ronr

Anyone from Minnesota waiting on insurance approval

Hi Missvee, I'm on a similar journey. Stay focused and do the best you can and be kind to yourself. I'm waiting for approval after being denied. I just can't let these insurance companies get under my skin but it is hard I admit. Stay connected to positive people. Regards Ron

Thank you for your response. Congrats on your great success fernandjf. How was your transition to the life changing diet routine? Was it painfull for you? Ron

Hello, I was denied by my insurance company for vertical sleeve surgery. 9 months of meticulous Mayo Clinic, University of Minnesota, Fairview Baratric in Minnesota. 2-3 k in personal expenses evaluated and being evaluated. I have every t crossed and i dotted. I'm in the medical business as well. BMI over 40, diabetes, kidney failure, neuropathy in feet, and on and on. My insurance covers 1 time surgery for weight loss and still they found loop holes in my policy I never seen to deny me. How disgraceful! Will try to appeal, my company may fire me for it. This is the most under utilized surgery in the US. Thousands a month in meds which they would rather pay. I have been on Atkins, Mayo Clinic diet, Medifast. Emily program all with limited success. Not a good day at my house. Ron

Ladies thanks for your comments. Denied because: Our peer clinical reviewer has determined: Non-certify proposed laparoscopic gastrectomy (CPT 43775). Based on information provided, this patient is morbidly obese, with life-threatening clinical co-morbid conditions. No documented BMI. What? There is on documentation that the patient has failed conservative weight loss treatment ( 2 year period that immediately precedes the request, one structured diet program for 6 months; or two structured diet plans for 3 consecutive months.) Ok you don't want to pay! I start my appeal process tomorrow 2/28/16 Stats 62 year old male. Confirmed diets Medifast 1 year. Emily 3 months, Atkins 3 months, work out 5 times a week. Weight is maintaining. BMI 40.5 Now I'm reading a blog from a PhD on this site that states that most people will regain there weight after 3 years or another addiction will pop up like drinking, pain kills, sexual activities if I don't spend 10k or more getting to the root because that is what long term mental health treatment cost over a year to address the potential underlying problems that caused the food addiction in the first place. Oh now that helps about right now, but may or may not be true because there is no confirmed data on the success long term of getting WLS. I know it is a tool and up to me. 100,000 patients. How many return to original weight, develop other addictions, die, and so on, where is that data. I've had 3 severe colon surgeries in my life. Not just normal resections. I spend 40 days in the hospital with several. I'm just pissed at my insurance company and myself today and have never voiced my thoughts. I have one sister that's 400lbs 5.00 feet tall another that has had the band and my best supporter, a brother that weighs 110 labs at 68 looks sickly. I have been over weight since 12. But in general have had a Ok life with 5 kids and 5 grandkids. So admire all of you for the guts and strength you have had to push forward with this WLS. Ron ​Ron

Valentina Thanks for the advice. regards Ron

Not being so sad and unhappy al the time.

Kayla, if they do I'm in trouble because I have depression and working on it. I hope all goes well with your approval. I'm waiting approval as well. Why insurance companies would argue with this procedure is just not rational. You will be fine. If not my backup is Mexico for $4,500. Ron

yee ha!!!!

Im in the same stage. It is nerve racking for sure. I'm 62 year old male Eon