using the BariatricPal App

Insurance requires a 10% loss which is 25 lbs. My goal is to lose 100 lbs.

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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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