shancanssleevejourney

I went through every step that my insurance required. The 6 month medical supervised nutrition counseling. All the tests required including pysch eval. I was told my surgery was covered up to 16,000 for a lifetime max surgery pay out. No problem, my surgeon office told me it was 18-20,000 so I figured worst case scenario I would owe 4,000. The hospital just sent me a bill for 32,000.00. They said insurance only covers for entire cost including hospital stay. I would have never done this surgery had I known. I am devastated and don't know what to do!

Thanks for the clarification and you are still doing amazing. I feel a little better now lol

I'm confused, you said you started the journey in January, so I am assuming you lost before surgery? How much did you lose after surgery. 90lbs is amazing no matter when you started, I am just celebrating my 3 month and I am almost to 50 and know I will never lose 40 more in two months so just jealous lol. Congratulations on being so successful.

Once you are authorized you are good to go. I had lost 9lbs prior to surgery and did drop 1 bmi point. It doesn't matter if you lose after the authorization. It's only to document.

Fighting a losing battle over insurance coverage. I was told one thing and billed completely different. I am in desperate need of anyone who would be willing to help me understand what they were billed, what was covered and what was not. I think they are pulling a fast one because we have Delta Health as our plan manager and they are both pointing fingers at each other. I need a baseline to see what is usual and customary for them to pay for the surgical supplies,operating room and overnight stay etc. If you want to do this privately please send me a fb message. https://www.facebook.com/shannon.vanhoosancannizzaro

I regret I use the term usual and customary it apparently caused a lot of confusion. I was given no set fees for anything I was just told a percentage.

I have no idea how the post above this went weird lol: I do have an out of pocket max but they say this surgery is excluded. I know usual and customary doesn't apply to most cases. I am just trying to find out what blue sheild of CA would normally pay if my employer group did not put this addendum in place

I do have an out of pocket max but they say this surgery is excluded. I know usual and customary doesn't apply to most cases. I am just trying to find out what I know usual it customary doesn't like to know skates is. I am just trying to find what they would normally pay if my employer group did not put this addendum in place

Thank you for responding, unfortunately it's true. I have spoken with all parties involved. There is a secret squirrel lifetime max pay out that no one has anywhere in our paperwork but it does exist. My fight will be based on not being properly informed of this limit. I am feeling more confident that this will be won based on that alone. I just was hoping that someone could give me what they were billed and what the co-pays were so I can use "usual and customary" as another tool to fight with.

The Hospital and Surgeon are in network. Nobody will take responsibility for not telling me. Everyone is saying it's my responsibility to fully understand my benefits. It's an "addendum" that was never disclosed. How the heck would I know to ask if there are any addendums?

I have already called and talked to the insurance and they claim it was a maximum of anything "connected" to the surgery, but I was never informed of that. The 32,000 is after the "contracted" amount and the 16,000 applied. The original bill was over 55,000. and also my Surgeon has an additional bill to me for 2800. on top of the hospital bill.

If I were a betting person @@AmberWarstler I would put money on it being cycle related and possibly a hormone issue.

Could you possibly be close to your cycle amber? I gain about 3-4 lbs in water weight around my cycle.

Yes please send me a friend request. Because it's a secret group it's the only way

Our journey is slightly different after 50 and I thought it would be a great thing to start a group that dealt with issues 50+. Feel free to come join the group. No one will be excluded but it is going to be a majority of 50+ journeys. Pre and Post op are welcome and would love to have some Veterans too! Here is the link to the group: https://www.facebook.com/groups/845709985483850/

I will get you in shortly. Love to have you

https://www.facebook.com/groups/845709985483850/847625945292254/?comment_id=849778108410371&notif_t=group_comment_reply Or you may still have to FR me Shannon Cannizzaro Lincoln CA, send me a Friend request and then message me you would like to join the group

Definitely a secret group so you may need to send me a fr on fb. I will check my other folder. I hate that it won't come straight to me ss

Definitely a secret group so you may need to send me a fr on fb

Just be careful on too much ice. Your new stomach may not be able to tolerate really cold fluids at first.

I wholeheartedly agree, that is an excellent description of stalls, especially the dreaded 3 week one. I had one then and another at 6 weeks when I upped my exercising. Super surprised I never even thought of that one but makes perfect sense. I just broke my stall after finding I was also not eating enough calories. I thought I was doing great until I started tracking and found out I actually was under.

I also had an extreme aversion to sweet stuff post op until about 5 weeks out. I couldn't eat a SF popsicle or even a yogurt without it tasting sickenly sweet. Try finding Isopure liquid, the one in the glass bottle and dilute it down. I diluted it more than half. Everyone will tell you to get your Protein in but honestly I only got about 40gms in one Isopure the first 5 weeks and then the rest came from blended lentil Soups, blended cottage cheese and refried Beans with melted cheese. The first 4 weeks your taste can change drastically, its very common! Right now the most important thing you can do is keep sipping as much as possible all day long! Follow the guidelines as best as possible but remember everyones transition time (4-6weeks) can be very different. You are going to do great just don't stress about it right now!

This has to be a hoax, there is no way someone took the time to have WLS and thinks like this

I could not take my Vitamins for about a month even with protonix on board, you are not going to be vit deficient in one month. I was fine. I started taking the meltables and chewables with a little bite of food and it made all the difference about week 5. The only Vitamin you need to be concerned with waiting is the Iron. Two hours before or after any other supplement. It's ok to take your multi with your Calcium. I have heard so many different things on here and got completely confused so I did a lot of research and talked to my NUT again and I actually take my multi, my calcium, my b12 and my D3 at the same time.

You can also put your facebook name in the post here and request to be added. The group went secret because some people have not told anyone about their decision yet and they don't want to show up as belonging to the group. Although all the posts were private, the group members are not unless you go secret. Just wanted to clarify why we changed the group settings.