LadySin

I work for an Insurance. I work in a department that specifically handles prior authorizations and well as appeals. We don't drag our feet, even though it may seem like it. But boy do we get busy as all hell. Especially around this time of year. I don't know the rules for you particular insurance company but for mine when a member or provider requests an urgent prior auth we ask them a few questions first. Is the patient's life in jeopardy if they don't have whatever they are requesting done urgent? Can they go to the ER? If there life isn't on the line we then ask if they are in unbearable pain. If either one is a yes we process all urgent within 72 hours. Some stuff we have to process same day like chemo treatments and fertility procedures. We don't fight the provider or patient's usually. If they answer yes to the questions we take their word for it.
So remember folks YOU CAN ASK YOUR INSURANCE PROVIDER FOR YOUR CASE TO BE EXPEDITED. You DO NOT have to ask your provider. Just remember to answer those questions correctly. Again I don't know the rules for every company but in order to even get an urgent you also have to ask for it within 10 days of the case submission.

I don't know if it's unusual or not but you could always call your doctor and ask. It's them, not the insurance company the sets the date. In fact, a MD can't even submit a prior auth request without including some kind of date. Even if it's tentative. It should take 15 days for the review. I'd my insurance Monday. and Wednesday if I were you. Not necessary but it stopped me from going crazy with what ifs lol.

Hello!! Just snooping around for January Surgery Twins
My op date is January 16th - going in for a revision from GS to RNY due to the "usual" complications - Hernia, Acid Reflux so bad it makes your head spin and a general lack of any real progress. I am 3.5 years out from my sleeve and while it worked wonderfully for the first 2.5-3 years, the GERD and its friends have me back tracking.
Nervous in general - normal to be, I suppose, but overall, very excited to have this surgery as I hear it almost immediately takes care of the acid reflux. and WOW, is that ever a drain on your energy and your life.
So that's a little about me. Looking forward to hearing more from all the other January People!

Good morning.

So this evening I will be going to my first support group meeting. I'm kind of excited to meet up with others on the same boat.
This group is actually at my Doctor's office (he has a HUGE conference room). There are 3 Doctor's in the group, so I am hoping plenty of people show up. They also make it known in the community that you do not need to be one of their patients to attend the group, so that I really nice.

Tonight's meeting is a potluck. LMAO I am making sweet and tangy meatballs. I hope that is good enough to bring.

My husband is also coming with me tonight. I am kind of shocked by this. It's not that he isn't supportive of my decision, because he is. He's just one that basically lets me take the lead on things and he waits for me to give him information.

How exciting! Not long now, can't wait to see how we all go with our surgeries and weightloss.

I got my date today, January 30th. I’m in disbelief that it was approved. I went through the process in 2016 only to be denied due to a miscommunication by my insurance 8 months prior. I was devastated and ended up quitting my job to find one with better insurance. At new employee orientation I requested a detailed list of approved procedures, lol. I don’t think I’ll fully believe that it’s really happening until they roll me into the operating room.

Thanks, My surgeon only requires a one day full liquid diet but I have to continue a restricted calorie diet between now in my surgery date.

Congrat Ed! I'm so freakin' Jelly! When do you start the liquid diet?

Thank you.
What is the process like to get approved in Australia?
As I am sure you have read on here, for those of us in the US it is all depending on the insurance you have and if your employer has the rider in the contract to allow bariatric services.
I am currently on my husbands insurance and they do not allow bariatric surgery. My employers plan does allow it though. So open enrollment is in a couple of weeks and I am moving from his insurance to my insurance. That will take effect the first of the year.
In the meantime, I made sure to choose a doctor and hospital that both insurances allow so i can at least get started in the process and not have to pay that much out of pocket.
Where I live, my house is in a fairly rural area. The hospital closest to me does not have bariatric surgeons. So my choices were to go about 50 miles south to Pittsburgh or go to another town about 30 miles west. I am going with the Dr and hospital just to my west. I like the Dr. and the office staff very much and it will be much easier for my family to get to and from that hospital than one of the ones in Pittsburgh.

I suggest managing your time line and staying on top of everyone. Submitters and approvers are only human after all.

Well, it definitely is heading closer to my surgery. I just had my psyche consult. The results were good and no recommendations. Just keep on what I am doing. I have preop physical on the 11 of December. Then I have a final decision appointment yet to be scheduled with the surgeon and nutritionist. I am looking at hopefully the middle to end of January

So, so, sooo much better! Things like tying my shoes, bending over to pick things up... just normal everyday things are SO much easier. I'm also making my 10,000 step goal almost every day now! I still have a ways to go, but I'm so happy with how its been going so far!

You look absolutely fab! How do oyu feel?

I couldn't believe no one has started this thread! My date is January 15th! Let's do this together guys!

Don't worry, I'm sure you're surgeon will have done their heaviest drinking the night of the 31st. It's our brothers and sister having their surgeries on January 1st whom we must pray for lol.

Hey Johnny! My date is January 15. I've been eating clean and exercising. I weight my self monthly but I've gone down quite a bit. I was to reach 245 by surgery date. I'm at most 257 right now.

I freaking love lifting but I don't know what they hell I'm doing. I don't have the tits to hire a trainer right now. Someday. Right now it's youtube, some dumbells I bought on Craigslist, resistance bands, an roller, and desk elliptical. I enjoy the ache of tired muscles. Now if only I loved the ache runners feel I'd love cardio. How can I get past that stitch in my side? I'd love to run regualry someday.

But what I really want muscle! I'm young enough to still want to be Ms America, hell even Ms Wakanda!

Keep it up! Id love to follow your progress!

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I am
new to this sight, I read the Forum but usually don’t respond. BUT ... i read yours & I had band removed after 3 yrs @ not very good results. The adjusting to the adjustment takes forever & bumping against washer & sink. I got gastric by-pass in July 5th & I am sooo happy. 6 Mths & 70lbs . no pain or throw up... I went to NYU Langone & was very pleased. Never hungry which is odd but then eating isn’t a Thrill or entertaining for me . i find things to do that are fun to do....

My gut reaction so take that as I know squat diddly. Any info I can give you is purely anecdotal at best. It's just that even my surgeon that hernia are commen and they patch them up. But they could come back. Anyway id imagine it just depends on the comfort level of the surgeon. They are doing the cuttin and snippin. I'm sorry sis.

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My gut reaction so take that as I know squat diddly. Any info I can give you is purely anecdotal at best. It's just that even my surgeon that hernia are commen and they patch them up. But they could come back. Anyway id imagine it just depends on the comfort level of the surgeon. They are doing the cuttin and snippin. I'm sorry sis.

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Hi Jessica. Thank you for taking the time to respond, and congratulations on getting approved and setting the date.
From what I understand the strength loss is temporary (at least I hope so). I'm planning on continuing to workout right up to surgery, and picking up again as I get clearance from the surgery.
Muscle has memory, so the muscle loss should only be temporary as long as we're following a high Protein diet and getting sufficient nutrients. I've taken lengthy layoffs from the gym in the past due to shoulder and foot reconstructions, and was impressed with how quickly muscle mass returns. It's the new gains that are always hard to come by. But at 55, I'm no longer worried about being Mr. America. Just want to get and stay healthy.
On a positive note, I'm now down 34 lbs, and am still a month away from surgery. I'd be ecstatic to lose all the fat and eventually regain whatever muscle mass I lose during the process.
How are you doing? Do you have good support at home? I'm getting a lot from my family, which I think is making the process easier.

Thanks for answering. I have just heard back from the surgeon's office, after asking what my options are. They are telling me I can have the bypass, not the sleeve. So, I am feeling somewhat better. I guess the bypass somehow reduces the hernia issues. I don't know much about this. I've got my homework cut out for me today getting up to speed. I sure had a good cry after that disappointing news. Hope is now rising again.

I just received notice that my surgeon has canceled my sleeve surgery because I have a 4cm hiatus hernia. I'm shocked. I understood hernias were repaired during this surgery. Anyone, please give me hope! Is this just an oddity to my surgeon, or cannot a hiatus hernia of this size be repaired? I am devastated, to say the least.

I can honestly say that I've never judged someone based on their size, and if I ever did, I would be totally ashamed of myself. It is not my place to judge, whether silently or outwardly. As someone who has struggled with my weight my entire life, I know how it feels to have strangers laugh at you, gossip about you, and stare in disgust or amusement. It's truly one of the worst feelings in the world, and the reason that I was too scared to even leave my house for several months. I was terrified of being laughed at.
Some of the replies here truly make me sick -- especially coming from people who struggled with obesity at one point in their lives. Judging people is never right. Regardless of whether you think you're "helping" them, you aren't. You're making things worse.

I know. I'm not good at it either. But I figure it's got to be better to try believing the universe is benevolent and giving me what I need at every moment* than t'other way around.

* I am completely dependent on everything other than me - even my body won't work without squidillions of bacteria in my gut doing whatever it is that bacteria in my gut do. It's a bloomin' miracle I'm here: Just one ancestor who got eaten by a sabre-tooth tiger instead of mating and no ummyasmin. In the face of that, what other appropriate response is there but gratitude?

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I follow a teacher who says that reality reflects back our own nature to us. If we look out at the world with predatory, judgemental eyes, then that is what gets reflected back to us. If we look out with curious, compassionate eyes, that is what gets reflected back. I know which I prefer
[emoji7]

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