strength.spirit.grace

Calling all September sleevers [emoji41][emoji1423] let's buddy up! Here for support, love, friends and chat. Let's lift each other up! [emoji56] Message me! Scheduled 9/18/17 HW 261 CW 236

Same for me; my insurance had 6 months of preop requirements so up until last week surgery seemed like a distant dream! [emoji42] [emoji23]

Hi! [emoji1423] I'm set for 9/18! We're pretty close!

Thanks!!!

LOL "I must hold onto this" haha girl I feel ya, I sill lie on my drivers license...it still says 150lbs. Homegirl at the DMV just sitting there staring at me like "you sure that's your current weight?" [emoji15][emoji849] The joints thing is my excuse for shrinking in height while gaining in weight...I read it somewhere...makes sense though! I'm in Seattle [emoji561]

short*

That's right...flip that [emoji211] and keep it moving! [emoji213][emoji213][emoji213] [emoji87][emoji173]️[emoji173]️[emoji188] I'm sort too! I'm 5'4, 5'3 at my highest weight....depends on how compressed my joints are from my weight [emoji29]

Yeah I used to be a gym rat eating Paleo and all that fun stuff for a couple years. Then ya know...life decided to be like "nah she doesn't need to be successful and healthy-let's throw some whack stuff at her" LOL! It's a cycle for me; 3-4 years of weight loss success then 1 year of crap and rebound weight gain. Again, portion control is my kryptonite. 🤦🏽‍♀️ [emoji23] Uhhh can I just say that our stats are like almost exactly the same?!

Yasss! [emoji1430] foodies anonymous needs to be a thing! I feel like I'm doing weird stuff too, maybe because my brain knows something big is about to happen. The bread/pasta/cheese thing is gonna be a big breakup. I have no problems eating healthy, I've done it millions of times before...it's the volume thing that I have an issue with...and bread [emoji506] lol foodies anonymous confession [emoji30]

Sounds good! This is an exciting time for us...we should take advantage and share! [emoji173]️ Seems like we're the only two so far...whenever you wanna spill your heart out I'm here....girl, lord knows the day before surgery I'll be a mess [emoji29][emoji24][emoji24] Lol

I love it [emoji7] positive vibes will get us through! Change is scary, but necessary....please keep me posted on how you're doing! [emoji1417][emoji1417][emoji1417]

9/5! Nice...that's coming up soon! Love what you said; as we get closer to surgery date cold feet and thoughts of backing is almost a daily (for me, at least) but positive thinking like that help keep me grounded! Thanks!!!

I'm scheduled for the 18th in Seattle too!!

Heyooo surgery scheduled sept 18th too! [emoji1417][emoji41]

Depends on your insurance. I have Regence BCBS Oregon and their policy is "bmi above 40 at the START of medically supervised blah blah blah"...BUT it's best Togo thru your pre-op process in the minds of insurance claims administrators. Unfortunately, their goal is to make money-not give it away. So their main objective when determining medical necessity is finding ANY REASON to deny you. Sure, they have the policy and you can check every box, but they may or may not deny based on that one weigh in that dips below 40 bmi. This is where you'll want appeal...most insurance companies bank on denials over small details like that hoping you won't appeal but if you do you'll most likely get it. Hope this helps!

I have BCBS Oregon...they still require the 6 mo medically supervised diet. Just finished and submitted to insurance 8/18. Still waiting on an answer....[emoji37][emoji37][emoji37]

Meh, it's totally up to you...I was wanting bypass right up until the end then switched last minute to the sleeve. The general consensus is that you lose more weight faster with the bypass. The bypass is effective for those who have severe life-threatening issues due to morbid obesity and need to lose the most weight quickly. Weight loss with the sleeve is a little more drawn out, you lose less day-to-day, but over the course of a few years the weight loss evens out with the bypass (if you follow the rules). I don't have any comorbid conditions, I'm just severely obese, so I chose the sleeve.

Hmm well I'm from WA state so the regulations may be different, but if you haven't been employed long enough to qualify for things like disability or FMLA, typically there is some sort of medical leave offered by employers or the state...it allows for 8 weeks of unpaid, job-secured leave due to medical needs. It's unpaid, but there is no length requirement.

Honestly, as far as insurance is concerned BOTH structured and medically supervised need to be-well-"medically supervised"....the wording is tricky, but all of the requirements, weigh-ins etc need to be documented or at least acknowledged by an MD, PA or RD. A structured weight reduction program is a commercial program like Weight Watchers, Jenny Craig or simply a diet plan from your PCP. A medically supervised weight reduction program is like a clinic or professional facility that is dedicated solely to clearance for bariatric surgery or non surgical weight loss. These clinics usually have rights to local hospitals or contract with other clinics for testing like sleep studies, endoscopies, and other required tests. I decided to go with the latter and just finished my 6 months. If you have the money, go with the professionals. They know exactly what is needed and set up every appointment for you. All you have to do is stick to their plan and they will work with your insurance requirements to ensure you have the best chance of getting an approval. The requirements you're describing sound a lot like mine. I have Regence BCBS or Oregon but their surgical policy follows BCBS. Even if you don't have that insurance, take a look at their published medical guidelines. Just Google "Regence bariatric policy surg58 2017" and it will pull up EVERYTHING that insurance requires. Hope this helps.

Hi All! I'm new here so my bad if I post something incorrectly...My surgeon's office submitted all required paperwork for a vsg to Regence BCBS of Oregon on 8.18 (last Friday) and as of this afternoon my "case is still under review". The Regence rep I spoke to said it can take up to 15 calendar days to reach a decision; which puts me at 9.1 at the latest to hear back. For those with Regence, or any other plan for that matter, how long did you have to wait to get your approval? Like I said, I'm new but I've got lots of stories to tell about the past 7 MONTHS I've spent fulfilling the vsg requirements Thanks & TTYL!

Thank you! Hopefully next week I'll hear some good news! Congrats on your approval!

YAYAYAYAYAY IM SO EXCITED FOR YOU!

I just told them who I was and asked about the status of an authorization request that was submitted last week. About to call again...the wait is killing me

Keep me posted! I hope you get the approval!

Here in WA state the law is for insurance companies to review and notify member of a prior authorization decision in 5 calendar days...but I think each company can change their specific policy depending on what service is requested. It sucks 'cause I feel like the insurance prior auth people are looking for reasons NOT to cover surgery instead of helping us out. Kinda backwards if you ask me but they are in the business of making money, not losing it :-/ Good luck on your next call! LOL