kplant
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Everything posted by kplant
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Dec 1! I was scheduled for Nov 10 but it had to be moved. This means I will have an all liquid diet (started today) for Thanksgiving. Truthfully, I hate turkey and a lot of other thanksgiving stuff so I am not to sad about this. Do any of you know what type of band you are getting?
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My instructions from the nutritionist say "anything that can be sipped through a straw" but it also says "thin liquids" Are soups ok? It a low fat thin tomato that I LOVE. I want a core group of foods for when I get out that I will find comforting and almost any trader joes soup is in that category.
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are soups ok the first week?
kplant replied to kplant's topic in POST-Operation Weight Loss Surgery Q&A
the instructions also say to not use a straw. That is just the consistency they are looking for. I think I will hit trader joes and just get a ton. The tomato is low fat and so good. -
For those with BMI 35-40?
kplant replied to ronwifey's topic in PRE-Operation Weight Loss Surgery Q&A
I sooooo agree with this. I was at 35 BMI for years and always had problems with slightly high blood pressure. 2 Summers ago I gained about 30 (for a variety of reasons) which increased my BMI to about 38/39. I cannot lose it (or I can and it reappears). My ins is even covering this. My best friend knows and my husband knows but no one else. I even told my daughter that I had gall bladder surgery because I didn't want her telling others and I didn't want her to have to lie. What people don't realize is I am 100 pounds over weight. I mean, if I lose 100, I will just be in the range for my height. I can't be that overweight and live a long healthy life and I need to for my daughter. -
My surgery was scheduled for Nov 10th but I just got approved today (!!) so I still need to get a pre-surgery work up done. The funny thing is, I got approved because I have over 35% BMI (it was actually 38%) and high blood pressure. Because I have been doing a liquid diet for 2 weeks, I am now at 36%! I now have 2 more weeks of liquid diet!
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My date WAS the 10th. It will have to be moved. I hope not the Mon before Thanksgiving as that is the only time my friend can't come to help (although I guess I could figure it out)
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I am supposed to be banded on the 10th of November. My insurance still hasn't said whether I am approved or not (and I will not get it if not approved). We submitted everything and they wanted one day of the dr office's notes changed to a different format. Does that mean it is likely? The surgeon's office won't change the date because then they have to resubmit some of the info. I need to set up childcare for that data and, get this, tell my husband. I didn't want to tell him unless I was approved. He probably wouldn't care and will help me (and probably take the day off). My best friend will come for 2 days if I need it (she is in another city but kept those days off). I am doing the liquid diet but still eating a meal here and there (all high Protein, low carb, low fat). On the upside I have lost almost 10 pounds but I feel so odd now.
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I will call again. It is annoying because they always say "oh, you were denied on the 21st. True but then more paper work was submitted, and again on the 27th, and so on until the 30th when they decided they needed the final dr visit notes in a different format. I guess I will call them again.
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I was denied and the letter doesn't really specify why. My dr office will do a peer to peer this afternoon (so my dr or nurse speaking to the dr that denied it). Should I wait and let them do that or call the insurance myself and find out what exactly the issue is?
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The surgical coordinator kept saying that I had the 6 months of office visits. I kept saying I thought it was only 5. When I have the "last" appointment (by my count 5 and her count 6), she submitted it to the ins. It ends up, she was counting the letter my dr wrote recommending surgery. He put the wrong date on the letter. How screwed am I? Should I have the doctor write a note pointing out HIS mistake? I asked the surgical coordinator at least 3 times what appointment she was looking at for the 6th apt and she wouldn't tell me. grrr
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should I do the pre-surgery work up tomorrow?
kplant posted a topic in PRE-Operation Weight Loss Surgery Q&A
My surgery was denied but now the surgical coordinator said that they just need a letter re-written. I asked if it is then approved and she said "Probably but who knows?" I am scheduled for pre-surgery work up tomorrow (blood work, etc) for surgery scheduled on the 10th of november. Should I still do it? I am already doing the liquid diet which I don't mind but I don't want to pay for the pre surgery stuff. I mean, if they deny me, in the end, wouldn't I have to pay for it? -
Suzanne, that would be helpful. I spoke with the surgical coordinator and she is so confusing but this is a huge office that handles a ton of bariatric surgeries. I am just guessing that she knows what she is doing but doesn't really deal much with the patients. I am guessing. My email is karameal AT yahoo.com
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should I call the insurance and how long until I know?
kplant posted a topic in Insurance & Financing
The surgeon's office submitted all of the paper work the 16th of Oct. I am scheduled for surgery the 10th of November. Should I call the insurance (cigna) to see if they received everything? How long until I know if it is approved or not? Thanks! -
I Got My Surgery Date...Where Are The November Bandsters?
kplant replied to Cappy's topic in PRE-Operation Weight Loss Surgery Q&A
scheduled for November 10. Not yet approved, however, so, who knows..... -
I am having surgery the 10th of November. For some reason, our surgeon makes us stay overnight. Will I will be well enough to check out by myself and take a cab home (10 minutes away)? It Dr. Ren from NYU.
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how to get home from surgery
kplant replied to kplant's topic in POST-Operation Weight Loss Surgery Q&A
thanks all! I am in Manhattan and so there are always tons of cabs in front of the hospital. -
including a personal letter with your insurance claim
kplant posted a topic in Insurance & Financing
I am wondering if anyone included a personal letter when their surgeon submitted information to insurance? My insurance has been helpful but the coordinator at my dr's office seems to really not know my insurance's policy. I would like to just include a letter that summarized a co-morbidity (hypertension) and points out that I have switched doctors for the six month diet (the insurance said that is fine) because I am having problems managing the hypertension (meds are not working) and two other obesity related problems (issuing sleeping and edema in my foot). This would also sort of point out that the dr is changing my bp meds to a more expensive (covered) med and that he has ordered one test and will order another (again, more obesity related expenses). -
I so worried. I met with the insurance coordinator at my surgeon's office.
kplant posted a topic in Insurance & Financing
she didn't listen and was so confusing. I told her several times that I have hypertension and that my insurance may approve it based on my record of being at 38% BMI and she kept asking for records of being 40%. I don't have them. She also kept telling me that my ins said I need two comorbidities and she even called the ins and they said 'no, just one' and when she hung up, she kept asking me what the other comorbidity was. She also told me I need to show two years of records. I have stuff from 2005 (and earlier), 2007 and 2008. She said I will get rejected because I need 2006, 2007 and 2008. Finally, she told me to not take my meds for hypertension as "controlled" hypertension isn't a co-morbidity and it clearly says on the web site that it is. I am just absolutely freaked out she will screw this up. Should I trust her or have the surgeon "speak to her about my file". -
I so worried. I met with the insurance coordinator at my surgeon's office.
kplant replied to kplant's topic in Insurance & Financing
sort of the point is that the meds are no longer controlling it. I am meeting with my GP for the 6 month diet requirement and we are working on finding something that works. He upped the diuretic to a very annoying level (I pee all the time) and it doesn't seem to be working. The next step is stronger (and more expensive) meds. I also had pretty severe edema in my foot that we are investigating (again, more money). -
My weight had fluctuated from 36-40% BMI but one time (all doctor's record) it dips down to 34.6%. Will they hold this against me? I can't seem to find a record of it being higher around that time. I have hypertension and cigna so, hopefully, I won't need to be 40% for that time.
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what will the nutritionist ask?
kplant replied to kplant's topic in PRE-Operation Weight Loss Surgery Q&A
hmmm. This is something I *have* to do to see the dr AND she (the nutritionist) has to "approve" me. My ins will probably pay. They have been almost chipper about paying for the psychiatrist and dr ren's appointment and answering all my questions about coverage. -
I was referred to Dr. Ren in NYC and, to see her, I need to get a referral from my GP, then see a psychiatrist, when approved by the psychiatrist, I will see a nutritionist. After the nutritionist approved me, I will get to see the surgeon. What is the nutritionist looking for?
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grrrr! I was trying to get a record for cigna that I have had a bmi of 40
kplant posted a topic in Insurance & Financing
The only dr I could find from the last 2 years was 18 months ago and he did not write down the weight the first time I visited him (even though we talked about it) and the second time he wrote "250+! Weight needs to go down!" I was 256 or so the first time I saw him, exactly 40%. Second time, I guess 254 or so. Grrrr. How can the ins companies expect me to get a good record if #1 I hate going to the dr because he weighs me (I had hurt my foot) and #2 if the dr doesn't keep good records! -
in what order did you do all the pre-op requirements?
kplant posted a topic in PRE-Operation Weight Loss Surgery Q&A
I am barely at 40%. The measurement I have at 40% is from jan 2007 and the min requirement is 24 months and so I may have to wait until jan. In the meantime, I need to see a gp to get a referral for the surgeon and eventually a psyche evaluation. I may also need to do the 6 mo nutritionist thing. How certain would the surgeon be that I will be approved? Could the surgeon submit my forms (this month) and then the ins will say what else I have to do to get approved? -
in what order did you do all the pre-op requirements?
kplant replied to kplant's topic in PRE-Operation Weight Loss Surgery Q&A
I am exactly at 40%. I went to the seminar but I guess I should call the surgeon to see what they think the next steps to get approval are. Thanks!