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denied

Jennimomma201943

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anl1990    91

anl1990
Posted

I am so sorry you are having such difficulties with this. Sending good vibes your way - I hope it ends up working out for you. xo

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LearningToLoveMeAgain    42

LearningToLoveMeAgain
Posted

19 hours ago, Jennimomma201943 said:

Good news! I finally got approved after 3 appeals. I have the surgery this Wednesday. Thank you everyone for the support. It was much help when I was a mess trying to get my appeal approved.

Congratulations!! That's wonderful news!! Good luck on your journey!

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mousecat88    2,279

mousecat88
Posted

On 4/7/2019 at 9:20 AM, Jennimomma201943 said:

I have been trying to find out how much it will cost if I self pay. Does anyone have any idea so I get a roundabout figure?

My total bill was $40,000+ but they probably cut discounts for self-pay.

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SeattleLady    277

SeattleLady
Posted

I did everything required by my fidelis medicaid. I fit into their requirements with my BMI. They are saying it's to low (35.7) for my height I'm still obese. Now I have been denied. The surgeon did a peer to peer and was denied. The head nurse had me file a complaint w the Attorney General and went for an appeal w their support and was denied again. Now I am going for an external appeal. I am very upset and disappointed. I do not know what to do.
Keeping fighting for your health. So them how important this procedure is for your health.

Sent from my SM-J727T1 using BariatricPal mobile app

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ALC128    5

ALC128
Posted

I did mine in Mexico on 3/28.. Total Cost was $3900.00. These doctors average 3 or 4 of these surges daily so they are very experienced. Of course you have to pay for flight and 1 night hotel to San Diego. No complications and have lost close to 30 lbs. my starting BMI before surgery was around 35.

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Jennimomma201943    16

Jennimomma201943
Posted

Ok I'm 4 days after my surgery and am starting to feel a little better. I had a hard time with the anesthesia so it set me back. At first I was like "what the hell did I do!" It's getting better though little by little. I just have a pit in my stomach a lot from not being able to have anything but liquid right now. Thank you everyone for your support. I had no idea how this forum would help me through this but it truly has.

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SusieQ2019    567

SusieQ2019
Posted

I am glad to hear that your surgery went well and you are doing great. Your will to never give up when others say no is truly inspiring. I have my surger next Monday and I cannot wait. This forum has also help me so much.

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Jennimomma201943    16

Jennimomma201943
Posted

On 4/21/2019 at 8:09 AM, SusieQ2019 said:

I am glad to hear that your surgery went well and you are doing great. Your will to never give up when others say no is truly inspiring. I have my surger next Monday and I cannot wait. This forum has also help me so much.

Thank you so much. Good luck to you on your surgery.

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Go To Topic Listing Gastric Sleeve Surgery Forums

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    • BeanitoDiego

      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.
    • BeanitoDiego

      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! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      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 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      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!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.

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