question about not getting approved. - ThinnerTimes

glad2beme · 07-20-2005, 06:27 PM

Hey, does anyone know why someone wouldn't get approved. I know I am being perinoid but just because I am approved to go to the educational class doesn't mean that I am going to be approved to have the GBS. When did they tell you that you were approved to have the GBS and what did you have to do before being told? Just nervous.

Dara · 07-20-2005, 06:37 PM

Quote:

Originally Posted by glad2beme

Hey, does anyone know why someone wouldn't get approved. I know I am being perinoid but just because I am approved to go to the educational class doesn't mean that I am going to be approved to have the GBS. When did they tell you that you were approved to have the GBS and what did you have to do before being told? Just nervous.

I think a lot of it depends on your insurance. With some insurances, you're pretty much guaranteed approval when you get a referral to Dr. Callery/Dr. Potts. Other insurances give you the referral, but then you have to jump through hoops to get the approval.

I know this is not the answer you wanted, but I really believe it all depends on your insurance carrier.

Don't be nervous. I'm a firm believer that if it's meant to be, it will be!

Good luck with your approval and surgery!

glad2beme · 07-20-2005, 06:45 PM

Thank you so much. I feel much better. My doctor put the request in and 3 days later I got the approval to see Dr. Callery. My doctor and my orthopedist both agree that I need to have the surgery. I have never been turned down from anything that my doctor has requested before. I have really good insurance. Thanks now I think that I won't be so worried.

Bypassingme619 · 07-20-2005, 06:47 PM

Your not paranoid you are just being cautious about what might happen and I commend you for that. Thinking like this will have you prepared and ready just in case approval doesn't happen. Hopefully your insurance is not going to want an 6 month supervised diet. A lot of insureance companies are asking for this. But if you can have your PCP write on your behalf about your weight and your weight history that could get you around the 6 month supervised diet. Make sure you have plenty of documentation submitted. Sometimes things like pictures or a video may raise your chances. Visuals are always good. My road to finally having surgery was 7 1/2 years. The main thing is always give them what they want and stick with the fight. A lot of people give up. Which I understand this is a very emotional time and it is difficult to repeatedly explain the things that have hurt you so much for years. I am sure you will be fine. I am praying for you.

LizardQueen · 07-20-2005, 07:29 PM

i'm keeping my fingers crossed everything will go your way and you'll be approved in no time. Every ins co is different and so are the time frames. Good luck!

glad2beme · 07-21-2005, 10:06 PM

THank you so much for your encouraging words. I have tried to go on the 6 month food diet and they denided me because I take coumadin. This is a blood thinner in case someone doesn't know. They said I was not a canadiate for the food program. So I guess one hurdle is jumped. I have had surgery on one knee because they want to wait before giving me a complete knee replacement, to lose the weight. I have arthritis and the bones were bad. I have a stress fracture in my left foot because of compinsating for the other leg. This makes it very hard to exercise. I was on the tread mill and loved it until all of this happened. Then on and on and on. I think I should make it but like you said I have to be cautious of my mental health as far as not getting to excited until they approve me. Wow so much to say. I appreciate your prayers and encouragement. Thanks

Andromeda · 07-25-2005, 02:08 PM

glad2beme, I hope things work out for you. I am attending my local doctor's seminar in a couple of weeks. I hope my insurance company doesn't snuff out my hopes. DOes anyone out there have insurance through PHCS (they are private insurance for municipal workers)? I am VERY nervous about all of this. I know the benefits of the surgery far out weigh the risks. I am too young to feel so old. I am tired of my body and my mind hurting. I am so anxious to change! Good luck!

feliciaespinoza · 07-25-2005, 03:10 PM

I know that when I was doing my whole preparing for the insurance part it was strongly recommended by Dr. Potts that I put together a list of diets that have succeeded and failed to the best of my abilty that it would not be checked or verified but they would submit it to the insurance and he told me that a Medically Surprivised liquid diet was one of the MAJOR diets they looked for, for instant approval and again he said nothing would be verified how could it possible be you could have had 5 different insurance carriers from different employers over a period of say 10 years so prepare one when you have some time I simply wrote down the type of diet what I was on, how much I lost and how much I gained (which always ended up being more then I lost in the end) and the Approximate date, I just put the month and year and I dated all this back 10 years. Its amazing how much I remembered...lol. Well good luck to you and I am sure everything will work out for the best.