LosingIt08

I am considering so many things... here they are: - use a lawyer to help with appeal with unsurance - self pay with Dr. Kirshenbaum in Denver CO - self pay with Dr. Ortiz in Tijuana I called the lawyer that posted on this site (Viscio) but have yet to heard back... not sure if I can take another disappointment in this process. Anyone use this lawyer or another lawyer with success?

Hey everyone, I have been missing for the past few weeks fromn this forum. I was really down because I was denied my my insurance company. It has been appealed and I am waiting waiting waiting. So my 25 year old sibling cousin who had lap bad surgery mysteriously went into a coma. We found out she was braindead and unfortunately she is no longer with us on this earth. My family is all freaking out because they are convinced that it was a complication from the lapband. They are begging and pleading with me that I do not have the surgery. It is heart wrenching, really to have her mother cry and beg and plead that she doesnt want me to die. As of now I told them all that the insurance denied it and I wont be having surgery. They were not supposed to know to beging with, but my grandmother opened her very lovely but very big mouth when my cousin went into a coma, I am guessing out of concern for me, To me that is not an option. As I have said to them, I would rather die than live the way I am living now. I don't go out, I have social anxiety because of my weight. I have no life besides work and home. Its like a am a prisoner of my own body. I have considered switching to gastric bypass, I just don;t see how she could have passed from complications fron the surgery. She didn't exactly take care of herself and in that way me and her are very different. WHAT DO I DO???:confused2::cursing::biggrin:

So I need you all more now than ever UHC denied me yesterday because they want more of a documented wight history. I have been seeing my doctor since 2003 and he wrote I have been overweight for 15 years. The Drs were so sure I was getting approved they were in shock, soooo I had to ask my Dr to write a specific letter or update the old letter that I have had a BMI of 40 plus for 5 years. Thats what they want UHC people.. documented BMI for 5 years. I have 2 co-morbidites, polycystic ovarian disease and diabetes (discovered during bloodwork for surgery) Did the nutritional and psychological consult, EKG and Chest Xray.. guess theywant my firstbiorn now too (when I have one.. if I have one PCOS doesn't help!) Even the reps at UHC could not answer why I did not get approved and they all think the medical reviewer guy is being a pain. ARRRGHGGG

Getting banded March 19th (tentatively .. waiting on insurance approval!)

I was denied again. They want a documented 5 years of morbid obesity, whatever that means. I have called and called and all they do is give the the run around and wont even tell me exactly what they want... WTF!!!???

nice to hear about your experience.. hopeing to hear from them soon and also about some other success stories. I feel so beat up, family is claiming to be "supportive" even though they disagree with surgery and just say I HAVE NOT TRIED HARD ENOUGH I am exhausted and tired of figthting and battling for something I feel is right for me, why I am trying to convince everyone else? I almost feel like if they are not with me then they are against me

Thanks WHeetsin.. I submitted a request to them Has anyone had any experience with using a lawyer? I would like to hear them.

No new info unfortunately...

UHC has yet again denied me for surgery. Apparently my 5 year weight history is not documentented enough.. Any advice? Considering surgery in Mexico at this point. I am so ready. WHat do I do?

Well I don't own a home and I am already in debt, the doctor I was supposed to have surgery with will cost me $15,500. SO far from what I see with Dr. Ortiz in MX the cost is about $8000 and so far I have read great things about him. I take this very seriously, and my health and well being are important to me and if they wernt I would just hop on a plane and have it done without doing research, I already know I can go for aftercare to my Dr here.

I feel like saying I HAVE A RIGHT TO KNOW WHAT HAPPENED!! It;s like the lap band is the scapegoat at this point, they need something to blame it on so let's blame it on that! If they think it's a band complication then FIND OUT. Things are very scetchy, like I said first there was going to be no autopsy because it wasnt required and she was under the care of a physician (she was in the coma for a week before we let her go) Now I hear there might have been... maybe they dont want people to really know just in case it doesnt come out they way they expect? I would think if they were so worried wouldnt they want to know if it was definately a band complication? To protect their daughter/niece/cousin (me) that has her mind set on things... I am not convinced that is was a lapband issue. She has had a hellraiser past .. she at one point was a coke and who know what else addict (went to rehab for that).. she was a drinker.. she was a smoker.. Rumor has it that she tried to kill herself more than once in the past year.. Me and her may be sibling cousins with the same genetics (my dad's little sister is married to my mom's little brother) but our lives were so very very different. God rest her soul, but I thinking maybe she was tired and gave up? I just don't know. The human will to live can be a strong thing when someone goes into a coma (I just watched a special on a young man who was braindead and came out of it) Maybe she was ready to go? Perhaps she was ready to be an angel watching over us and protecting us and bringing my family together? I am having surgery no matter what, my mind is set and I am S-T-U-B-B-O-R-N. I will do what I have to do and just keep it a secret from the family, they were not supposed to know to begin with.

I am still going to go through with surgery, just not sure which one. We do not have a cause of death.... I do know she lost about 30 pounds in 5 weeks which seems awfully high. I also know she had red bull and vodka in her apt. I know that is a definate no no after surgery. Just because it was there doesnt mean she was drinking it at the time though, I don't want to make assumptions.. At first there was no autopsy, now I am hearing there was.. there are a lot of unknowns and it is driving me crazy!

So I need you all more now than ever Posted this in 2 forums, sorry if you read it twice, just need the positive comments and success stories from people with Insurance appeals.. UHC denied me yesterday because they want more of a documented wight history. I have been seeing my doctor since 2003 and he wrote I have been overweight for 15 years. The Drs were so sure I was getting approved they were in shock, soooo I had to ask my Dr to write a specific letter or update the old letter that I have had a BMI of 40 plus for 5 years. Thats what they want UHC people.. documented BMI for 5 years. I have 2 co-morbidites, polycystic ovarian disease and diabetes (discovered during bloodwork for surgery) Did the nutritional and psychological consult, EKG and Chest Xray.. guess theywant my firstborn now too (when I have one.. if I have one PCOS doesn't help!) Even the reps at UHC could not answer why I did not get approved and they all think the medical reviewer guy is being a pain.

Thanks everyone, keep the good advice coming I am so frustrated :smile2:

take a look at my signature and you will understand why people are against it.. follow your heart

Looked in the mirror at yourself and wanted to crawl up and just die? I have my TOM for the first time since October (I have polycystic ovarian disease.. how joyful) and I am also at my heaviest I have ever been. The only thing I can say that is positive about myself is "well at least I will look great (if I was pregnant!") My stomach is so huge. I literally look like I AM 6 months. I am so bloated and fat and just uggghhhhh shoot me please! None of my clothes look right.. and those are my FAT clothes.. I am leaving for a business trip tomorrow. There are mirrors everywhere in that damn office and hotel (I was there in Jan) and I just cant stand to even look at myself. 3/19 feel so far away ....

Heyyy.. I am an ATT employee too, formerly Cingular. (We will have to make our own little AT&Ter group.. lol) I am not sure if you are a bargained or non-bargained employee (I am a manager, non-bargained ... meaning not in a union) I have UHC. When I called they said the requirements were a BMI 40 or higher and 5 year documented morbid obesity. My Doctor ordered many tests before they were asked for. I am sure this is becuase they know what they are doing and what the insurance compnies will ask for with approvals. They said UHC generally takes about 30 days. I had the following done prior to submitting to insurance: EKG Chest Xray Bloodwork Nutrionist Evaluation/Consultaion Psychiatric Consultation Surgeon consultation. I am currently still waiting on approval I believe they submitted 2/13. Keep in touch! I will let you know what happens. In the bloodwork process I found out that I have Diabetes and I already knew that I had Polycysitic Ovarian Disease so I do have 2 co-morbitites. The nutrionist is actually the one that pointed that out... not MY PCP

I was told to take 1500mg to 3000mg of Biotin by my nutritionist to help with this. She also succested a chewable multi Vitamin with Iron and 2 viactiv Calcium supplements. I have started this routine already, figured it can't hurt! I hope this helps

Hilarious Post, LOL

I think its funmy that a lot of the March girls picked the daisy ticker.. anyone else notice that? Great minds think alike!!!

Congrats! I hope to be joining you 2 days later!

LOL that is too funny Pearly

Love it! Definately will be using that one :thumbup:

Thanks for the respnses, actually got a little teary eyes. I am so glad that I found this site and that there are people out there who understand what I am going through and how emotional just waiting for insurance approval can be. I guess a lot of people don't understand what it feels like to be hopeless and feel as though you are trapped inside something, fighting to get out. I need this, and I hope all goes well.

I have been waiting lots longer than a few days with UHC. My surgery is scheduled already and I know they were questioning my wight history. I called and it wasnt in the computer yet so the person I spoke to said not to worry just yet. ANyone have this experience? Also how do you get the case manager on the phone???