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l heard back from OBESITY law .com... their fee is between 400-750 depending on how much you want them to do..Thankfull B/C B/S federal approved me, before l actually needed them...l was also told that when they deny you its usually bec something is missing from your file....thats it...good luck to all

Thank you for this information :wink2:

I too have BCBS FEP Standard Option and I am in the final process with testing so hopefully by the end of this month my file will be submitted for approval. This is the worst part of it for me. All of the testing is nothing compared to the anxiety you feel when it comes to insurance.

Did you call the 800# on the back of your card when you called to let them know hey I am still here and I am not going anywhere?

I thank everyone here for providing all of this information. It encourages me to keep going. If they deny me for whatever reason even though the employee benefit guide states something totally different than what they are making me do I will fight it.

I wish you all the best in your upcoming surgery. You will do great your a fighter!

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Thanks that link worked. I'll recommend the site to others who are still waiting for appeals on rejections.

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Thank you for this information :)

I too have BCBS FEP Standard Option and I am in the final process with testing so hopefully by the end of this month my file will be submitted for approval. This is the worst part of it for me. All of the testing is nothing compared to the anxiety you feel when it comes to insurance.

Did you call the 800# on the back of your card when you called to let them know hey I am still here and I am not going anywhere?

I thank everyone here for providing all of this information. It encourages me to keep going. If they deny me for whatever reason even though the employee benefit guide states something totally different than what they are making me do I will fight it.

I wish you all the best in your upcoming surgery. You will do great your a fighter!

thanks for your reply...l too have FEB basic...in my policy book it states you don;t even need an approval...lol...l questioned BC about that and they thought it was quite funny..l actually ecame quite friendl with them over this fight...if you get denied, its probably only bec a paper is missing from your file....DON"T get discouraged...make aPIA out of yourself.. called then every day ror probably two weeks...l think l know everyone in the Boston office..its worth fighting for...l'm just waiting for a date, as my surgeon has been out on emergency medical leave for two weeks an dthey don't expect him back for another two weeks...l'm so excited though and want to tell the world....let me know how you make out...

Lisa....do you work for the Government?:Banane34:

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thanks for your reply...l too have FEB basic...in my policy book it states you don;t even need an approval...lol...l questioned BC about that and they thought it was quite funny..l actually ecame quite friendl with them over this fight...if you get denied, its probably only bec a paper is missing from your file....DON"T get discouraged...make aPIA out of yourself.. called then every day ror probably two weeks...l think l know everyone in the Boston office..its worth fighting for...l'm just waiting for a date, as my surgeon has been out on emergency medical leave for two weeks an dthey don't expect him back for another two weeks...l'm so excited though and want to tell the world....let me know how you make out...

Lisa....do you work for the Government?:rolleyes:

Oh trust me if I am denied they will know who I am real quick. See I live in NJ but I am from Brooklyn, NY and there's a saying "You can take the girl out of Brooklyn but you can never take the Brooklyn out of the girl" :teeth_smile:

I hope that you get your surgery date real soon. I just got back from my sleep study. sleep? ! Yeah right! But it's over. This is the only thing left.

I just need the pulmonary doctor to write the final clearance and then they are sending my package to the insurance for approval.

My husband works for the government. He does not think that there's going to be any problems. But he's also up for a fight if necessary. He's a great support system and will do anything for me.

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WE didn;t need a sleep study or a pulmo exam..all we need here is Nutrition and psych..no diet...no liquid phase...nothing...l should know this week my date..naturally when l get my approval, my surgeon is out on emergency medical leave for who knows how long....l know it will happen soon....l'm so excited...my email is Lisamarie11581158@yahoo....maybe we can be cheerleaders for each other....

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WE didn;t need a sleep study or a pulmo exam..all we need here is Nutrition and psych..no diet...no liquid phase...nothing...l should know this week my date..naturally when l get my approval, my surgeon is out on emergency medical leave for who knows how long....l know it will happen soon....l'm so excited...my email is Lisamarie11581158@yahoo....maybe we can be cheerleaders for each other....

Do not even get me started about the sleep study and I needed pulmonary clearance because I am a chronic asthmatic and my surgeon wanted to make sure that my pulmonary doctor was on board with this surgery. When I went to make the appointment for my pulmonary doctor the staff would not make the appointment with him and insisted that I see the sleep doctor who did my sleep study in 2006 which was negative for sleep apnea. I had it out with this doctor when she told me I had to have another one ($$$$ is the main objective here not my health in my opinion). Then she tells me well why did you make an appointment with me? I told her it was her staff not me I did not want to see her in the first place. Her staff insisted on it because of the type of surgery. She defended them. Bottom line was that she would not clear me for the surgery unless I had one and the surgeon's office told me that if she wrote that they would insist on it.

So this weekend I had one with no machines just the crap wires. Which I am sure will show that I am negative again for sleep apnea. Fortunately, I had a 6 month follow-up with my pulmonary doctor this Wednesday so I am going to insist he take over for her and provide my clearance. He knows me better than anyone when it comes to my asthma. I am not going to see that other doctor again.

Now here's my question for you what is considered nutrition? Do they require a number of months? Do they require that the documents be no older than a certain year? I have 9 months worth of documents from a doctor but it's older than 5 years. I have 3 months worth of documents from a nutritionist monitored program that is from 4 years ago. I have some documents from my primary but I hardly had any reason to visit him I am normally a well person. Jenny Craig also wrote a letter stating what my starting and ending weight and the time frame which is also from some years ago. I am currently in my second month of monitored diet with a nutritionist who reports my progress to my surgeon. It's so confusing and my anxiety level is through the roof. I just want this done already.

I also have written letters from other doctors in support of this surgery so hopefully they will accept this too.

My BMI is > than 40 so in my opinion based on how I read the benefit handbook is I just need psych part which I have already. But my surgeon told me that I had to have primary, cardiac, pulmonary, psych, and nutrition. I am losing on my own I was not told I had to lose weight. It's wrong that they hold us to any of it if since it is not clearly specified in the handbook. Because when I called to find out if they will pay and what I had to do since it was not clear they told me they follow the handbook.

Thanks for the feedback I truly appreciate it :biggrin2:

Here's my e-mail - lh215bk@gmail.com

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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