Toyaboo22

I finally got the call from the insurance company and I'm approved. So now it really hit me that I'm really going through with this. 6 more days!!

Oh crap, I didn't know they would do that. I'm so sorry to hear that.

Good luck

How soon after you being sleeved did you go on the cruise? I'm scheduled on 9/12 but originally was supposed to go on a 7 day crusie on Oct.6. Now I'm thinking I should call the cruise line to see if I can reschedule for next year some time. I just think that I wouldn't be able to really enjoy myself three weeks after surgery. Plus we're supposed to be going with a group of people and I think they would question why I'm not enjoying all the food.

I was supposed to start my pre-op diet on Aug.30th but haven't. It's not a liquid diet just cutting out carbs so I guess I'll start tomorrow with the holidays being over. I'm nervous, excited, anxious, and a whole lot more but I'm going to leave it to God. I've noticed I've been on this website way too much lately, lol. It's addicting.

Well I have Anthem BCBS and didn't have a 6 month diet requirement. I just had to have nut/psych visit, bmi over 40 or 35 w/comorbidities, surgeon consult, pcp approval, and bloodwork, chest xray, ekg, u/a, and stool sample. I haven't had my approval/denial yet but hopefully everything turns out ok.

I attended a seminar and two weeks later had a consultation with the surgeon to discuss what surgery might work best for me. After the consultation, I had to go to my PCP to have the mandatory test ordered and after that was scheduled for my pre-op appt with the surgeon. It wasn't a pre-approval process that I went through. My surgeon's office was not going to submit anything to BCBS until after I paid my money upfront and all the test and nut/psych visits were completed. That was on Aug.30th so I'm not sure when they will submit as my surgery is scheduled for 9/12. The reps at BCBS do seem to be a little rude at times and I've found that they will tell you anything as they really are unsure of things. I would ask them to send you a copy of what all is required and if they cover WLS under your plan. I have a copy of what they sent me if you would like but every plan is different.

I can't wait to see them. Congrats again!

LOL

Hello

That's wonderful. Congrats!

I completely understand where you're coming from

Hello, I'm 28 and looking to get sleeved on 9/12. I stay in Tampa,Fl

So I was speaking with the coordinator at the surgeon's office and I was told that I need to pay my deductible, out of pocket amount, then 20% of the procedure (insurance would pay 80%) along with a $675 program fee. All of this is due at my pre-op appointment on Aug.30th and once this is paid, she will then submit to BCBS to see if it is approved. I forgot to say that all of this is non-refundable and they can't guarantee an approval from the insurance company. I'm trying to figure out if this is a common practice among surgeons everywhere. I really can't afford to give up all that money for it to be denied. Then what?? I'm also trying to figure out how in the world they're making me pay 20% up front if they don't know what the insurance company is going to allow them to charge. She also said that if approved, once the surgery is over with and the insurance sends them their claim, they will refund me me via check in the mail whatever amount I overpaid.

I'm going to call the insurance company today to confirm if they are in network and to see if this should be happening. Thanks for your suggestions.

That's weird, let us know how that goes.

If you drink plenty of fluids throughout the day how are you only urinating once in the morning? That has to be painful. I hope everything works out for you.

Only my husband knows so far. I feel so guilty not telling my family but I know my mom will go and tell everyone. Maybe down the road, I will come clean.

Hip hip hooray!!

Good luck

When I went for my consult a couple of weeks I guess I signed a paper agreeing to this non-refundable policy. I honestly didn't remember signing it but they faxed me over a copy with my signature on it.

The total amount that I was told to bring on Aug.30th was $6975. I asked them to explain to me the fees and she provided me with a breakdown. Their breakdown: Surgery is $22000 20% of 22000 = $4400 $675 Program Fee $500 deductible $1900-$500= $1400 (out of pocket expense) With that much down to pay, I might as well go to Mexico and make a vacation out of it. My husband doesn't want me to do that though

This is exactly want I'm scared of (a loophole for denial). My surgeon's office is requiring me to pay my deductible, out of pocket cost, $675 program fee, and 20% before they even submit to insurance for approval or denial. All this is non-refundable so that makes even more nervous about this insurance thing. I meet all the requirements of the insurance company but still have the fear that they will find something to deny me on. The only person that knows I'm considering this is my husband and I don't plan on telling anyone else.

My visit lasted two hours and consisted of her asking what about all the foods I eat/don't eat and what can I do to change habits after surgery. She went through a list of foods/vitamins/protein shakes that she sells, trying to get me to purchase them from her. It felt more like a sales pitch rather than a real nutrition consultation. I did learn a lot but I could've benefited more by going through a meal plan and what I should do before/after surgery rather than why her products are better than the rest.

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