Kelly1121

My NUT says absolutely not on either of those until at least 6 months post-op.

I'm a little more than a week behind you - December 7th for my RNY.

I'm scheduled for 12/7 - can't believe this is finally happening! I started the supervised weight loss period more than a year ago. Just sent a request to join the FB group too.

You look fantastic!! Congrats on this huge milestone!

I am absolutely over the moon excited right now. I finished my 6 months supervised diet/nutrition with my surgeon's office back in April, but I was denied when it was submitted to insurance, despite having a BMI of 42 and GERD (they denied it and said GERD wasn't one of their approved co-morbidities, and my insurance plan requires a co-morbidity regardless of BMI). I immediately contacted Lindstrom Obesity Advocacy and began the appeals process with them. Within a month of them sending in my (wonderfully written) appeal letter, I just received a call to let me know that United has approved me for surgery and has provided their office with the approval and authorization number, and UHC let them know the official approval letter was mailed on 10/4, so I should likely receive it in today's mail. The moment I have it in my hands, I can contact my surgeon's office and pick up where we left off and hopefully get surgery scheduled within the next month. I am beyond excited! This is actually happening!! I've primarily stayed off these boards for the last several months because it was a bit depressing to read about everyone having surgery when I didn't think I'd end up approved. What a great ending to the day!

I got a letter from United Healthcare today letting me know I am denied for surgery. My insurance plan requires a comorbidity for everyone - even a BMI over 40. I have GERD, and several 'minor' issues related to my weight, but do not have any major comorbidities. I'll call my surgeon's office on Monday, since I'm sure they received the same notice today. I'm so bummed, and not sure where we go from here. I know I can appeal, but I don't think I'd win because I don't have anything major. My BP has been increasing every year, but is not high enough for meds. My cholesterol is high, but not high enough for meds. I don't think I have sleep apnea (although never been tested). My recent glucose test had me at 5.6 - the highest level in 'normal'. Again, going up, but not high enough to require interventionI suspect I might have arthritis (long shot - but something is going on and I have auto-immune issues... never thought I'd WANT to have arthritis, but now I'm thinking I might need to go in and see my rheumatoligist that I haven't seen in several years). Has anyone ever been through a denial for this reason? Think there's any shot of making a case that I'm on track to develop these comorbidities in coming years, so doing surgery now would be best to be preemptive before real issues arise?

You look fantastic!

My insurance says I need to be in a medically supervised weight loss program for "six months" and the bariatric center I'm working with says that when they called about insurance requirements they stated "six visits". I'm going to call insurance on Monday and verify once again, but I'm curious, if you've gone through a required # of visits, did they count it as visits within a month? For instance (my first visit was 11/15/15) - six months to me means: 11/15-12/15: month 1 12/15-1/15: month 2 1/15-2/15: month 3 2/15-3/15: month 4 3/15-4/15: month 5 4/15-5/15: month 6 - making me ready to submit to insurance around the end of May. OR - was it viewed as this? 11/15 - month 1/visit 1 12/15 - month 2/visit 2 1/15 - month 3/visit 3 2/15 - month 4/visit 4 3/15 - month 5/visit 5 4/15-month 6/visit 6 - making me ready to submit to insurance around late April. If it's the second, I'm a month closer to surgery than I was originally planning, which would be incredible! Like I said, I will call insurance on Monday when the bariatric center is open to confirm, but I'm curious now. I have United HC.

Great job!

How did the peer to peer go? Was it overturned?

Wow! You look fantastic! I also really love the dress you are wearing in the current pic!

You look incredible!!

Hope everything goes well today!

You look INCREDIBLE! Congrats!

Congrats!

I had my final sixth month weight loss appointment today, so my doctor's office is submitting everything to insurance tomorrow. The NP told me today that she's "certain I'll be approved", but I don't feel like I really can believe that until I actually receive the official approval from insurance. Insurance has 15 business days to approve/deny, then I have pre-op apts, will schedule surgery, etc. I'm going on vacation for a week starting May 27th, so theoretically, we are planning on surgery the week after that once we return. It feels surreal to be at this stage but I am just waiting for something to go awry. Hoping for a quick response from insurance so I can breathe again!

Yay! Found out it really was just six visits. Submitting to insurance tomorrow!

I am certain I will be the exact same way! Glad I'm not alone in this.

What a huge disappointment! Glad they are being cautious with your health, but I hope time passes quickly before surgery!

I just sent you a FB message. I'd love to be added!

I am also with Dr. Swain at Honor Health in Scottsdale.

Unjury Chocolate and Chocolate Truffle Nectar have been my favorites up to this point. Chike coffee protein is also pretty good.

You look great!

You look fantastic! Congrats on your great success!

Yay!! Congrats!