clickersister

Just an update......not once in 9 weeks did my surgeon's office call to follow up on the insurance process, and since I've received my copy of the rejection letter that was sent to their office (6 days) they haven't even called me to notify me or to follow up on it. Oh, and I forgot to mention that they have tried twice to bill me for office visits that were already paid for! I had proof that they were paid! Needless to say, I have already scheduled my appointment with a new surgeon. My only issue with this is that he will probably try to talk me into the RNY. It's not what I want, but at this point I will probably do whatever the insurance company allows. I can't spend another year at this weight..................

No, I've done all that. I've been jumping through hoops for the insurance company for 20 months. I feel like the surgeon's office has had knowledge of little things (a simple blood test) that could have been done before they even submitted the information, and for one of the items, the surgeons office had the info and didn't submit it. Also, I was told by their office 3 different dates that the info was submitted......once to my face in the office.....when in reality it was never sent in at all. I'm really frustrated right now and I know that a competitor's office would never have let that happen because my niece went through them, and they review the criteria and make sure it's ready to be accepted before it's submitted, then on the chance that it might be rejected, they have special people on staff to file an appeal. My surgeon's office has basically shrugged their shoulders and given me the impression of "Tough luck" and left me to flounder. That's not a very comfortable feeling when you don't feel like they're looking out for your best interests. Sorry, just had to vent.

Well, I was just rejected for the second time. The rejection letter said that I met all of the requirements, but other options had not been pursued. I'm thinking that my surgeon's office knew both times of more things that should be done but chose to take my money for extra office visits instead of telling me what I might do to be approved. The more rejections.....the more money for them. So I will be changing surgeons and trying again.

Thanks, tmbowe. Yes, it is frustrating. Early last week my dh was told that the outside review board would make a decision this week. Well, it's already Friday afternoon and of course, we've heard nothing. I'm under the assumption that's a good thing, because it only took two weeks to reject it the last time.

I finally met all the requirements and my surgeon's office said they sent all of my info in on August 7. Then on August 18 they said they submitted a little more information. In the middle of September my DH called the insurance company and was told the information was received on September 2. HUH??? That was almost a month after the first submission! So he called the surgeon's office and was told that they sent it on August 25. Why did they tell me, to my face in the office, that it was sent in earlier? So he waits a week and called insurance again (Sagamore) and was told it was sent for outside review. It's been 12 days now! I'm so discouraged and fearful of being rejected again. (I was rejected 20 months ago because I didn't have 6 month supervised weight loss, which I have now, but I don't meet the BMI requirement anymore because I lost 16 pounds. I still have the co-morbidities.) I almost went the way of gastric bypass, and I think my journey would have been smoother and I could've had the surgery by now. I'm very frustrated and about ready to throw in the towel. Sorry, I just needed to vent.

Thanks for those answers. Please don't be sorry you started this thread. I've been trying to get my band for about 20 months now (long story) but I'm hoping for insurance approval VERY, VERY soon, maybe today. And I've been reading posts about hunger the whole time. I really did wonder if the hunger increased after banding. It's good to know that it will be the same as before. I know I will be successful, because all I have to do is look at how successful you all are. I especially like the before and after picture thread; I get so motivated and inspired, and I just know I'll have my pics on there before long! I'll let you know when I get my approval and surgery date! Thanks again, kind people!

I'm not banded yet; I'm hoping for a September date. When you current bandsters talk about needing fills and being hungry all the time, I get a little concerned about that hunger. Is the hunger MORE than the hunger before you were banded? If so, how can that be? If not, why does it seem harder to control than before banding? If we've spent years at a constant weight, then why does it seem like we gain AFTER banding? I don't have a hunger problem now (just an overeating problem LOL), so will I have a hunger problem after I'm banded? I know this sounds dumb, but I truly wonder this every time I read about someone being hungry all the time. Thanks.

I'm hoping to get my approval and surgery date next week. It is so nice to see everyone support each other. You have all done so well and give me so much hope that I can do as well as you! I have 100 pounds to lose and I'm looking forward to being able to do things with my family again. I have a VERY sedentary job.......I literally do NOTHING but answer the phone and monitor a security system, so I can't even get up and walk around. I spend most of my time surfing the web. How much work do you think I'll miss when I get banded? I'm hoping to have my surgery on a Thursday and be back to work on Monday. Does that sound possible? Thanks.

I will be using Dr. McEwen for my surgery, hopefully in the next month. I had went through everything last year and was turned down by insurance because I hadn't had 6 month supervised weight loss (the insurance company did not tell my dh it was required when he called them about eligibility), so now I have that behind me and I've scheduled the appointment with the surgeon and the insurance has been re-filed. I'm so excited and so ready. I'm down about 16 pounds since my first visit last year, but I still have about 100 to lose. This forum will be great for keeping me on track and motivated.

I haven't been banded yet but I'm already trying to eat like a bandster by taking tiny bites and chewing thoroughly. I'm starting to get a little worried, though. I usually eat healthy, and I usually only eat about half of what everyone else does. I never get a large sandwich or extras like cheese fries with a meal. Last night we ate out and I had a small salad, 1/2 baked potato and 1/2 of a 10 oz. steak. This is typical for me!!!!!! How did I get 100 pounds overweight?????? I used to have an ice cream addiction, eating about 1 to 1 1/2 cups every night, but I kicked that over a year ago. My dh and I talk about it all the time and can't understand. Will I lose weight with the band?

Christine, I haven't had my surgery yet but I wish you best of luck and please stay in contact with us.

That would be great!! You'll be getting your surgery next week! I'm so happy for you! I have about the same amount of weight to lose. How tall are you? I'm just over 5'8" and I started this journey when I weighed about 272. I'm down to about 256 now, and I'd like to get down to a size 12. That may be at 150 or 160. Even though I'm 51, I still 'think' like a younger person, and I have a lot of active goals. I think those goals will help me during weight loss. Do you have goals, and if so, what are they? You're very young, so you've got a lot of time left to do fun stuff. I think you're making a very good decision! Well, thanks and take care. Talk to you soon!

Hey everyone! I was going to be banded last year but was declined by insurance because I hadn't had my supervised weight loss yet. Well, I finished that this year, then lost my mom due to cancer, so now I am on the road to being a bandster again. I have a visit with the surgeon scheduled in two weeks, and I expect the surgery to be less than a month after that. I am SO READY. I had considered the RNY but decided that wasn't for me. The lapband will provide me with a TOOL to lose the weight without being too hungry. I am looking forward to being active and happy as a slimmer person. I am a 51 year-old grandma of 5 year-old twin girls, a 12 year-old girl and a 14 year-old boy (two older ones are only home in the summer). Plans of theme parks, white-water rafting, golfing, and lots of hiking and bike rides are in the future. I am very excited, but also realistic, and I KNOW I will need lots of encouragment and ACCOUNTABILITY. I would like a mentor/buddy who will be firm, yet kind, with me when I hit a bump in the road. Who am I kidding? I want someone who will NAG, YELL AND SCREAM if I don't do what I'm supposed to.:thumbup: Soooooo, if you are up to the task of being my buddy/mentor, please contact me!