helleva

thank you Formely FLuffy, I will definitely look into the info you gave me. THanks Bubbaloo10, I hope that it was my coordinators fault. I was working with this one lady the whole time and just before my paperwork submission she left to have surgery and was out for two weeks. She left the paperwork to be submitted by another lady. I'm hoping my original coordinator will be back this week so that she can over look it and re-submit to my insurance. Thanks Minat, I was reading about GERD and how it can be linked to obesity. I asked my coordinator if I was diagnosed with GERD could it possibly help my chances of getting approved. She did state that anything at this point will help. I thought it would be an easy decision because of all of the above ^^ but my insurance company seems to think differently. I'm assuming they believe I don't have cormorbidities that my father has yet.. and when I do get them (which i am at my weight) that i will no longer be their problem and another insurance company's problem. thanks Likesulema, oh do i hear you! I am so frustrated. I really thought i'd be approved first time around. I just like I'm sure many have struggled my whole life with obesity. I don't care to wear a bikini and look like a model. I just want to live a healthy life and live long enough to raise my 1 year old and possibly see my grandkids one day. I hope and pray that my insurance will approve my surgery with the peer to peer or the appeal. Thank you for the compliment of donating my kidney to my dad. but it wasn't a choice.. it was a must.. I NEED him I greatly appreciate all of your responses and information in trying to help my situation all you great folks really help ME and you give me so much hope reading your success stories from insurance to your new life after the sleeve! Denise

Hi, I have Blue Shield of Califonia. My paperwork was submitted Monday. I just checked my insurance claims online. My Preops have been approved. Does this a good sign that my surgery will also be approved? thanks, Denise

Aww.. hopefully we still can be! If not I hope at least you do I'm sure you'll be fine.. keep me posted. & once again good luck I got my fingers crossed for you <3 Denise

I wonder if I need two medical reasons? Yes, I am going to a Center of Excellence. I had my hopes so high because the lady who submits the paper work said i'd be approved for sure.

Oh gosh I know! Its so nerve wrecking I had so much hope reading others approvals. I don't get it. Thought I'd be approved. I waited 5 days then I called my insurance. I didn't get the denial until today though. I really hope you get approved please keep me posted on your situation. Best of luck! Denise

thanks nanny 3 kids, I will look into it for sure. I just thought they'd approve me for obesity, gestational diabetes, 1 kidney, sleep apnea, and my family history! Is that the only thing you had wrong with you?

Thanks nancy3kids, I don't know if I have one. I do know I had at in my blood before. Don't know if that has anything to do with that. Plus, I believe I have GERD. I'm going to make a doctors appoinment to see what tests I can have done. Thanks again for the info. It truly helps. Denise

Thanks Newbie I have faith it will work out.. I hope you get an approval from bcbs:) please keep me posted. When you get your good news. Thanks, Denise

Thanks SV2 means a lot! have a great day..

Hey, I heard the exact same thing about my bcbs. I think it just depends because a lady on here had gestational diabetes and was approved just with that alone. Thanks, I don't plan on giving up. I'm hoping my physician and/or coordinator will fight with me. They really thought I was going to get approved first time around. I wish you lots of luck. It makes sense to do the procedure well taking out the band. Keep me posted and thanks again for responding to my post! Denise

Hi, The reason was "not medical necessary". I don't understand. I had gestational diabetes, only have one kidney, and I have sleep apnea. I have been over weight most of my life. My father had diabetes, high blood pressure, renoplasty (spelled wrong but can lose his eye sight at any time from diabetes), kidney failure, and more from being over weight. My doctor for the past 11yrs. Recommended this procedure because he's seen my struggles and knows I'm headed down the same road as my father. I'm so sad and disappointed Thanks for responding, Denise

Hi, I was just told that I have been denied! I'm so disappointed!! My coordinator I going to try and set a peer to peer and if not she will have to appeal. Just thought I'd update. Thanks, Denise

Hi, Just an update. I was denied! they do not see a medical need for the surgery. My coordinator is going to try and set up a peer to peer or send in an appeal letter. So disappointed :'(

Hi, They weren't my pre-ops lol.. I guess I was too excited. My paper work was submitted 5/14 and I'm still pending. :/ I'm getting a bit worried but I will definitely keep you posted. Denise

thanks for the good hope and info.. thats awesome your having your surgery soon yes, please keep us posted!

I will be praying for Jimmy tonight at 7 pm <3

Kiki, Thanks for the response. I had gestational diabetes along with sleep apnea. Glad you were approved did they contact you or did you call the insurance the next day? Thanks, Denise

Trcy, I just want to get the approval and get this over as quickly as possible. I'm ready!! Good luck to you I pray we both get the answers we are looking for in a timely manner <3 Denise

Hi tracy, I have Blue Shield of California ppo. My paper work was submitted today. My coordinator told me it should take any where from 7-10 days. I will let you know as soon as I get word is your paper work submitted yet? Please wish me luck! Thanks, Denise

praying for you Jimmy!

Thanks BKmama Do you have bcbs of California? If not upon reading upon different groups was bcbs Of CA on the list of discontinuing the 6 month requirement?

Hi thenewlife76, I'm thinking my surgeon sent me to the sleep study to improve my chances. I went on Friday April 27th. The preliminary report was sent to the surgeon May 5th. I found out yesterday May 8th that I have a mild case of Sleep Apnea. I go back this Saturday May 12th for the CPAP. So the process was not long at all. I hope this helps My coordinator told me I need 6 months of a consecutive supervised diet?! I have the past year on record but it was not every month. It was every 2-3 months. This is what worries me about getting approved te first time around :/

Hi thenewlife76, I'm thinking my surgeon sent me to the sleep study to improve my chances. I went on Friday April 27th. The preliminary report was sent to the surgeon May 5th. I found out yesterday May 8th that I have a mild case of Sleep Apnea. I go back this Saturday May 12th for the CPAP. So the process was not long at all. I hope this helps My coordinator told me I need 6 months of a consecutive supervised diet?! I have the past year on record but it was not every month. It was every 2-3 months. This is what worries me about getting approved te first time around :/

Meli1234, Thank you! Thank you! You just gave me the hope I've been looking for I hope BS does the same for me!

Hi thenewlife76 Thanks for replying. I think we should be approved with sleep apnea alone. I went 2 weeks ago for the sleep study. I didn't think I had it because I'm not a snorer but, low and be hold I tested with a mild case. I really want this procedure just like I'm sure you do. I hope our insurance approves us both so, we can start our new lives <3 hey, did they require you to do a 6 months of supervised nutrition class?