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flmama

LAP-BAND Patients
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Everything posted by flmama

  1. flmama

    average hospital stay?

    My surgeon has you stay 3 days. He does a leak test on the table and then a leak test the next day (before allowing any liquids). Then he wants to see you drinking well and being compliant before being released to go home the next day. So 2 nights and 3 days. Compliance is a big thing for him.
  2. I hope you're feeling better OP!
  3. flmama

    Beware of low B12

    Its cheaper for me not to file. My PCP charges $10 for a b12 inj with no spot...just walk in vax clinic hours. I have a $35 copay if I file it. So check and see what it would be just to get the inj.
  4. Saw my surgeon today...he said 6-8 weeks! So I am hoping for a mid-late March surgery date.
  5. Well you cant target weightloss. You can certainly focus on different muscle groups, but that won't help you lose weight in that area. It sounds misleading in that area.
  6. Why is this a problem? You have health insurance now, right? Are you moving from one group policy to another? Or individual policies? If you're moving from one group policy to another, HIPAA/portability laws say that no pre-x exists as far as the new company is concerned. Make sure you get your Certificate of Health Coverage from your current carrier that shows dates you were enrolled. Your new carrier will want it if not at enrollment, the first time you submit a claim and they ask if it's a pre-x condition. We just got new coverage 1/1. New carrier tried to deny anything for my sleeve as pre-x, but I showed them our previous Certificate of Health Coverage from prior carrier and that I had more than 18 months of "creditable coverage" with them, and they moved forward. If you have a waiting period for a new job where you can't get insurance, that doesn't count as a gap per the portability laws either. You may pay more $$ for the coverage because of the sleeve if it's an individual policy though.
  7. flmama

    Aetna Insurance

    I have aetna, but my employer opted out of those requirements. They only require that I have "tried and failed" to diet in the past.
  8. flmama

    Psych Eval

    I know, it's a crazy long wait! For some reason, not many doctors in our area take our new coverage. We could only pick from 2 pediatricians. 3 or 4 PCPs...2 of them had waits until August/September too, luckily one had just added a doctor and I was able to get in right away. A prior auth is pending...that was my first thought too. Even if they will just pay for part of it, that would be awesome. They told me it could be several days before I hear back. A psych eval is my surgeon's requirement, not the insurance company...the nurse on the pre-cert line kept saying "we don't require a psych evaluation..." So I was just looking for some worst-case scenario $$ info if I have to go OOP. My surgeon is 4 hours away, and I did see if I could get an appointment with someone in their area that they work with, but I haven't had any luck with people returning my phone calls yet. My FSA will totally cover my deductible and OOP for the surgery, so if all that is standing between me and getting it done is $200-300 for a psych eval, I'll totally pay it.
  9. The only two doctors in my area that provide psychiatric testing and are on my insurance (yes, all two of them) don't have any availability to do my psych eval. So I'm going to have to go to someone and pay cash. How much was your psych eval if you had to pay cash?
  10. flmama

    Psych Eval

    Meaning, one could see me in August and one could see me in October. My surgical consult is February 6. I would be happy to wait for an appointment later in February or March, but 7-9 months is a little much, no?
  11. Well call and ask them if they will take clearance from your Pcp since that is who provides care. You don't even have to go into details! If you call right now you will know in 5 minutes whether you have to be upset or not.
  12. flmama

    HURT BY COWORKERS

    Fyre ...I just LOL! You remind me of my brother!
  13. Ask them if your Pcp will work since he has been managing your care. If not, just go get yourself a new cardiologist...I doubt they are requiring you to have a history with them. They just want them to clear you for surgery which would just take an exam and review of your records and tests...maybe updated tests if you need them. Don't be upset until you have to be! Good luck!
  14. flmama

    HURT BY COWORKERS

    I'm guessing you are the one who usually coordinates the gift efforts aren't you? Ive found people are rarely as nice as others are to them. I know it hurts. You just have to decide if you will continue to contribute going forward or not. It sounds like you are unappreciated on multiple levels. Don't waste any of your time on this...not work expending your healing energy on people who don't matter.
  15. flmama

    Greek yogurt challenged

    Yoplait's 100 Cal Greek yogurt is some of the foulest stuff ive ever put in my mouth. Local store was giving samples and it tasted so chemically and not much different from their regular yogurt. Def didn't have the tang and thickness of real Greek yogurt. I like Chobani and Fage best. Voskos is a close second.
  16. flmama

    So pissed...

    Agree with Mizzz...it's def a good starting point. I hope they do the right thing and refund you right away. But if not, you've got your ducks in a row to start a complaint.
  17. flmama

    So pissed...

    Then they need to bill insurance correctly and refund you your $400 per your agreement. And actually, in your state, you would complain to the medical board. There is information in this document about balance billing in your state (and it specifies that it is for out of network providers/facilities only) with links at the bottom who to complain to. http://www.tdi.texas.gov/consumer/cpmbalancebilling.html
  18. flmama

    So pissed...

    DO NOT agree to pay anything above and beyond your deductible and coinsurance or copay. That is balance billing and it is illegal almost everywhere unless you are out of network...and then they can only balance bill you for the difference between what the insurance paid and what they normally would pay (example if they normally pay 80% but only pay 60% out of network, they could bill you for.hour normal 20% plus the 20% difference).
  19. flmama

    So pissed...

    I would send a firmly worded letter that per your agreement, the $400 was refundable. If they misbilled the insurance company that is a separate issue that they need to resolve with the insurance company, and since your deductable and coinsurance (if applicable) are paid in full, you will be looking for a check from them within 2 weeks otherwise you will bring the issue to the attention of your state's Attorney General office. Also, this sounds like backward balance billing...which is illegal in most states if you are using in network providers.
  20. flmama

    So confused!

    Thank you!! I am excited that it will be sooner!
  21. I had confirmed coverage/benefits with my insurance provider and pulled requirements from their website (and even talked over those requirements with customer service). But my new surgeon's office just called and said that there are NO requirements for my specific plan...just that I have tried to diet in the past and failed. But no specifications about timelines or it being medically supervised or whatnot. I just have to list diets and details and they submit it. I will still have the psych eval and see a nutritionist through the surgeon, but not for a specified time frame. And I've already started working with a trainer on my own and seeing my PCP 1x a month just as a precaution for documentation purposes. I'm just waiting for the other shoe to drop and hoping that if they do institute some requirements, that what I'm doing fits the bill. My surgical consult is scheduled for 2/6. EEK!

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