-
Content Count
764 -
Joined
-
Last visited
Content Type
Profiles
Forums
Gallery
Blogs
Store
WLS Magazine
Podcasts
Everything posted by happy1957
-
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
Date set Dec 28th at 7:00 am.... Happy, Happy, Happy!!! labs done last night, liquid diet starts tomorrow. This is a whirlwind of good things to come. :-) Merry Christmas everyone! -
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
OMG!!!!!!!!!!!!!!!!!!!!!!!! Thank you everyone for your prayers.... I was officially approved today! I am so overwhelmed and shocked to tell you the truth. This was my final appeal. To all of those of you that have been denied. Please don't give up!!!! The surgeons office is making arrangements as I write this to set a date for this year!!!! This is the best Christmas present ever. Thank you for listening!!! Thank you God for helping me save my life!! -
Allow a couple hairs to get long enough to pluck. If you pluck them and the root is black or very dark, then the laser will be able to find them easily, if not, it's just hit or miss as the laser pulsates over them. I personally am very fair, my body hair is very blonde with the exception of an occasional thick hair I like to call the family "goat" hair. We all have them, you know the ones, the fine wire that decides to pop out of your chin when you least expect it. Although it looks dark to me, once plucked, the root is still blonde, making it very difficult for the laser to zoom in on. The laser operator can go over the area repeatedly in hopes of catching the hair root and for me who has had access to repeated treatments, finally has had that one or two stubborn ones removed, it wasn't easy. I'm just saying, a dark haired person is so much more successful and the cost is usually cheaper because the laser can find those roots easier. In any case, cheaper Dr's are not better, they are usually the ones in the "learning" phase, spend your money on the newest technology and the most experienced people. It all works eventually. I have seen some true miracles. I would wait until weight loss goals are met and hormones are balanced before spending money. Make it part of your make over plan. You deserve it. The length of treatment depends on how much area is being done. It can be quite painful and maybe sideburns or marionette first. Worry about one area at a time. I know that dark side burn hair on woman, seems to disappear very quickly and makes the client very happy. Depends on what bothers you the most. Each session is 15 minutes or so, but of course there is 30-45 minutes of prep time with local anesthesia creams for numbing. At least in our office, some Dr's don's use that at all. :-( Then for something really special, try putting hair back where you may have lost some, I am true advocate for the product that gives you back youthful eyelashes. You know the one, it starts with the letter L and sounds like ateash . Well, I think it makes people look younger, nothing like a longer set of eye lashes, people tend to put on mascara, make themselves more presentable and sincerely others look at them differently and overall they do look younger. I think it's the least expensive thing you can do to change how you look. I have seen some drastic changes. It is an up keep product, but I see the results and honestly, it's better than botox in my book. Eyelashes and freckles and youthful!!!
-
Hi everyone, I actually work for a Dr who does the laser hair removal. It works fabulously, provided you are dark and the hairs you are plucking out have dark bulbous roots. The laser will target those black roots and kill them, but those of us who are truly blonde or have turned white, the laser will get them hit or miss. It will take more treatments and doesn't do as good as a job. I love the post from the Greek lady and assume you're dark? Typically a semi full bearded person of dark decent are the most successful clients we have. If you are fair and have light hair, don't waste your money. If someone tells you that they can cure you 100% in 2-3 treatments, they are lying to you and themselves. :-(
-
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
Just a update.... I had the phone conference. It was really quite easy. There were 5 people present, one Dr. 2 nurses, the narrator and myself. They just asked why I thought they should overturn their decision and and I started with that I understood their ONLY reason for my denial was the low BMI in 2009 which was caused by but another attempt at diet and exercise, although I had started 2009 with the correct BMI. Then I just opened up like faucet. I had no problem telling my story which was easy because it was the truth. I will admit, I did get emotional at one time because it's difficult pouring your heart and soul out to strangers when you can't even pour it out to the people you love without feeling condemned in some way. It was a humbling experience. I know these people have a job to do and if things don't work out, it's not one individuals fault. It's a majority vote and I suspect God's will. It was my second level and last appeal. I meet all the requirements, have all the records around that date. They had very few questions, thanked me for representing myself, said I did a great job and that after hanging up they would continue the decision making process and let me know in a few days. My letter said they had to let me know within 5 days. I'll keep you informed. Thanks for listening,. -
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
Thanks for your response and suggestions. I think a anti anxiety medication may be warranted. I have no idea what their expectations are of me. I am in need of this for health reasons. I am slowly slipping into the obesity multi health issues world. It needs to stop before I am totally handicapped by my weight. -
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
Thank you for your response.. I will check this out. A low BMI in 2009 is the issue. Aetna requires a consistent 24 month BMI. I fell below their required 40 BMI in 2009 while working with a trainer. :-( yet have been heavy my entire life with a roller coaster of weight loss and regain plus. -
Has Anyone Had Experience With A Phone Conference Appeal?
happy1957 replied to happy1957's topic in Insurance & Financing
I was denied because of a low BMI in 2009 when working with a trainer. I had started out the year at the correct BMi and my only weight reference is the on line weight chart where I started the guided diet and training and it ended abruptly when I stopped. I had lost enough weight to fall to a BMI of 32. I quickly regained the weight, but all they see is the 32 BMI. :-( AETNA) I would like to improve, high blood pressure, recent high blood sugars, high cholesterol, joint pain, strong family history of diabetes (death of dad) and stroke, death of brother and mother (who is institutionalized) . I appreciated your help... any suggestions is great!! -
Third Time Is The Charm With Bcbsil!
happy1957 replied to DisappearingDivis's topic in Insurance & Financing
Congratulations...... I do not have BCBSIL, but my 3rd request to Aetna was mailed out yesterday. I am hoping for a very Merry Christmas approval. :-) You have given me hope... I wish you the best of luck with your surgery. -
Excited Waiting For Gastric Sleeve Surgery Insurance Approval
happy1957 replied to mouse trap's topic in Tell Your Weight Loss Surgery Story
Congratulations to all that have been approved. Aetna has denied me yet once again for that one low BMI in 2009. I will appeal again and hope that my documented weights at the beginning of the year when I was heavy and had started the training program will be enough, if not, I have to wait 6 months and start the entire process all over again. So I guess stay fat, wait another 18 month before doing something about it.. Doesn't that seem insane? -
I suspect that celebs have all the money in the world to travel the world where this surgery has been going on long before it ever hit the US. So they can travel, vacation, hide their identity and pay for silence. I honestly think that only time will tell. Kirstie Ally is pretty old to be losing such a substantial amount of weight "again" in such a short amount of time. Her success will reveal the true answer as we all know, the chance of successful weight loss and keeping it off is about 2.5% and she has given it a heroic effort many times over. Again, health is the real issue and if it can be done and kept off in a healthy manner, fabulous!!! If I had the financial backing, I would fly to the ends of the earth to have this done. I am so envious of all of the successful sleevers here. I enjoy reading and seeing your successes... Thanks to all of those who share.
-
Excited Waiting For Gastric Sleeve Surgery Insurance Approval
happy1957 replied to mouse trap's topic in Tell Your Weight Loss Surgery Story
I too have Aetna... My BMI was right at 40, I was denied because I lost weight in 2009 and fell below the 40 BMI, my co-morbidities are high cholesterol/ high blood pressure/ and reflux, which are not considered true co-morbidities to Aetna. I am appealing the decision based on prior weights of 40 BMI's in 2007 and 2008, but that one low year, although it is close to 24 months., still isn't the 24 consecutive months needed. My experience has been nothing but negative with Aetna, from lost documents, to miss filed documents to lack of returned phone calls etc. They are hoping I go away. If I am denied this time. I will go direct to the the state Insurance commission to file the next appeal. I hope your experience is better..Never give up!! -
Seven Month Update (Pics Included)
happy1957 replied to Felicity2u's topic in Weight Loss Surgery Success Stories
I am writing this with complete sincerity. I am so overwhelmed by your progress, you are beautiful!!. I personally have been denied by my insurance, but you give me hope and inspiration to proceed with my appeals. You should be so proud of yourself and the hard work you have put in. You look amazing and I can read how confident you feel, you're just beaming with pride. I am also amazed with your hair, it actually looks thicker. With a huge weight loss in such a short period, you would suspect some thinning, did you experience that, if not, did you do anything to prevent it? Keep up the good work and keep wearing that beautiful smile!! -
Looks like Aetna and my Dr were unable to connect during the allotted time frame for a peer to peer review. The next step is a written appeal. Wish me luck. :-(
-
4 weeks post op pictures :)
happy1957 replied to Sassygirl06's topic in Tell Your Weight Loss Surgery Story
You look fabulous! Keep up the good work. Spoil yourself and buy a special (show the world) outfit for the holidays. I am soooooo envious. :-) Be proud of your accomplishment. -
EFF WORD EFF WORD EFF WORD!
happy1957 replied to JourneyOfAFatKid's topic in Tell Your Weight Loss Surgery Story
I can relate and feel your pain. I too was denied, although by Aetna last month after 7 months of hoops. They denied me based on my lower than required BMI of 40 in 2009 while working out with a trainer and dieting. God forbid you show that you have sincerely tried. This was addressed in a letter beforehand but they ignored it . I am still waiting for my surgeon to do a peer to peer . I meet all other requirements with the exception of the 24 month continuous 40 BMI. I was ok in 2008 and 2011, had no documentation for 2010, but 2009 killed me. Next stop INSURANCE BUREAU!! Don't waste your appeals by yourself. God to your states insurance bureau and get an advocate, it may help. Good luck.. -
I feel your pain, I too was denied by Aetna this month. They pay for the sleeve under my plan, but it's because I had dieted in 2009 and was below the 40 BMI I needed to prove for 24 consecutive months. Although my weight was clearly above the 40 BMI in 2008, partially 2010 and currently. Will your plan for RNY? Have you given that thought? I am sick thinking I have to remain this weight for a few more months to pacify their needs when they have 23 years of weight records that clearly show my roller coaster weight history of cycle dieting. It is disheartening. They are hoping you will just go away, but don't give up. Write a nice letter of appeal, being heard but not over bearing. You never know what could happen. I wish you the best of luck!
-
Six Months Pics 103lbs down
happy1957 replied to Felicity2u's topic in Weight Loss Surgery Success Stories
Be proud of your success. You look great and I'm sure even feel better. I assume your life has changed now that you are free from those pounds and can do things you haven't been able to do in a very long time. You look radiant. Keep up the good work, I hope one day my insurance approves me and I can be right there with you. -
I met the current Aetna requirement of 40 on my insurance, but it had to be steady for 24 months so I was denied. I had of course dieted during that time and fell below. I need to maintain the 40 until next year, but will appeal.
-
This is weird, but did anyone ask...
happy1957 replied to Catracks's topic in PRE-Operation Weight Loss Surgery Q&A
This is a very serious and important message to everyone. My sister who was sleeved on 08/30/11 without any prior complications or red flags, nor any surgical complications was told that a tiny tumor was found on the portion that is sent off automatic for pathology evaluation. Her pathology results came back two days ago and unfortunately it was a very rare form of stomach cancer, not seen inside the stomach during the required pre-EGD, but as a tiny bump on the outside of the removed portion the stomach. Her sleeve was LIFE SAVING in more than one way!!! Had she not had the Sleeve, this cancer could have been been devastating before it reared it's ugly head. She has many things to overcome on her journey, hopefully all will be ok. If you're at all curious, http://www.gistsuppo...hat-is-gist.php, The photo of the removed stomach is amazing. It looks like they ate a full course meal. -
I've been denied by Aetna...another bump in my journey.... it's because of my low BMI in 2009. My PCP had addressed that in a letter, just another cycle of diet and exercise, either they didn''t see it or ignored it. My Dr is scheduled to do a Peer to Peer appeal next week in hopes of getting me approved. My sister is all sleeved, at home and doing well.
-
Ok... so I'm putting my business in the streets
happy1957 replied to slhobbs81's topic in Insurance & Financing
What exactly does 5500.00 cover? Air fare? surgery? Complication insurance? A massage boy? :-) I was just denied by my insurance, just curious, I am still planning to fight the battle. -
Still Waiting on Insurance Approval - 8 Days Later
happy1957 replied to beachlover09's topic in PRE-Operation Weight Loss Surgery Q&A
At this point my Dr will do a peer to peer appeal and I'll hope for the best. If my track record of cycling with the same 30-50 lbs every 3 years isn't going to fly, then I guess I die fat or hope for an anonymous donation for a Mexican trip... I will also get a good nights sleep and maybe chat with the insurance bureau on how to be my own advocate in the appeals process. I am not ready to quit yet. No need to worry, I have absolutely no control! :-( It's my party and I'll cry if I want to .... -
Hello ladies or spouses of ladies who have experienced this, I am 54, and am on Estrogen replacement. I have read many stories of how people leave the hospital after surgery and are told to abruptly stop many, if not all medications. I am reaching the age of the natural change of life, although went through surgical menopause at 29. If anyone has had the experience of stopping HRT as part of the surgery, I would like to know the effects. I personally think using old, stored calories is enough of a challenge to start with, yet do I take advantage of this time to stop the HRT? I do not want the effects of menopause (lack of libido, hot flashes, vaginal dryness, mood swings etc.) to come crashing down on me on top of all the physical and emotional changes associated with VSG. Help!!!!!!!!!!!!!!!!!!!!!!!!!!