sharonk

Yeah, i dont have $5000 much less $1000 to spend. Too many expenses now and with the current economy im not tkaing the chances. Not only that but i dont fly so mexixo is out of the ? for me.

I was thinking the same thing bayou!!!

Thanks chrissylu. I literally just got a call from my drs office and they discussed my case and are confused at the 3rd denial. Apparently when i called to request all the documents it must have lit a match under their butts. My dr says that the last he spoke to the insurance dr he was asked to submit a document and did so. He NEVER had an official conversation about my case. So why did the insurance dr deny the appeal is a mystery now to us all. My dr has agreed to try aonther dr on dr review but he is going to be out of the country till april 1st. More waiting....but at least they are trying again which they didnt say they were oing to do earlier today

Maybe i should now change the subject line to....DENIED FOR THE 3Rd TIME. all i can do is cry and get angry at the very same time. I dont know what i want to do at this point. Keep appelaing or let it go?! I want this so much but do i want to sit here and continue to not try and lose weight on my own so that i keep a bmi of 40 or do i give in and give up to move on with my life and start my yo yo dieting habits all over again?! What a way to start a weekend!

Maybe i should now change the subject line to....DENIED FOR THE 3Rd TIME. all i can do is cry and get angry at the very same time. I dont know what i want to do at this point. Keep appelaing or let it go?! I want this so much but do i want to sit here and continue to not try and lose weight on my own so that i keep a bmi of 40 or do i give in and give up to move on with my life and start my yo yo dieting habits all over again?! What a way to start a weekend!

I gotta give you mad skills for hanging in there that long. I honestly dont know if i could do it all over again. Although, i didbwomder how i was going to get through the 6 months when i first started! Lol Heck, april will be 1 full year since i started this whole thing.

Well as of this afternoon im being told by the drs office that my paperwork was resubmitted on tuesday as 40 bmi and we are awaiting the dr on dr review or answer or whatever it is. Originally iwa submitted as a 39 bmi but i didnt have any serious enough medical problems to qualify. I guess the drs office thought otherwise?! My insurance also tried to say the 6month supervision paperwork was not substantial enough FOR A 2nd TIME. If i WAS in fact resubmitted this week at 40 then they SHOULD approve me since i ahve gone through ALL of the steps. I have read my medical policy at least three times so im pretty well rehearsed on the qualifications. Thanks for your encouragement!!! Im hoping tomorrow i will have an answer and it will be that i am approved!!

Yay for ap! Will you all be adding a place for one's own profile editing?

Yay for ap! Will you all be adding a place for one's own profile editing?

I took phentermine a few years ago and lost a bunch of weight but as soon as the dr stopped writing the prescription i have gained it all back plus a bunch more. It definitely cut back my hunger big time. Sometimes i would go all day without eating and ended up getting dizzy. In the beginning it messed with my sleep but i soon got past that and was able to sleep again. I tried it again a year later and it didn't work at all the 2nd go round! Guess my body got immune to it since i took it for like 5 months. I def don't recommend because its only supposed to be used for a few months at a time and like i and others have already said, you gain it all back in lightning speed.

I took phentermine a few years ago and lost a bunch of weight but as soon as the dr stopped writing the prescription i have gained it all back plus a bunch more. It definitely cut back my hunger big time. Sometimes i would go all day without eating and ended up getting dizzy. In the beginning it messed with my sleep but i soon got past that and was able to sleep again. I tried it again a year later and it didn't work at all the 2nd go round! Guess my body got immune to it since i took it for like 5 months. I def don't recommend because its only supposed to be used for a few months at a time and like i and others have already said, you gain it all back in lightning speed.

You are right KR..it took more than 30 days to appeal it so you are lucky your Dr.s office know how to work the system well! It only took 4 days on the first submittal! I'm now waiting to hear about a Dr on dr appeal. The office told me that they would call me when they find out something. So i asked them what was a reasonable time to wait and she said this Friday. Ugh

Thanks for your input G!...i have tried asking my insurance to tell me why they denied it but they say they don't have that info available to them?! Something about their system wont allow the reps to see it. Not sure what else i can do to get the info i need?! I'm guessing they are going to say that my 6 months of Dr./ diet supervision wasnt substantial enough but i did what my band Dr recommended. I really don't know though, I'm sure they can deny it on the slightest things. Argh

I think they try to find snags ANYWHERE they can. I'm right there with you on the waiting! It sux big time!

I think they try to find snags ANYWHERE they can. I'm right there with you on the waiting! It sux big time!

I just printed the medical policy for my insurance (bcbs) and i don't think any of it can ever be totally clear to the average person. I think they do that on purpose . Sorry to hear about your struggles c. I hate to say it cuz i don't wish this on anyone bit i am glad I'm not alone when it comes to this annoying insurance crud! Good luck to you also!

Thanks guys...I'm going to give it one more shot! I just hate waiting!!! I don't want to do out of pocket because I'm too worried about having complications and such and then having to fork out even more money that what was expected. Plus the fact that i don't have that kind of money.

Yes, let us know what you think! My sis tried themand didn't like them but she didn't try the angle hair version. I'm not sure olive could get past the fish smell tho...eek

Well i have gone through my 6 months of supervised visits and did all the other necessary tasks for my insurance company's (Highmark BCBS) requirements to be consired for the surgery. All of this was completed back on Nov 1st 2011and i'm STILL waiting for approval! ARGH. Well i should say i was denied within 1 weeks time the first go round (Dec 12th or something like that) on the basis that my dr. did not submit a more complete review of my 6 month supervision. He sent in a summarized version of it and apparently that is not enough. Well it took about 1-2 weeks for that to get resubmitted and now i have been waiting for an answer ever since. Each time i call my insurance to check the status they give me a different answer to my case. One minute the case has been closed/denied and the next it's open and still under review. I'm so sick of trying to get an accurate answer from these people and i feel like my paperwork has slipped through the cracks. Long story short, they (insurance) say they have until 2/9 to get me an answer because that is the date the Dr. submitted as a predetermined surgery date (not my actual date for surgery). I want to call insurance every day still to see if my case has been finished but i know i will just hear the same roller coaster answers as before and i really don't feel like explaining what is going on since how do i know what they are now telling me is true/accurate?! The dr's office has been getting the same answers too so they are no help either. Any who, just venting! Hope others are having better luck than me, just wish it was my turn now! i hope this long wait is a sign that they will approve me the 2nd go round since the denial only took a week!! Cheerio

Thanks!!! I'm hoping insurance holds to their words and gives me an answer this week! Lets hope its the answer i want!

Android app= yay

I wish you could skip to more recent pages/comments per individual topics on the mobile website. I know i used to see that option before but now i can't. Makes things very frustrating.

I wish you could skip to more recent pages/comments per individual topics on the mobile website. I know i used to see that option before but now i can't. Makes things very frustrating.

Oh...gotcha! There are soooo many steps that i dont even know whats reaaly next. I guess i just assumed they wont schedule my surgery date until we find out if im approved. Hope this week flies by for you!!

As of this Friday, I have officially completed all steps needed for my drs office to submit the paperwork for insurance approval... 6 months of going to visit my pcp, nutrition consult, 6 months of support group meetings and of course the dreaded psych eval! I wasnt concerned before that insurance wouldnt approve me but now that the time has come, im a nervous wreck! I feel like im going to be denied since i am otherwise pretty healthy. If i remember correctly and since my bmi is only 37-38, we are using my high triglycide(?) Count as the co-morbitity. The last 6 months have felt like forever and i have my heart set on having surgery before christmas. I at least hope bcbs will get me an answer fairly fast as the wait is already killing me and its not even monday yet. Ahhhhh! Maybe i should stop reading others post on insurance denials but i do need to prepare myself for the worse... anybody know a percentage of overweight but fairly healthy people who get denied?? Prob not but just thought id ask...plus i needed to vent. :/