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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 11-20-2007, 11:53 AM   #21 (permalink)
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Surgeon: Dr.Holland of Sacred Heart Hospital
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Talking Good Luck!!

You and I are embarking on this journey together. I was just approved and my surgery is on Dec. 17th. So I'll keep you in my prayers.....and you keep me in your's. I also gained during my 6 month supervised (13 lbs.) It didn't seem to have any bearing on my ins. approval.I was approved in 2 days.(Capital Blue Cross)

My Doc told me something that really put me at ease while I was waiting for approval. "If you could do it on your own, you wouldn't need me" . See you on the loser's bench.
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Post-op(Lapro RNY)
Surg.Date 12/17/07

Max/Curr./Goal
284/264/135
Height:5'4" BMI:45.5


My Metamorphasis has begun!

Last edited by Metamorph7; 11-28-2007 at 12:49 PM.. Reason: typo
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Old 11-20-2007, 11:59 AM   #22 (permalink)
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Thank you so much! It is WONDERFUL to have somebody at about the same place I am. I go in next Tuesday for more testing. As far as I know, all that's needed is an EGD (?) that the doctor requires and then it's just wait and see what the insurance company says.

Is your doctor requiring some sort of a filter before he'll do the surgery (something about blood clots getting to the lungs and heart)?
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Old 11-20-2007, 02:27 PM   #23 (permalink)
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Quote:
Originally Posted by Metamorph7 View Post
You and I are embarking on this journey together. I was just approved and my surgery is on Dec. 17th. So I'll keep you in my prayers.....and you keep me in your's. I also gained during my 6 month supervised (13 lbs.) It didn't seem to have any bearing on my ins. approval.I was approved in 3 days.(Capital Blue Cross)

My Doc told me something that really put me at ease while I was waiting for approval. "If you could do it on your own, you wouldn't need me" . See you on the loser's bench.
My 30th birthday is on 12/17! I figure that feeling crappy and going through hell week on a yucky birthday is appropriate.
Good luck!!
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Jen
5'9", BMI: 28.5
311/311/193/165?
Highest/Pre-Op/Current/Goal

RNY Surgery date: December 13, 2007

Total pounds lost, to date (9/18/08): 118 lbs.

Onederland is SWEET!!!!
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Old 11-20-2007, 02:30 PM   #24 (permalink)
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Originally Posted by rev217 View Post
Thank you so much! It is WONDERFUL to have somebody at about the same place I am. I go in next Tuesday for more testing. As far as I know, all that's needed is an EGD (?) that the doctor requires and then it's just wait and see what the insurance company says.

Is your doctor requiring some sort of a filter before he'll do the surgery (something about blood clots getting to the lungs and heart)?
No I don't have to have the filter. My doctor only uses those for patients over a certain weight...400-500 lbs, I think...so I didn't need it.

Good luck! The pre-op tests and waiting are a pain but I'm currently only about 3 weeks out from surgery and am just excited!
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Jen
5'9", BMI: 28.5
311/311/193/165?
Highest/Pre-Op/Current/Goal

RNY Surgery date: December 13, 2007

Total pounds lost, to date (9/18/08): 118 lbs.

Onederland is SWEET!!!!
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Old 11-20-2007, 11:25 PM   #25 (permalink)
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Default Yay!!

Good luck Jen... seems all the waiting and stress has finally had some results!
Now just a short count down til you become a grand loser - woohooo!!!

Keep us up to date - you'll be in our thoughts for sure!

An
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06 May 2008: Lap RNY
START: 119kg (262 lb)
DAY OF SURGERY: 101.8kg (224.4 lb)
NOW: 72.4 (159.6 lb) as at 25 November 08
GOAL: 72kg (158 lb)


ONEDERLAND: 22 June 2008
CENTURY CLUB: 13 November 2008
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Old 11-27-2007, 02:22 PM   #26 (permalink)
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Unhappy

I'm at the very beginning of my 6 month supervised diet and I'm concerned how this diet will affect my approval chances. I'm right on the border for morbid obsity right now. If I lose just a little weight I fear I'll no longer qualify for the surgery since I don't have any of the co-mobidities. I'm pre-hypertensive and have pre-high cholesterol as well as elevated liver enzymes but all of that still falls short of the official criteria. I have other medical issues but not the ones the insurance company are looking for. I've done diets before, lost weight and ended up gaining it all back. Its like an endless cycle for me. I don't want to intentionally screw up this diet just to meet criteria but I also don't want some insurance company turning me down because I lost 5lbs or whatever my weight ends up being after 6 months. Maybe I would have ended up gaining anyway, that does seem to be the trend in my overall life. I made the decision to have the surgery. I really don't want to go through another yo-yo cycle to please my insurance.This whole process is so nerve racking. *bleh*
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Old 11-28-2007, 12:47 PM   #27 (permalink)
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Jen,
We're almost there. I was really blessed with my Insurance Company's approval. It only took 2 days. So we're all systems go for the loser's bench in 18 days. Are you all set to go? My nerves are starting to get a little crazy but it's nothing compare to how excited I am.
__________________
Kyhara

Post-op(Lapro RNY)
Surg.Date 12/17/07

Max/Curr./Goal
284/264/135
Height:5'4" BMI:45.5


My Metamorphasis has begun!

Last edited by Metamorph7; 11-28-2007 at 12:48 PM.. Reason: Typo
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Old 12-05-2007, 09:04 AM   #28 (permalink)
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Quote:
Originally Posted by Ataraxia View Post
I'm at the very beginning of my 6 month supervised diet and I'm concerned how this diet will affect my approval chances. I'm right on the border for morbid obsity right now. If I lose just a little weight I fear I'll no longer qualify for the surgery since I don't have any of the co-mobidities. I'm pre-hypertensive and have pre-high cholesterol as well as elevated liver enzymes but all of that still falls short of the official criteria. I have other medical issues but not the ones the insurance company are looking for. I've done diets before, lost weight and ended up gaining it all back. Its like an endless cycle for me. I don't want to intentionally screw up this diet just to meet criteria but I also don't want some insurance company turning me down because I lost 5lbs or whatever my weight ends up being after 6 months. Maybe I would have ended up gaining anyway, that does seem to be the trend in my overall life. I made the decision to have the surgery. I really don't want to go through another yo-yo cycle to please my insurance.This whole process is so nerve racking. *bleh*
My surgeon told me that the insurance company goes by the weight at which you start on your first in-office weigh-in, not what you lose during the diet. That being said, I was so nervous that I was going to lose weight, that I ended up gaining weight. Fortunately, my insurance company didn't hold it against me.

Try not to stress about it...but if you're like me, that's like asking the sun not to rise in the morning...and good luck as you begin your journey. Keep us posted!
__________________
Jen
5'9", BMI: 28.5
311/311/193/165?
Highest/Pre-Op/Current/Goal

RNY Surgery date: December 13, 2007

Total pounds lost, to date (9/18/08): 118 lbs.

Onederland is SWEET!!!!
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Old 12-05-2007, 09:07 AM   #29 (permalink)
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Originally Posted by Metamorph7 View Post
Jen,
We're almost there. I was really blessed with my Insurance Company's approval. It only took 2 days. So we're all systems go for the loser's bench in 18 days. Are you all set to go? My nerves are starting to get a little crazy but it's nothing compare to how excited I am.
OMG! I am nervous!!! I really didn't think that I would get nervous because I've been so antsy and excited all of this time. But now that I'm 8 days out...yes...I'm nervous!

I find myself thinking all of the things I've read on here...am I going to be able to do it? Am I going to be the only one who fails? Is this the right decision?

When I get too deep into that mindset, I try to do something to distract myself but I just wish it was 12/13 already!!!!

Good luck on the 18th!
__________________
Jen
5'9", BMI: 28.5
311/311/193/165?
Highest/Pre-Op/Current/Goal

RNY Surgery date: December 13, 2007

Total pounds lost, to date (9/18/08): 118 lbs.

Onederland is SWEET!!!!
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Old 12-18-2007, 12:32 PM   #30 (permalink)
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heey! i gained almost 20 pounds and was still approved! hellz yeah! bring it on.
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Surgery date: Lap RNY Jan 16th 2008
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