Westfield27

Good luck to you also!

I know what you mean about pins and needles. I just want to call my insurance company everyday hoping it's been approved.

I was told by my surgeons office that there was a 90% chance of me being denied due to a 7lb. weight gain during the three month nutritionist program. I was initially told if I gained weight it would not matter by my nutritionist but now that my paperwork has been submitted I have been told differently. I followed her plan exactly as she told me and still gained 7lbs. Two of my three weigh in I was very bloated due to water retention which she noted so hopefully they look at the whole picture. I called my insurance company in a panic because I really want this. They suggested in the mean time I go ahead and make another appoint with my nutritionist and lose as much weight as I can before that visit so that if I am denied I will be able to appeal right away with proof of weight loss. Her other suggestion was that I do one of the many pre op diets from now until then ( August 12th). She told me my best choice would be two liquid diets (protein shakes or smoothies) and one sensible meal at lunch or dinner time. Do any of you agree with this method? At this point I am willing to do whatever it takes to have this surgery. I made the appointment for August 12th so I would be doing this for the next nine days because I plan on starting Sunday. I was told if I was approved by the appointment to cancel it.

Thank you!

I weighed myself this morning and I am now 394.4. My starting weight with the nutritionist so she says was 385 ( I'm pretty sure it was 392 I have it written down myself). But since 385 is what she wrote I now have to go under that. So basically I am going to do my best to lose 20lbs if possible. I plan on doing the two liquids a day with a sensible meal a day. I will also do my best to exercise as much as I can.

Thank you!

100 phone calls until the point I became an annoyance and she most likely said let me get this done before she drives me crazy. The last few weeks have been hard to get to this point. No one would return my calls so I started calling higher up to get the answers I needed. I'm sure I made quite a few people mad but I really need this.

Good Luck! Mine was submitted yesterday and I am overly anxious.

Thank you!

That's my plan. I'm going to do my best to get back under "385" which apparently I started at in case that I am denied. Tomorrow I am calling the nutritionist to set up another appointment.

Unfortunately, it has already been submitted. Im trying to remain optimistic my bmi is 58.8 with pcos and high blood pressure. I hope thats enough.

What makes me the most angry is that I was told it didn't matter if I gained or not.

They said the nutritionist wrote down that I started at 385 which I dont agree with and that my last weigh in was 392. So basically I gained 7lbs.

Oh man. That doesn't give me hope

I've heard from elsewhere to simply ask your surgeon to call on your behalf and plead your case of how important it is that you get this surgery.

I have told all of my family as well as my coworkers. Most of my coworkers are really fit and eat healthy. They all support my decision to get WLS. I have yet to run across someone who has been negative towards my decision. Well I take that back I had a cousin post a status on facebook about it on the sly but I feel it was out of jealousy so I disregarded it. It's totally up to you and whom you feel comfortable sharing your decision with.

This gives me hope. I also have Aetna and gained 7lbs. My paperwork was submitted to Aetna today but I was told I have a 90% chance of denial due to weight gain. What exactly is a peer to peer? I may need my doctor to do this.

So now I am aggravated. After being told by the nutritionist that me gaining weight wouldn't matter with Aetna apparently it matters. My file was submitted to insurance today and the lady who submitted it called to tell me there was a 90% chance that I would be denied because Aetna has been very anal weight gain. I wish they would have told me this 4 months ago when I started this all. January 19th I will no longer be covered by my parents insurance so it's kind of a countdown to try and get this done. I guess all I can do is pray for the best but I really wish I would have known about this months ago. What was excitement that my papers had been submitted is not dread and anxiousness.

I also know many people who have gotten pregnant very soon after WLS and have had normal pregnancies. They are however closely monitored by a nutritionist, OBGYN, and their surgeon. I agree with you at what point people choose to get pregnant is up to them. Being able to conceive is one of the biggest reasons I am choosing to get this surgery as well. I am choosing not to put a time frame on it although I would like to hit goal before getting pregnant.

Did anyone call and tell you that your information was being submitted to your insurance company? I have been trying to call my bariatric coordinator for weeks with no luck to see if it's been submitted or if I am still missing something for submission. I feel like I'm being a pain but I am so overly anxious and ready to have this surgery already. I am so tired of feeling sluggish and as if every day I have a new health issue. I just wanted to know if anyone was actually contacted to let them know it had all been submitted to their insurance (Aetna). Thanks!

Well I just spoke with my bariatric coordinator and was advised she was still missing my psychological evaluation which I faxed over to her because I had a copy of my own and my medical records from my primary care doctor. So fingers crossed it will all be submitted to my insurance company by the end of the week

Congrats!!! It seems this whole experience for me has been nothing but teeth pulling and nail biting. I may just be overly anxious but it feels like I am fighting with everyone to get their part done.

That's how I feel. I am paying for their service and it seems no one wants to return my calls or anything and it's very frustrating! I think instead of calling the bariatric coordinator I am going to go ahead and call my surgeons office tomorrow and see what the deal is. Everyday I get more and more anxious because I know I NEED THIS!

So today I completed my 3 month program with my NUT. I told her that I was worried about being approved by Aetna due to the fact that my weight fluctuated the entire three months. She told me she's never heard of anyone being denied due to gaining so I'm praying that she's right. Next week I meet with my Psychologist for the final testing phase with her and the only other thing I am waiting for is my letter of medical necessity that I am still waiting for from my PCP. I was told by the bariatric coordinator that she also received word from my OB/GYN yesterday that he was in the midst of writing one as well. My PCP informed me yesterday that she had completed my letter just needed to fax it but I swear they are in their own little bubble and does thing when THEY WANT to do them. I also asked them if they had submitted my medical records and said they seen nothing about it. I asked my bariatric coordinator if she requested them and she said that if had been done when I started the program three months ago!! I am crossing my fingers this will all be taken care of by the end of the month so that I can submit all my paperwork and hopefully be approved! I'm so exited I just want it to be submitted already. And on top of all of that the valet at the hospital this morning wrecked my car ugh!

Will do! I told my NUT about your post and she told me she's never heard of anyone being denied for weight gain so I am praying she is right. Besides a couple loose ends I should have all my paperwork submitted in the next two weeks