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Finally!

BrookeM07

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BrookeM07    17

BrookeM07
Posted

I have been reading thru these forums for over six months now, and I'm finally posting my own thread!

I have been overweight my whole life. I have non-alcoholic Liver Disease that consists of Fatty Liver & several hepatic adenomas, PCOS, Metabolic Syndrome, Insulin Resistance, Leukocytosis, Infertility, Severe GERD, IBS, Chronic unspecified inflammation in the body, the list really goes on and on. On top of my own co-morbidities, I have a very very strong family history of Heart Disease & Diabetes. I thought about pursuing Bariatric Surgery a couple years back, but after doing research, I talked myself out of it because I didn't want to have to wait ANOTHER 18-24 months to conceive. Well, after 6 months of fertility therapy & horrible side effects, I decided I needed to stop and reassess the situation. I went thru all my requirements, and submitted my Pre-Auth to insurance in March '16, to be denied 2 weeks later due to lack of support from my PCP. My Primary is very "old fashioned", and doesn't believe in "Non-Traditional Weight Loss", so I was left hanging & she would not right up a letter of medical necessity or provide documentation that I have been actively trying to lose weight for the past umteen years. So, I ended up going to my Bariatric Center & just doing another 3 months of NUT appointments to add on to everything I already had to HOPEFULLY achieve requirements while by-passing my PCP.

My appeal was submitted June 10th, and I was getting multiple responses for "Wait time" from my insurance. One person said it was the standard 7-10 days, and then another said that an appeal isn't the same thing as a pre-auth, and they are allowed 30 days. At this point, my lab work is getting worse; liver is getting worse; retaining ridiculous amounts of fluid; CRP is thru the roof; in ER with sky-high WBC; I just need this done! Just got word from my insurance today that my denial has been overturned and I have been APPROVED!

Going thru these threads for 6 months, I never understood why people cried when getting the approval. I now understand... Something that seemed so unobtainable the last few months is finally real. It's my Holy Grail honestly.... I woke up today just having an awful morning & that 1 phone call just turned my day upside down. My golden birthday is 1 week from today (27 on June 27th), and this by far is the best present ever!

Now, to just wait on a date! So many happy tears in my cubicle today!

-Brooke

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James Marusek    5,244

James Marusek
Posted

Congratulations and good luck on your upcoming surgery. Let us know if we can be of any help. :) ;) :P :D :lol: B) :rolleyes: ;-)

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Djmohr    6,965

Djmohr
Posted

@@BrookeM07

First, congratulations!!!!!

Isn't it crazy that once we make the decision to move forward and hit road blocks it causes such distress? I can remember crying when things would get held up because of some stupid mistake that was made to hold me up along the way.

I am not a cryer!

It is a crazy roller coaster but so very worth all the effort to get through the process. I think it is made difficult to ensure you are very serious about moving forward. In my opinion this is mostly because the hard work has to come from each patient. WLS is not a miracle cure for obesity. It is simply a tool that with very hard work from us, will create a miracle.

Never in a million years did I think I would lose all of my weight through the process but I did. I look fantastic, feel even better and all of my comorbitities are gone.

I wish you the very best of luck and hope that all of your dreams come true and ultimately you are able to conceive!

You are on your way to a whole new life and let me tell you life at a normal weight is grand!!!! Congratulations for working hard to get through this first hurdle.

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BrookeM07    17

BrookeM07
Posted

Thank you, I imagine I will be coming back with more once I get my date & everything!

Congratulations and good luck on your upcoming surgery. Let us know if we can be of any help. :) ;) :P :D :lol: B) :rolleyes: ;-)

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BrookeM07    17

BrookeM07
Posted

A roller coaster ride of emotions is definitely an understatement! Now that it's "Real", these feelings have intensified. I'm excited, hopeful, overwhelmed and just downright scared sh*tless!

@@BrookeM07

First, congratulations!!!!!
Isn't it crazy that once we make the decision to move forward and hit road blocks it causes such distress? I can remember crying when things would get held up because of some stupid mistake that was made to hold me up along the way.
I am not a cryer!

It is a crazy roller coaster but so very worth all the effort to get through the process. I think it is made difficult to ensure you are very serious about moving forward. In my opinion this is mostly because the hard work has to come from each patient. WLS is not a miracle cure for obesity. It is simply a tool that with very hard work from us, will create a miracle.

Never in a million years did I think I would lose all of my weight through the process but I did. I look fantastic, feel even better and all of my comorbitities are gone.

I wish you the very best of luck and hope that all of your dreams come true and ultimately you are able to conceive!

You are on your way to a whole new life and let me tell you life at a normal weight is grand!!!! Congratulations for working hard to get through this first hurdle.

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j16    166

j16
Posted

Congratulations!!

Sent from my iPhone using the BariatricPal App

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CeeGee    30

CeeGee
Posted

Congratulations! My surgery date is on your birthday. . I'm glad you got the approval and excited for you because I know how excited I am. I wasn't going to tell anyone at work but I find I'm telling everyone now.

Sent from my iPhone using the BariatricPal App

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BrookeM07    17

BrookeM07
Posted

Thanks everyone! It is still somewhat surreal to me! Still waiting on my Surgeon's office to get back to me to schedule the actual date, so that is adding a little more anticipation to the situation :/

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GBLady41    393

GBLady41
Posted

Congratulations!

Sent from my iPhone using the BariatricPal App

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Shrinkinqtpi    202

Shrinkinqtpi
Posted

@@BrookeM07 we are in the same exact place. Good luck!!!!

Sent from my iPhone using the BariatricPal App

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Mysticpink74    50

Mysticpink74
Posted

Have a date yet? If so how long after insurance approval did it take to sched surgery?

Sent from my iPhone using the BariatricPal App

Thanks everyone! It is still somewhat surreal to me! Still waiting on my Surgeon's office to get back to me to schedule the actual date, so that is adding a little more anticipation to the situation :/

????

Sent from my iPhone using the BariatricPal App

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BrookeM07    17

BrookeM07
Posted

Congratulations!!

Sent from my iPhone using the BariatricPal App

Thank you!!

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BrookeM07    17

BrookeM07
Posted

I'm really hoping to get my surgery in by the end of July, but my surgeon is out of the country for the rest of June, and they won't even put me on the schedule until he is back in office.

@@BrookeM07 we are in the same exact place. Good luck!!!!


Sent from my iPhone using the BariatricPal App


No date yet- I'm really hoping to get my surgery in by the end of July, but my surgeon is out of the country for the rest of June, and they won't even put me on the schedule until he is back in office.

Have a date yet? If so how long after insurance approval did it take to sched surgery?


Sent from my iPhone using the BariatricPal App

Thanks everyone! It is still somewhat surreal to me! Still waiting on my Surgeon's office to get back to me to schedule the actual date, so that is adding a little more anticipation to the situation :/




Sent from my iPhone using the BariatricPal App

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pammieanne    269

pammieanne
Posted

Oh wow! Congratulations!!! Can't wait to hear when your surgery date is!

Hang in there! This nightmare is almost over!

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    • BeanitoDiego

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      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
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