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My journey is begining and a little rant



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Tomorrow I will have my first appointment with my surgeon. To say that I am excited is an understatement. I made my decision 9 years ago to have the surgery done. I have been over weight my whole life except once when I was going through a very messy divorce. During the 9 years a lot has happened. I became a first time mom at the young age of 53 to not one but 2. No I did not give birth we are adopting. I had a complete hysterectomy at the age of 25 so being a mom was never on my list but I did pray for a child of my own. I know that my age may play a factor, but I want a better quality of life and I want to see my children graduate. My husband is very supportive and wants what is best for my health. I have dealt with fibromyalgia for the last 20 years plus I am watching my fasting blood sugar go up. Diabetes is huge in my family history and it scares me to see it go up.

I had an appointment with another clinic and was informed that I would only qualify for their medical weight loss and not the surgical. I informed them of my choice (my BMI was 39.9) I went back 6 weeks later, I had quit smoking (I smoked for 45 years) and I gained 12 pounds in 5 weeks. The nurse practitioner Add to dictionary informed my that there was people that gained weight just to have surgery. My BMI was now 41.2 and again I stated I was wanting the surgery and she informed me that the surgeon would not do the surgery and I would have to wait another six months to even be considered. I was very upset when I left so I called my insurance company (my benefits had already been confirmed that this was a covered procedure). Did I ever get a surprise, not only did I have someone that would listen, they called the clinic asked if they had a problem explained what had happened and recommended that I look for another clinic and found one for me. Tomorrow is that appointment along with appointments with the physiologist and dietician. By the way the other clinic called this week to inform me of the different surgeries that are now available to me.

Yes I feel like this is a long post but there is a lot on my mind today.

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Stay strong... 👊

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Good for you for sticking to your guns, CharlyScott! You knew what you wanted and didn't allow the nurse practitioner to steer you in another direction. You were smart to call your insurance company and get that matter straightened out. I am just starting out in this process and have also been given information that doesn't sound correct and will be calling my insurance company. May God bless you in your journey to good health.

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So happy for you!

My kids are a huge motivator for me. Not only do I want to be here, but I want to set a good example and be active in their lives as they grow.

Also, good for you quitting smoking. You probably added years to your life with that big decision.

I hope your appointment goes well and that you are in the path to a healthy weight real soon :)

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It's nice to hear a good story about an insurance company! Glad you stuck to your guns and will get this done.

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A little update. My appt went wonderfully I am excited about the clinic. Everyone was very friendly, professional, and answered my questions and concerns. All I am waiting on is final insurance approval. I am super excited


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9 hours ago, CharlyScott said:

Another update from me. My date is June 5. Really excited.

That is great!!! You have to be your own advocate my sister taught me that.

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I really like seeing someone switch doctors and take control of their healthcare.

Medicine in America is a for profit business. If they can drag you through 6 months of visits and then do surgery when medical weight loss fails and they know it will fail. They get to double dio and milk your insurance.

It is more cost effective for your insurance to get you to surgery as soon as possible.

Congrats on the adoption. My grandparents adopted my mom in their 50s and I am so grateful they did. They had so much love to share. Older parents make wonderful parents. Thank you for adopting.

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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.
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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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