Waiting for Healthnet approval

Dayle · June 20, 2008

HI,

I've decided that the band is probably my last hope for health and am waiting for Healthnet to approve. Then I can get things started. I have about 110 lbs to lose. I have high B/P, asthma, a bad knee, and rising glucose levels. I have tried every sensible diet and a few stooopid ones with limited success. I did Nutrisystem twice and lost a lot of weight, but put it all back on. I did weight watchers also. Seems like Healthnet is taking an awful long time. Dr's office tells me they've been taking 8-12 weeks to respond to referrals. It's been 6 wks now. I'm anxious to get started. I bought a cute little blender and have been practicing chewing my food really well. I didn't even realize how I just gulp it down. I will do a happy dance when I get my surgery date.

Gaila · June 20, 2008

Hi Dayle,

I'm just getting ready to approach the insurance approval phase. It should be interesting. I have about 120 pounds to lose so I am also looking forward to moving to the new me! It's funny you should mention the food chewing......I just started doing the same thing and couldn't believe how fast I was eating. It's definitely a good idea to start making those behavorial changes now - would love to chat with you through your process since we're around the same age, etc. Are you interested? Best of luck!

Gaila

Dayle · June 21, 2008

Gaila,

Absolutely! Let's take this adventure together! It'll be helpful to have someone going thru the same stuff at the same time.

My family is very supportive. I have two adult daughters and an adult son. My oldest daughter is married and so is my son. I have two grandchildren. My youngest daughter has one more year of college and then I'll be facing the empty nest phase of my life. My family lives close by and as I said, they are very supportive of my decision to pursue the lapband. My best friend, however, went ballistic and started screamint "NO,no,no" at me and didn't shut up long enough for me to explain that it's NOT bypass surgery. I don't think I'll mention it to her again until after my surgery and she notices that I've lost some weight. Don't need her negativity especially when she doesn't know what she's talking about.

Where are you in your process? Have you spoken with your doctor? Got a referral? It's quite nerve racking. I'll relax some when I have insurance approval. Are your family and friends supportive?

Dayle

droppindown · June 21, 2008

Good luck with healthnet. They denied my claim for not enough evidence of recent "diet" attempts. Total BS. I had over 10 years of yo-yo weight loss documentation. Some of it medically supervised, some of it simply records of rollercoaster weight loss from my reg. drs. They did not like it was not within the past 6 months. Like I am going to discover something new that I haven't tried before! I went ahead and did self-pay, but am trying to appeal and get them to reimburse me (yeah right).

Dayle · June 21, 2008

droppindown,

Jeez. Good luck getting reimbursement. My doctor wrote a detailed letter re: my health concerns and my failed attempts with both Nutrisystems and Weight Watchers. I hope it helps me get approved.

Dayle · October 17, 2008

Just to update, it took 14 weeks to get Healthnet approval to see the Obesity coordinator. I saw her last week. I got an EKG, and did the history, etc. Now I need Healthnet approval for the psych, nutritionist and cardiologist. Another 14 weeks I'm guessing. Obesity coordinator said she doesn't see any problem in getting approval for the band because of my medical issues. At least the ball is rolling now. Hope it's downhill.

droppindown · December 3, 2008

HOLY CRAP!!! I refuted the rejection, sent my records in along with a letter asking for reimbursement and....I got it!!!! Health Net is going to reimburse me for my self Pay!!!! Whoo Whee!

Dayle · December 3, 2008

:thumbup:Congrats!!!!!!! I wish I had the means to front the money. I'd sure like to get on with this. I'm getting recipes in order and it's turning into a cookbook. I'm as ready as I could be. Now you can buy smaller clothes with your reimbursement!