Jersrose43

An obgyn can do it too. Any doctor actually as long as it is NOT the surgeon

I got to 240. I was not an over eater. I was however LAZY I didn't cook. I ate out. A lot lunch at work everyday was bought in a cafeteria. Did I choose the salad bar - uh nope - pizza. Albeit 1 slice but still pizza over salad. And it was like $2.00 and a soda $1. And salad was 4.00 a pound. Breakfast usually an egg sandwich and a coffee. So no I didn't overeat. I was lazy. I made extremely poor choices. And there was absolutely no excerciss in my life ever

Most non maternity medical leaves go to short term disability. Many maternity ones do as well. Just FYI. The carrier will review the request under regular fmla first then if you don't qualify for fmla you get reviewed under short term disability. Fmla is activated after 1250 hours of work. I had an employee going through oncology treatment and had one paid fmla at the beginning of the year and a short term medical disability at the end of year. I was told by hr with the second one I could post her position and hire a replacement. I didn't. She was out for 4 months. That's the benefit of fmla protect your rights.

I have Cigna. I met with surgeon. Then several months later the EGD then the colonoscopy During the three month period of preparing I did the abdominal ultrasound as required by surgeon, the cardiologist visit and got the letter from my PCP. After I did all that they submitted to insurance and then scheduled my surgery after it was approved.

You can report him to bcbs and he will be evicted from the network. He just violated his contract.

Ask your surgeon if you will be impatient as per last paragraph. Not just overnight. That can be outpatient. And has to be a full fledged hospital too

From the U.S. Department of Labor's regulations relating to the Family and Medical Leave Act (FMLA 29 C.F.R. § 825.113): (a) For purposes of FMLA, “serious health condition” entitling an employee to FMLA leave means an illness, injury, impairment or physical or mental condition that involves inpatient care as defined in §825.114 or continuing treatment by a health care provider as defined in §825.115. ( The term “incapacity” means inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefore, or recovery therefrom. © The term “treatment” includes (but is not limited to) examinations to determine if a serious health condition exists and evaluations of the condition. Treatment does not include routine physical examinations, eye examinations, or dental examinations. A regimen of continuing treatment includes, for example, a course of prescription medication ( e.g. , an antibiotic) or therapy requiring special equipment to resolve or alleviate the health condition ( e.g. , oxygen). A regimen of continuing treatment that includes the taking of over-the-counter medications such as aspirin, antihistamines, or salves; or bed-rest, drinking fluids, exercise, and other similar activities that can be initiated without a visit to a health care provider, is not, by itself, sufficient to constitute a regimen of continuing treatment for purposes of FMLA leave. (d) Conditions for which cosmetic treatments are administered (such as most treatments for acne or plastic surgery) are not “serious health conditions” unless inpatient hospital care is required or unless complications develop. Ordinarily, unless complications arise, the common cold, the flu, ear aches, upset stomach, minor ulcers, headaches other than migraine, routine dental or orthodontia problems, periodontal disease, etc. , are examples of conditions that do not meet the definition of a serious health condition and do not qualify for FMLA leave. Restorative dental or plastic surgery after an injury or removal of cancerous growths are serious health conditions provided all the other conditions of this regulation are met. Mental illness or allergies may be serious health conditions, but only if all the conditions of this section are met.

Final is a federal legislation and it is NOT up to your employer. Here is the legislation Employees can take job-protected leave under the Family and Medical Leave Act (FMLA) for serious health conditions. But the U.S. Department of Labor's FMLA regulations say, “conditions for which cosmetic treatments are administered (such as most treatments for acne or plastic surgery) are not ‘serious health conditions’ unless inpatient hospital care is required or unless complications develop.” (FMLA 29 C.F.R. § 825.113(d))

I wore dresses and shorts with string ties

Nope. Called the pcp and got the letter. Then sent the letter to surgeon. He needed the letter for insurance approval. Basically recommendation that I have it. What I've done and I am healthy to proceed. A week before surgery I went for ekg, blood and clearance

8 days and you're still on liquids--- you're hungry. Call the doc and ask if you can move onto cream soups and cottage cheese. Your stomach sounds a little ready.

It's not the industry that has the issue. It's your employer They choose what riders to have. And if they are self funded they can write whatever policy they want. You will find that plans you get from non self insured employers tend to cover it. We need to talk to the benefits people at employers. They need to understand the cost of long term weight are way worse than a $10-30k surgery. That's the employers negotiated insurance price by the way. Charges can be crazy but insurance doesn't pay that

Sounds like anthem wants you at a center of excellence. So as having worked years ago for the blues here is se advoce. Hope it works. Call your local bcbs plan- is that regence?? What are their centers of excellence in that state for that bcbs plan Contact anthem advise them of the COE in that area. Advise anthem that you wish to use your BLUE CARD - AWAY FROM HE CARE program. Do you have a little briefcase on your card? That's a hint that you are covered worldwide for services through a local bcbs partner. Anthem needs to play nice and honor their bcbs association licensure agreement.

If you can afford it look at the obamacare plans in your area. Use it then drop. Always an option. Just check with the carriers first before enrolling. It's unfortunate that many employers are short sighted. I'm sorry. Woke up on the judgement side of the bed today?

Your doctor if he is willing and you qualify for a hernia surgery, could bill that and you pay the difference of the vsg

Your new surgeon will just have to call the insurance and reference the authorization and change the performing surgeon. Def be cautious of the change in hospital due to center of excellence.

Is your plan through an employer ? If yes the employer decides whether they will cover it or not. If you stay with the employer it is likely whatever policy he offers HMO Pos or indemnity- it won't be covered.

I have Cigna and I work there. My insurance coordinator told me she submitted everything. So I asked - what exactly ? Bullet point it for me as I already knew I had been senied. I called every single day. She failed to send the letter from the pcp. And I knew she was lying that she had sent it. My pcp didn't even write it until the week AFTER she sent in my paperwork. Her mom had a stroke and she left the letter unsigned on her desk. When she got back she signed and sent me a copy and the surgeon. I was so pissed. It required an appeal at that point and a peer to peer. So don't always blame the carrier. When she called me back that it was approved I told her I knew that already Cigna sent me a letter 8 days before she called! Needless to say my surgeon heard all about it. She was the reason I was ready to go in April but didn't have surgery until June 24 !

That's awesome. I have BCBSIL PPO and the surgery is covered under my employers contract. It has to be deemed medically necessary! Well, I fall within the guidelines of what BCBSIL require >40 and I can see a Master's Degree or higher NUT to say I'm mentally stable and understand what's expected before, during and after surgery. But ... My surgeon, through Cadence Health Bariatric Treatment Program, @ Central Dupage Hospital is having me to meet with my PCP for bloodwork and a letter stating there are no medical contraindications to surgery and a release to exercise, NUT, Pulmonologist, consult with an Exercise Specialist prior to surgery, Gastroenterologist eval or blood test to screen for H.pylori, an ECD and attend at least 1 support group. This along can take months. Is all this needed to help with the approval from the insurance company? These are all things your surgeon requires to ensure a successful outcome. This is major surgery and lifestyle change. You have a surgeon who wants to ensure success.

I waited and started my first visit in December 2013. Then started the program. Mine was 3 months. I was ready in June. I think you underestimate the program. It's part of the journey not a reason to back out. I learned a lot from meeting with a nutritionist and reading and analyzing everything I could. Including coming on these boards. It's time to ensure that you are truly ready for a lifestyle change. I've read a lot of posts where folks just went right into it without a wait period and truly felt they weren't ready. Use this time to your advantage. I had a $4500 deductible and $9k out of pocket. I was not willing to pay and put my finance at risk of a December snowstorm or holiday. I waited.

That's is correct. So have them try a $50 charge to make sure it goes through apply it as a deposit. That way you aren't surprised when you show up and it doesn't work

Look at this thread. Be careful of weight gain. Again search the entire board not just one forum. I went to gastric sleeve the. Insurance forum http://BariatricPal.com/index.php?/topic/332570-Very-nervous-about-Aetna-weight-gain

Look in the insurance forum. You will find a lot more than that

I would have the clinic try to put through a $50 charge. Many of those are HSA accounts and the cards are restricted to where you can use them. For instance you can't use it at a gas station but can use it at a pharmacy or a target. That's in accordance with American federal legislation governing HSA accounts since the dollars are pre tax.

Wishing you the best. This is a positive thing. Don't look upon it with negative thoughts.