My surgeons office just called me. I was denied. She said she has never experienced this before with my insurance plan. They gave two baloney reasons

First that my blood pressure needs to be higher even though I'm on medication??? WTH does that even mean?? They want to see a constant of 140 over (I don't remember the number) while trying to be controlled

Second. I have not lost enough weight. I'm down to 199 if I get any lower I will now qualify.

I started loosing weight on my own at 245 lbs. I originally went to the bariatric center to get help with medication weight loss. That was when I found out I had high blood pressure and the dr said definitely no she would not give me medication to aid in my weight loss. They took that weight 215 and compared it with the next weight they had 9 months later ( once I decided to go for surgery) I had gained 9 pounds...over the period of 9 months.

Sorry if I'm all over the place with this I'm just so upset. My dr has had to up my high blood pressure medication once because it was not working. I have a appointment with her this afternoon to see if she can fax that to my surgeon. The bariatric center has 14 days to fight it. If they don't win it's a definite denial. My surgeon is going to do an eye to eye?? With the insurance.

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@JazzyJay: Don't be so hard on yourself!!! That's going to cause your more stress & a higher BP! lol Before this you thought your Dr was managing it with meds, now you know better. Yes a high BP can cause headaches, so can stress. Too much meds can cause dizziness & fainting, so it's a fine line to walk for a Dr. If your BP has been lower when you go in for your exams, they may have thought they were prescribing correct dosages. But since you have a high amount of stress in your life, that prescription just isn't cutting it. Again, don't be so hard on yourself. This is a learning tool, now you know. I have hbp & I don't check mine daily, but I can tell when it's off & I check it then. I've been dealing with it for 14 years. Cutting the stress from your life is the best thing you can try to do at this point! Both for your BP & your weight/surgery. Cutting Stress is a major factor is helping to overcome major obstacles in life. ❤️

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Thank you! I needed to hear that. My dr gave me a blood pressure monitor. Now I can check it daily at home. She also upped my dosage and added a new medication for hbp. She also gave me a script for my headaches. Thank the Lord. And because she is such a good dr. She faxed a letter to my surgeon. Now my surgeon will have something in her bag of magic to do the peer to peer. I guess it's just a waiting game now. Fingers, toes and eyeballs crossed

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@JazzyJay: I have headaches & migraines too. I have a couple conditions besides being overweight & one causes migraines & puts pressure on my optic nerve causing vision problems. Losing weight helps relieve the symptoms. I had lost 65#, but I've put it all back in once they removed me from the medication I was on which helped the symptoms & also helped with weight loss. I'm back to square one again, vision disturbances & headaches.

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Great job with the 65 lb loss. That just shows you can do it again. But even better

Yeah headaches can be so debilitating. I couldn't imagine them along with vision problems.

Where are you at as far as your surgery?

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@JazzyJay: I went for the initial consult last February, but my husband was totally against it & talked me out of it. I've gained weight since then, & am even worse off so I called & set up another consult for next Friday to restart the process. I'll meet the new surgeon, a nutritionist & the Patient Advocate I met with last time all next week. I haven't told my husband yet. He's going to be mad I set this up behind his back without discussing it with him, and rightfully so, I just don't want him to talk me out of it again.

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That is wonderful of your Dr to give you the monitor, adjust your meds & send the paperwork to your surgeon. She obviously is very supportive of you having this procedure done! My primary Dr is horrible. I need to find a new one, but I live in a fairly rural area & don't have much to choose from. The Bariatric facility I'm going to is about 1.5 hrs away in Cleveland. I seriously doubt my Dr would support this procedure if it comes down to it.

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@JazzyJay: I'm sorry it took so long to reply, my kids both had Choir concerts tonight & we just got home a bit ago & had dinner.

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Edited December 8, 20169 yr by laurak814

That is wonderful of your Dr to give you the monitor, adjust your meds & send the paperwork to your surgeon. She obviously is very supportive of you having this procedure done! My primary Dr is horrible. I need to find a new one, but I live in a fairly rural area & don't have much to choose from. The Bariatric facility I'm going to is about 1.5 hrs away in Cleveland. I seriously doubt my Dr would support this procedure if it comes down to it.

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That sucks you don't have support from your dr. Or for that matter a different one to choose from. After my dr saw my most recent weight loss she questioned if I should have the surgery at all. I explained why and she supported my decision. Which is awesome. I don't really "do" dr.s. I find them very hard to trust due to false information that led to my father's death, but I got lucky with her.

I moved to Omaha from California 2 years ago. I assumed it was going to be pretty rural. It's not. It's a decent size metropolitan city which is nice.

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@JazzyJay: I went for the initial consult last February, but my husband was totally against it & talked me out of it. I've gained weight since then, & am even worse off so I called & set up another consult for next Friday to restart the process. I'll meet the new surgeon, a nutritionist & the Patient Advocate I met with last time all next week. I haven't told my husband yet. He's going to be mad I set this up behind his back without discussing it with him, and rightfully so, I just don't want him to talk me out of it again.

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Good luck with your appointment. Do you have to start over?

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@JazzyJay: I'm sorry it took so long to reply, my kids both had Choir concerts tonight & we just got home a bit ago & had dinner.

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No worries

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I won't be able to talk today. I am sub teaching.

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My surgeon got my denial reversed today at the peer to peer!!! Super excited.

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@JazzyJay: Yahoo!!! That is fabulous news! I'm so excited for you! I've been wondering what was going on today. Do you know what she had to do/say to get it reversed?

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@JazzyJay: Yahoo!!! That is fabulous news! I'm so excited for you! I've been wondering what was going on today. Do you know what she had to do/say to get it reversed?

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Yaaaayyyy!!! Thank you. My primary dr faxed my surgeon a letter explaining my hypertension and how she has had to up my meds and add meds. She also said my BP is uncontrolled and I am at high risk for other health problems to follow. I'm not sure exactly what my surgeon said to my insurance company but her nurse told me she kicked ass! Next week I go in for my pre-op blood work and I get scheduled for surgery. Best Christmas Evererrrr????????

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My surgeon got my denial reversed today at the peer to peer!!! Super excited.

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I am so excited for you.

Cocoon to Butterfly

My surgeon got my denial reversed today at the peer to peer!!! Super excited.

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I am so excited for you.

Cocoon to Butterfly

Thank you so much. I was prepared to fight like you did! Thank God I didn't have too.

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