KimB7811

Couldn’t have said it better myself!!! We need to put up one hell of a fight against those good ol’ Insurance companies we pay an arm and a leg for to use! Makes sense right? But I have a feeling everyone here going through this are pretty tough and aren’t going to take no for an answer! In the meantime, we can all rant hear 😄

Not yet! We haven’t submitted anything to the insurance yet. I am meeting with my surgeon next Friday, the 12th, so I’m hoping that’s the appointment I will get told everything is ready to go in for submission. This waiting period is agony! Thanks for thinking about me. This site is so helpful and supportive through this whole process. It’s definitely a great community of people all going through this!

That sucks you had to fight that hard but I’m glad you finally got approved! I’m hoping he does. He seemed confident but you never know until that approval!

I have BC/BS Fep too. I’m really nervous for submission because of being on the low BMI side. Only 35.5/36. I have 2 co morbidities (Hypertension and Severe Osteoarthritis in my knee). My surgeon said he feels pretty confident I will have no issue with my insurance and those issues for approval but I’m doubtful. He said BC/BS is one of the better ones for approvals too. I’m sorry you got denied GTGirl. But fight the insurance on it. You’ll get it.

Got my psych evaluation done on March 27th! It was definitely a very easy appointment that went well. I had to just answer about 3 questionnaires with about 20 questions on each. They pretty much continually ask over and over if you feel unhappy or about the same as you always do or if you binge eat, etc... then I went in and sat and talked to her face to face for about an hour. She even said the reason they do these is just to make sure the patient can follow directions or be responsible enough since this could be potentially dangerous if they didn’t after the surgery. She asked me a few things starting all the way back from my childhood... and my life story in general. Do I have a support system... how I would handle holidays and such... how I feel this would benefit me and what I feel the risks are. Asked if I’ve ever been depressed or have family history of it. I did tell her I had terrible post partum depression with my second daughter and saw a therapist for a few months, which seemed to not be an issue. Then she basically said she’ll have the report written up in about 2 weeks and faxed over to my surgeons office and will send me a copy as well. That’s when I joked and asked “ so I passed?” She said yes but it’s actually not up to her....????🤷‍♀️ I was a bit confused by that because I kind of thought it was but she said she sends the report over with the papers and someone else decides. I guess it’s someone at my surgeons office? 🤔 anyhoo.... So, now all my appointments from what I understand for insurance submission are done. I called my doctors office to touch base to let them know and find out what the next step is. She scheduled me for an appointment with my surgeon on April 12th so I guess he’ll go over the next step with me. Meanwhile, I’m going to really try to be good until then and make sure I weigh in around the same if not a pound or two under then the first time I saw him because he did tell me not to gain weight in the meantime. My insurance doesn’t state anything about gaining during pre-op but I’m sure it can hurt submission. I’m really hoping he gives me some good news next week like maybe a tentative surgery date or tells me they are submitting everything to insurance. Tomorrow I have a Bariatric support group meeting that is held at the hospital once a month. My nutritionist told me she likes to see her patients at at least one before surgery and I figured it would be really good to hear from others that have had it as well just like this site. 😀

First off, congrats on such an amazing success so far with your weight loss and transformation! I’m not in any way a fitness expert or anything, and I haven’t had Bariatric surgery yet, but I’ve experienced something similar before. When I got down to my lowest weight a year ago and I was at the gym for 2 hours a day doing cardio and lifting, I hit a major wall all of a sudden. I was counting my calories on my fitness pal daily which was only 1200 but was burning more then that a day. Then my weight loss doctor said something to me that made a lot of sense. She said your body gets used to that level of activity and calories you are burning and therefore you will have to do even more for your body to “react”. So she suggested to actually take a step back from the gym for about a week. Giving my body a rest and a chance to recover while watching what I ate. And in that week I dropped 9lbs. It was kind of amazing how my body really did just need some rest. Maybe it’s worth a shot even though I know it’s hard to not work out everyday.

Psych eval went great. It was def more of an eval that I expected it should be and from what I have read from everyone’s experience on here. I just had about 3 papers of 20 questions to fill out and then about an hour of face to face talk. She asked a little of everything all the way back from my childhood through high school and up. And of course why I want this and how I think it will work and the complications I might think could arise or the challenges... stuff like that. I asked at the end jokingly if I passed and she said yes but then she said it’s actually not up to her...🤷‍♀️ I asked if she meant the insurance but she said she said it ultimately goes to someone else that looks at everything but she really wasn’t sure who that was.... not sure if she was talking just about the psych part??? Does anyone know what she meant??

Some can be real winners. I would’ve looked at her and asked wth that had to do with Bariatric surgery! Lol

i actually was thinking it had something to do with the questionnaires as well too and my surgeons office going over them. I was going to wait until I receive a copy of the letter from the psychiatrist, so this way I know she wrote it up and sent it to my surgeons office as before I contact them. This way I’ll ask if everything is ok and also find out when to make my next apt with my surgeon since I don’t have one scheduled right now.

About to walk into the psych evaluation. This is it as far as my requirements! Hoping this goes well!!!

I’m an hour away before my Endoscopy! Praying everything goes good with this and then I just have my Psych eval next week before I should be ready to submit to insurance! Eeeeek!!

Wow, you can’t catch a break! But you are tough and I do feel that these Drs like to prove and test for things sometimes that aren’t always necessary. I believe if you look hard enough in all of us you’re going to always find something....lol. Unless it’s causing a problem then let it be! Lol. Just stay positive and I will send positive vibes your way as well!

Fingers crossed that you will hear good news as well Frustr8 on your next endoscopy!

That’s awesome that you no longer have it! It’s crazy I didn’t know I had it. I’m more concerned about the ulcer I guess. Did you have that as well?

Endoscopy is done! It went really well aside from finding out I have GERD and I had no clue. Apparently I have a small ulcer that’s causing some reflux that I seem to never feel so he prescribed me Omeprozol to take every morning and said he took a biopsy of some bacteria. He said I can still have the surgery though and to just follow up with him in 2 weeks. 😄

Endoscopy is done! One more thing checked off the list to the road of my surgery. It went really well aside from finding out I have GERD and I had no clue. Apparently I have a small ulcer that’s causing some reflux that I seem to never feel so he prescribed me Omeprozol to take every morning and said he took a biopsy of some bacteria. He said I can still have the surgery though and to just follow up with him in 2 weeks. They took me in a hospital type waiting room with beds and curtains. Told to just take everything off up top and put on a gown with the back open and go to the bathroom to take a pregnancy test. I assured them my baby days are over but did it anyway. Good news! Test was negative 😂. Then after hooking me up with an IV and taking all the vitals and stuff.. I get wheeled into the surgical room where the doc and anesthesiologist is. They told me to lay on my left side and take 5 deep breaths and I should be asleep shortly... well I think I took 1 and 1/2 breaths before I was out cold. Next thing I know I was being woken up in the waiting area saying it was over. I swear it must’ve been about 10 mins total! Next week is the psych!

That’s amazing! Congratulations on your hard work and success!!

Did everyone else get papers to sign to release all their medical records in the big questionnaire and packet from the psychiatrist? Just wondering if that’s the norm.

Congrats on that success CyndieRI. That is incredible!

I actually made an apt with a difference psychologist for next week as well and she explained it will be something similar to that as well. Just a few forms and a face to face which seems better to me.

Just got back from my apt with my weight loss dr that I have been going to for about 2 years. It was hard stepping on the scale today though and seeing the number. I’m at 224 point something or other. It’s a number I swore I would never have gotten to again so I’m praying I get approved for this. I feel like crap. I am really starting to “feel” the weight again and it sucks. It was encouraging sitting down with her today though and talking. She read me the letter she is faxing over to my surgeons office for insurance and it seems very good. She definitely is pulling for me! Meanwhile...still has me on the phentermine but I’m hoping to stop that as soon as we hear from insurance. Meanwhile yesterday I got to deal with someone from the Dr’s office for my Endoscopy that obviously doesn’t seem to know her job that well and decided to give me a slight heart attack. She proceeded to tell me on the phone that my out of pocket for the year hasn’t been met yet and that I would be responsible for the entire procedure and facility until out of pocket is met. Well... I knew that didn’t sound right at all considering our only out of pocket expenses are co-pays. Thankfully, after an hour later of verifying what I already knew on the phone with my insurance, I had to call HER back and explain my insurance to her and explain I only will be responsible for a $150 copay on Friday for the Endoscopy... the rest is 100% covered 🤦🏼‍♀️ Let’s hope the endoscopy goes smoother! 😆

Ty!

Yea... I’m thinking this seems a bit much? Especially releasing my entire hospital medical history. I think I’m going to find someone else! I mean... I’m not perfect, but I feel like right off the bat, this guy seems to want to really try to dig hard in finding something lol

First of all congrats on your success so far! But I’m glad I’m not the only one who obsesses over this. I’m already thonking about that issue and I haven’t even had the sleeve surgery yet!!! I have lost (easily) anywhere between 60-100 pounds a handful of times throughout my life so far and yet here I am!.... getting ready to submit my request to insurance for Bariatric surgery because I gain it back and then some every freakin time! So I’m already terrified that this will ultimately end in the same scenario. I know this is different though. It’s a great tool given for weight loss that I feel this time might be pretty darn hard to ignore.

Just starting my journey. Had my first apt on the first with my surgeon, having my endoscopy on the 22nd, my nutritionist apt the 9th. .l also have been on a dr supervised weight loss program for close to 2 years now which she is currently writing up a paper to submit stating why she feels I’m a good candidate as well. My paperwork is coming together... but however, I’m just really thinking this is going to all be for nothing because insurance will deny me. I think it states I have to be with a BMI of 35+ for at least a year and I think I was at a BMI of 34 around nov before it started to go up.... not sure if that’s where they might snag me if they ask for records first? I’m barely squeaking by with BMI even though I have severe hypertension and need a knee replacement. I have my insurance requirements printed out and I’m trying to make sure I line all my ducks in a row but I can’t shakethis feeling they’ll snag me somewhere... anyone have an issue getting approved when they were on the lower BMI side?