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Irritated

Charisse Jordan

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Charisse Jordan    4

Charisse Jordan
Posted

So this happened! I was denied by my insurance because I did not do a year of a weight loss medication first. I cannot take them because my Dr said there isn’t one that won’t interact with my anti depressants so I will fight that. Insurance also said they have no records of having co morbidities that are made worse by obesity. I have a brain disease that puts me at high risk of stroke if I don’t get the weight off as well as GERD and osteoporosis through out my body. I guess the girl handling my pre approval didn’t find out what was needed to get me approved and get the right documentation, now I am trying to get everything for her to turn in with the appeal. I’m a little irritated but I will fight this, getting approved is the only thing left to do, I have come too far

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qtdoll    536

qtdoll
Posted

Yeah that's extremely frustrating. I needed both failed weight loss attempts w my Dr AND comorbidities to get approved. I'm sorry this is so difficult for you. Keep fighting it!

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learn2cook    622

learn2cook
Posted

So sorry to hear it , but stick with it. Your surgeon wouldn’t have done all this work with you if you didn’t need it, (or he/she didn’t think they would be paid for it). My surgeon had to have a phone conference with the insurance doctor, then it got approved. Keep up your good habits because the surgery will act as a sort of lock on your pre-surgery weight loss (not scientifically proven but I chose to believe it.)

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Fred in Pa    236

Fred in Pa
Posted

Sorry to hear that...who is your Insurance?

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Fred in Pa    236

Fred in Pa
Posted

1 hour ago, Charisse Jordan said:

Blue Shield of CA

Can your surgeon do a peer-to-peer call? Sometimes that helps cut through the red tape.

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Jeanniebug    476

Jeanniebug
Posted

Ask for the name of the person who has denied your claim. Chances are, it wasn't a doctor who reviewed it. Insist that a doctor review your claim.

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aeb10892    3

aeb10892
Posted

That is irritating for sure... I'm pretty sure you can get around the 1 year of weight loss meds with your doctor's advocacy, though. I also was advised not to take any weight loss drugs that were on the market at the time because I have a pretty severe anxiety disorder and some stimulants can make that worse (oddly enough a low dose of Adderall relaxes me though?)

Im also thinking this is not an uncommon issue- for example, stimulants are not advised in patients with certain heart conditions. You know what is significantly associated with heart conditions? Obesity. Which would made better by surgery!

I hope you get it sorted out. Again I'm pretty confident that working alongside your doctor they can waive that requirement, but the process may be unpleasant.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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