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Insurance Approval Jitters



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So I just found out today after meeting with my surgeon that I have to lose 15 lbs in 6 wks for my next app on Sept 1. If I have lost it by then he will set surgery up for 3 wks after that. So not really excited right now cause I have to wait 2 more months :(

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So I just found out today after meeting with my surgeon that I have to lose 15 lbs in 6 wks for my next app on Sept 1. If I have lost it by then he will set surgery up for 3 wks after that. So not really excited right now cause I have to wait 2 more months :(

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I know it's disappointing but hang in there. It will be here before you know it and you will be down 15!

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I have already had 2 nutrition appts and planning the last for November 1st. I will also be calling my case manager to have my file submitted immediately as, my goal, is to go ahead and start the two week preop diet in the day following that last appt, call the insurance for updated daily and be ready the minute we get the approval!

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So I'm kinda frustrated, I had my appointment a week ago and while I don't expect an approval in that time frame I had expected that my paperwork be at least submitted to my insurance. And to make it worse I've been calling the surgery center who is supposed to handle that and they don't answer their phones ever, return voice mails (i only left one) or emails for that matter. I was finally able to get all my shopping n such done for my low carb diet to start for the next 5 weeks. I waited to start after my birthday. Today is day two and I feel so worn out and tired. No sugar no bread no soda hardly any caffeine. Trying to stay around 30g of carbs a day. Wish I would feel better. When do the cravings go away???

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Congratulations ❤️

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So I've been reading this thread and I know its been a while since you posted, buuut I just have to know what came of all this for you?! Lol it's like someone tore the last pages out of a novel and i need to know the ending lol did you get your surgery? I wonder about every one on here i would LOVE an update if anyone's got the time!!!




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Hi! Yes.....got a different patient advocate and was approved! Surgery date was 12/1 so I got it done last year and the cost was zero since I had met deductible and my max out of pocket! Since starting the 6 month approval process to today I'm down 60 lbs! Thank you for asking! ?

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Hi! Yes.....got a different patient advocate and was approved! Surgery date was 12/1 so I got it done last year and the cost was zero since I had met deductible and my max out of pocket! Since starting the 6 month approval process to today I'm down 60 lbs! Thank you for asking!

WOW CONGRATS!! Thanks for the feedback, I look up to all of you who have been thru it so i can remind myself "it can and WILL happen for me too"!! Lol KEEP up the awesome success!



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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.
      · 0 replies
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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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