Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Anyone doing the pre- auth requirements ? Looking for a buddy.



Recommended Posts

Hi. I am going through the pre- authorization requirements for the gastric sleeve. I am eating way more than I should. I have such bad anxiety about possibly not getting approved, or being approved and actually going through with this. I am looking for anyone either in my position or who have been there and want someone to talk to ! I am freaking out.

Share this post


Link to post
Share on other sites

I was in this exact situation. I was thinking am I going to put in all this effort and then just get denied. Plus it took me a full 6 months before they are able to put in for approval. Matters how many weigh in months the insurance company requires before they can submit for approval.

I had to do 6 months of weigh ins plus see a million other doctors for approvals before they are actually able to put in the request from the insurance company, so you won't know right until the end. The good news is, even if you get denied the first time, I have yet to hear of anyone that wasn't approved right away after challenging it.

I ate like a friggin beast too because I didn't want to lose weight and them come back and say hey you don't need the surgery. I ate everything and anything for the longest time, I gained weight for the weigh in months period. I had so much anxiety and also depression saying am I doing the right thing because I had to maintain my high weight level which was very uncomfortable for me. I had trouble just doing daily activities which sucked. Also it doesn't put you in a healthy mindset because you can't really go on a healthy fitness routine and lose a lot of weight for the 6 moths if you want the surgery. So its kind of a mental battle and frustration......

Hang in there, it will be surgery time before you know it....

Share this post


Link to post
Share on other sites

Thank you so much. That is exactly how I feel ! My BMI was right at the cutoff when I started 35 ( because I have health issues too ) and when they weigh me with clothes around 37- 38. I was scared that if I even peed too soon before the weigh in I would not pass so I have just been eating. I have gained at least 10 lbs and I feel terrible and I usually do eat healthy and work out but because I have PCOS I can never lose weight which is why I really want the surgery. I am now heavier than I have ever been and I am scared I will get denied and have ended up putting myself even further from my goal. You are so right though , I will be having surgery before I know it. This waiting period and going though all the qualifications is sooo rough though. Glad to know I am not the only one who has gone through this.

Share this post


Link to post
Share on other sites

Hello Nurse,

I use to love that from animanics cartoon, I digress. Hope youre recovery and 1st few weeks are going well. I know where you are coming from. Im going on 3rd month post op now. To say it was difficult for me to get approved is an understatement. I'm a military veteran so they make you go THROUGH IT to get approved. I think there are plenty of ppl who can relate. If you've got any other questions reply or message me. Im also finding some greaty healthy recipes and websites for when your diet changes through the diff phases, stages.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • 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. 
       
      · 0 replies
      1. This update has no replies.
    • 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
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×