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Approved yesterday, not approved today?



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I am just about to lose it!!

I spoke to the surgeon's office and she is saying there is no way I am already approved. They have no submitted anything, yet UHC is saying it is approved. What is going on? I am so lost as to what to do next. No one can give me a straight answer. I'm just moving along with all the other stuff (pysch evaluation next week and support group tonight), but I am just so frustrated. I still don't know for sure if I have to do a 6 month diet before surgery, so everyday I go without knowing is another day added to my wait if I have to do it...No one can give me closure on this!

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Did you get a letter from the ins company saying you are approved or you spoke to someone. Maybe they meant that the surgery is covered if you are approved. I would think that the doctor would know if they submitted your records. Call your insurance company again and ask what policy do they have to approve the surgery. The code for Lap Gastric Banding: 43770. Let them look up the policy and they might direct you to a website or a document with their policy.

Good Luck

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I have UHC as well. I was told by UHC that lapband surgery was covered and I received a letter saying it was a covered procedure, but that didn't mean I'd been approved. It's a cluster, for sure. Keep the faith - it will happen!

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I thought it was odd in your post yesterday that they told you that they had already approved you and scheduled the surgery...I don't know of any insurance company that does it that way. And now you find out that the surgeon hasn't even submitted it yet???:eek: Sounds like maybe the person you talked to is clueless. Have them submit all of the information, give it a week then call the insurance company for a follow-up. I'll keep my fingers crossed

:)

Good luck and keep us posted.

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yeah i know what u mean I thought I was all set now I find I have to have 3 months worth of doctors visits talking about my weight be for the insurance company will cover it I have lost 25 pounds waiting for this band I am about ready to lose it, healthy1

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I got the call Monday 6/14 from surgeon that I was approved and would be schedule later that day. Didn't receive a call, so I called Tuesday 6/15 and was told I had to wait to be scheduled because I am PENDING. What? So I call Anthem Blue Cross of CA and find out that while I was approved Monday my surgeons office resubmitted authorizion making the following changes:

Hospital instead of the original clinic

In-patient instead of original out-

patient

and different surgeon (my surgeon no

longer works there) other surgeon in

the office is taking over

While I am okay with the changes I am upset that I didn't ask for them and that the insurance com. informed me of them instead of my surgeons office. They stated it was to help with my out of pocket cost because their clinic is out of network and the hospiatl is in-network.:smilielol5:

Anthem states they will have an answer by Monday 6/21 and since it was approved the first time they see no reason why it won't be approved.

Monday is not coming fast enough for me.:thumbup:

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I hope you get/got some good news today! :thumbup:

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    • 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

      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

        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.

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    • 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!!
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