CheriB78

Thanks James, I am leaning to just let it go and continue to get healthy. I appreciate all your help and info.

I have 2 insurance companies, WebTpa (had to have approval from Active Health which does medical determination for the procedure and BC/BS federal. I had a lap band in 2008 which did not work very well. I was having a band removal and RNY (which I actually had last week on the 9th of February). Active health approved my band removal but denied my RNY because I did not lose the required 5 percent of weight, which my surgeon said not too, I would be too close to the 35 BMI level. BC/BS approved everything ( they paid for the band in 2008) but are out of network. I would like expert advise if I should try the 2nd level of appeal and with what information? Or just let it go and pay the bill that is left. The thing that really gripes me, is I had been with company for 18 years and a director that had been recently hired got approval in a few months and was not required to lose weight or go through the 6 months of diet, exercise, etc. I have since resigned and am starting a new job next week and am not sure to proceed with the appeal and insurance commissioner or just let it go. Any advise would be appreciated. Thanks in advance Cheri

Thanks for the update, I always want to know and hope things get better.

Love the feedback

Thank you so much Nologoz, that helps me feel so much better, I have been listening to so many friends and family that don't think I need a surgery to help me lose 60 pounds but I have hated the band with throwing up daily for years and want it out, trying to get my other insurance to cover the RNY and not just the band removal. They wanted me to lose 10 pounds in 6 days and I have 4 left before Thursday and they said they would approve it. I now am thinking if I can do that why can't I lose the 60 pounds, but I know in my heart I need a tool to help me and need to go through it. I am a little scared but not of pain, I can handle that, just a little scared of long term complications.

Actually i am changing jobs after being with my company for 18 years so I only have 3 weeks before I start a new job with another company. I wanted to have it done and on my way to a new beginning.

Good idea, I had a weak moment earlier, I have drank 100 oz of water and 4 shakes but I ate a 5 calorie 1/2 a pickle and I feel like a heel. I taped the note, thanks

Thanks everyone, that is exactly what the surgeon said, 5 protein shakes, no food at all and 96 oz water daily, OMG is this hard, only my second day but it'll all me worth it, this is probably helping me getting ready for surgery too. Thanks for the support.

Thanks, that what my hubby said too, he's helping. He said we go out and trim trees on our property, so guess today I'll be loading branches with him all day for some extra push before the treadmill... YEAH

I'm frustrated big time with my primary insurance, they approved my band removal but denied my RNY. My secondary has approved both. My surgery is scheduled for February 9th. My doctor told me to maintain weight and not to lose but my primary said the one requirement was I had to lose 5 percent of weight plus 6 months, so I have until Thursday morning to lose 10 pounds to have surgery approved. My doctor put me on 5 Atkins blue label only or EAS carb control. Does anyone know of other ways that might help. I can't eat any food and have to drink 96 oz of water a day. Any help would really be appreciated.

I'm struggling and am so frustrated today, my primary insurance has denied my RNY for one reason, I did not lose the 5 percent weight but the doctor told me to not lose, maintain my weight because of BMI, my insurance said if I can lose 13 pounds by Thursday they will approve it, my band removal and RNY is scheduled for February 9th. The doctor said 5 protein drinks a day and 96 oz of water, no food come back Thursday and they will do an immediate request for approval again, I'm scared that I can't lose 13 pounds in 6 days, if I don't: no surgery! Does anyone have any other suggestions for the 13 pounds to come off in 6 days. I started this morning on Atkins blue label only drinks for the next 6 days. Any ideas would be welcome.

Does anyone know a brand of liquid vitamins to use for the first few weeks that give all the necessary nutrition? Thanks in advance.

I am also in the same boat as in waiting for insurance approval. Surgery set for February 2nd, have secondary approval waiting on primary. Band to RNY

Curious how Dr. Keith patients are doing, I am waiting from approval for primary insurance, already have secondary approval with BC/BS. If BC has to be primary, he is in network.

I had surgery scheduled for 1/19 but insurance approval dragging their feet, surgeon is full on 26th, have added me to February 2nd, only operates Tuesday's. I have my fingers crossed!!!!