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Insurance-how did you deal with waiting for a decision?!

How you do make it thru the wait, while you are waiting to hear whether or not your insurance approved or denied the surgery? The "not knowing" is horrible. And the more I read various posts, the more scared I get that I am getting my hopes up for nothing. :phanvan

The anxiety is driving me crazy....I don't want to be optimistic, and then be disappointed. But at the same time, I'm doing all this research and talking with people who have had WL surgery to see how they liked it, etc. I've even gotten the support of my mom and dad (and I thought my dad would be completely against the lap band-he shocked me with his support). And I've tried so many diets, and lost 40 or 50 lbs, but I always gain it back with additional weight. I can't seem to do this long term on my own, so I really need insurance to cover part of it (because I can't pay $13K for surgery).

The office said I should know in 1 to 2 weeks (it's been 1 week), but from what I've seen on here, United Healthcare can take forever sometimes, and then deny you. And of couse, right now we have the Thanksgiving holidays, so nobody is going to be looking at it then. The doctors office actually asked if I wanted to schedule surgery for November 30th, so they seemed pretty confident of a quick approval from United Healthcare, but I can't take off the beginning of the month, so if I'm approved, I'm going to have it during my Christmas vacation time.

I've heard that some people call their insurance company to check the status of their request, but I'm scared that if I call the insurance company directly, I may mess something up and cause myself to be denied.

Just wondering how others made it thru this. If you did call to check on the status of your request for preapproval, exactly what did you ask when you called in?

Thanks!

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Thanks everyone for your responses. Sometimes it just helps to know others are in the same boat. I did call my insurance company the Wednesday before Thanksgiving but they didn't see anything in the system. So I'm not going to check on anything until maybe Friday. I would hate for it to be "lost in the system" and to be waiting and they haven't even received anything!

Just a girl - I would love to keep in touch. Where in Texas do you live? I'm in Houston.

In reading everone's responses, I wonder about the company who checked on my insurance, although I know they do it all the time. Before my appt, I spent all this time looking for copies of receipts, and my weight watcher weight booklets from the million times I tried it. (it's a good program - I just can't keep the weight off long term). I got a copy of medical records from my doctor (which I had to pay for). Looked for old credit card statements from years ago for stuff I didn't have actual receipts from.

All that, and the place I'm using said they didn't need any of that for my insurance- that all they had to do was submit the letter of necessity. I would have rather they got a copy from me and submitted it, so that I don't get a denial where they are asking for all that information. I say better to give them too much information than not enough. I don't want any delays. If I don't get it done over Christmas break, my next chance probably won't be until Spring break. So I'm praying. 2 years ago I wouldn't have even considered surgery. This time last year, I was desperate and depressed and talking to someone who had gastric, who encouraged me to do it, but I felt like I still had to try again (so I spent another $4000 for a diet center and personal training sessons). Of course, I'm right where I was this time lst year, although I did lose weight this year - I gained it all back as usual. So finally I realized that nothing is wrong with getting help in the form of surgery (although I prefer lap band to gastric). Sometimes you can't do things on your own, no matter how much you try.

The physical aches and pains I experience on a day to day basis are getting harder and harder and its interfering with my enjoyment of life.

Last night was a great example. We went to a basketball game, and just walking from the venue back to the car (we were lost and ended up walking in a big circle) my back was killing me and I was sweating and trying to hide my back pain from the others I was with. And I just can't stop eating! Lately I feel like I'm never full. It drives me crazy.

Anyway, sorry for going on and on. I'm just really down after last night's experience. It's not the first time, but I'm tired of not being able to do something normal like walk from a stadium to the car with out pain. Anyway, I'll snap out of it!

Thanks everyone for you support!

Congrats Kimmi!!!!!!!!!!!!!!

I am so happy for you!! (and jealous ... lol) I call the surgeon's office today and they told me they submitted my information yesterday the 26th. So now I am as nervous as ever!! Anyway, I live in Lufkin which is about 1-1/2 hours north of Houston! I would love to have my approval and set my surgery date for over Christmas break since I work for a school district and will already be off. Maybe I will have a couple of weeks to recover and get myself together. Oh, I also wanted to know when you submitted your info for insurance approval? How long did it take for you to get an answer? I already can't take much more ... lol!! I wouldn't mind keeping in touch ... since we will hopefully be banded around the same time.

  • Author

Thanks! It actually didn't take very long - it just seemed like it did! The entire process, beginning to end took 17 days. Which to me is an eternity because not knowing causes so much anxiety!

I had my initial appt/medical evaluation on Fri, Nov 9th. On Wed, Nov 14, they called to tell me they had verified benefits and would prepare a letter of medical necessity and submit it to insurance. Not sure exactly when they did that. The following week was Thanksgiving week-as of that Wednesday, they didn't even show anything in their system. But when I called the insurance company today, they said it was approved on Monday, Nov 26th!

I am hoping your insurance runs as smoothly as mine. I would love to have a banding partner, who is going thru everything at the same time I am! I'm doing it while on Christmas vacation so that nobody wonders why I am off work (we have gossipy people at my job), and also, I will have from Dec 21-Jan 1st to fully recover. I have a stressful job, so I need the recovery time going back.

Being a teacher, Christmas Break would be the perfect time for you also.

In about 1 1/2 weeks, I would call your insurance company to check on the status. At first I was afraid to, but I couldn't take the suspense!

KIMMI it looks like my approval vibes worked LOL now I amsending them to you just a girls we all can really sick to that New Years Resolution to get healthy in 2008 :whoo:

Approved!!!!

OMG!! I just called BCBS just to check on the status (eventhough I knew it was just submitted Monday ... I am so silly) and she said I had been approved Thursday!! I am in complete shock. They faxed the info Monday and I was approved on Thursday!!!!!!!! The representative was shocked ... she said it usually takes atleast 2-3 weeks ... she said she had never seen it go through that fast!

Okay ... now I am scared!!!!!!

My insurance process was relatively stress free. I have Health Net of California. Once my PCP put in the referral for the Bariatric clinic and I started that journey and decided to move forward, I called Healthnet to see if they cover weight loss surgeries. They said they did if I had a BMI over 40 and showed a medically monitered weight loss plan for 6 months prior. (luckily my old PCP with a different insurance but some health care group, kept track of me when I lost 90 pounds about 2 years ago on my own) So that counted for me.

When It got down to it and I was scheduled for surgery I was nervous becuase they hadn't discussed insurance so far. I called the clinic and they assured me not to worry and that they really fight to prove that it is medically neccessary for me to have this. They did the work for me. I was approved within one calendar week excatly.

  • Author

Congratulations on your fast approval!!! :clap2: I think it really has something to do with it being the end of the year. It seems everyone is being approved so quickly!

I completely understand the shock that comes with being approved fast and knowing that the surgery is actually really coming - its scary!

I keep thinking - 3 weeks from today, and I'll be sucking on an ice cube after surgery! :P

I'm trying to make out my lists of what to buy and what I'll need. If you look under one of the presurgery threads, at the very top there is a thread that has some lists that people posted their lap band shopping lists, or things they wish they would have had before or after surgery and didn't.

It's very helpful.

Congratulations again! Do you have any idea of when your surgery will be?

On Oct 3 I got my appointment for Oct 25th, so I had 3 weeks to plan. At this point I'm about 5 weeks post op finishing my third week back to work. I can't believe how fast it's all gone by. I'm glad I only had short notice of the date though.

oh my goodness I am so envious of you guys who have finished the waiting game it's been weeks still waiting!!!!!!!!!!!!!!!

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