droose

Had my surgery on 3/10/21, this getting my denial overturned on 3rd appeal. I am now getting a bill for the full cost of anesthesia that states "we do not offer coverage for this type of sedation" . . .WHAT!? I don't even know where to go from here, how can this be something new?

It appears to be resolved! I fought with appeals for 10 months to get approved for my surgery, the big hurdle was weight loss surgery wasn't included in my coverage. I won my final appeal because the surgery was my only viable option to properly repair my hiatal hernia. I called insurance, they told me it was automatically rejected based on my coverage, they will process it again and it should be fine.

Maybe try a protein water?

I was told we should get 48-64 oz. take care.

You need to keep your fluids up, dehydration can explain dizzy and forgetfulness, if possible maybe use a protein water. Try canned chicken instead of tuna. I bought those little wieners in a can and some canned tamales. My nutritionist said soft foods is anything you can cut with "this" as he held up a toddler plastic fork. That discussion was as he told me I could eat shrimp as a soft food..... I really hope things get better for you.

Doing well! I haven't posted since well before surgery, just been plugging away at life! 12 days post-op, I'm feeling great. Haven't taken pain meds since day 2, I struggled hard with the anesthesia which kept me nauseous for a solid 48 hours. Once that was out of my system things were looking up. How are you feeling now?

After fighting insurance for 10 months my surgery is scheduled for March 10th. So excited!

I am doing the bypass for my Hiatal Hernia which caused GERD and Esophageal Spasms. Due to my weight the standard procedure is not an option. As my insurance coverage does not cover "weight loss surgery or medications" it was a 10 month multi appeal process to get my surgery approved. I do hope your post surgery is going well! Mine is scheduled for March 10th.

When my surgery was scheduled (would have been Wednesday), we knew it would be denied but my doctor and nutritionist were confident it would go through on appeal with the proper paperwork. The denial came back, there was some delay getting information and giving the information to my Dr. before COVID put a hold on surgeries. When I ask about the status I am told "it's on his desk" and "he needs to write up the information for submission" it has been 2 months with no progress. All I want is for them to finish submitting everything so that when surgeries are allowed again (possibly as early as 2 weeks) I am ready.

Still waiting for the insurance company, they haven't given a decision yet.

I hope you find the right fit! Keep me posted.

Thanks He comes highly. Yesterday I received a call that he "wrote a beautiful 4 page letter" and the appeal was submitted. I am relieved that the process has started moving again.

Always here for you, I do understand. I am blessed enough that most people involved in my day to day life understand how real this is. I did loose 70 pounds once.... found it all and since have been completely unable to loose anything. The surgery was recommended to me as the best option for repairing my hiatal hernia/GERD/esophageal spasms. Once I did my homework I feel that it really is the best option for every aspect of my life. As for the co worker, they haven't walked in your shoes. Hang in there, our time will come!

In Washington this is one thing our Governor addressed with an "Emergency Order". All non essential surgeries (that are not emergencies or will not do harm if it were to wait 3 months) have been banned until May 18th unless he extends it later. Really sucks, my surgery was scheduled for May 13th. We are not selfish to feel disappointed, this is a very emotional topic that will change our lives, we will get through this together.

I'm scheduled for mid May, haven't heard of changes yet. With the current situation they will need to keep all available beds and ventilators open I'm guessing until we see the curve going down. It is extremely frustrating to be told we have to wait. I do pray you are able to get re scheduled as quickly as is possible. I pray you and everyone stay healthy and safe from the virus.

I'm so excited for you! I've been waiting forever for my insurance appeal to go through. (ok, only a week but feels like forever). Keep us posted

My first consult was January 30th and dietitian Feb 6th. I needed an EKG, Labs and medical clearance from my primary. My surgery is May 13th, earliest date I could get because he is booked solid. I do not have coverage for weight loss surgery BUT it is needed for a hiatal hernia. My doctors are confident what they can get it approved on appeal (we know it will initially be denied).

I need to buy a blender for pre/post op meals. Does anyone have recommendations on products?

Great place to start. 🙂

Thanks!

I have also been concerned about taking my meds curshed. What an awesome suggestion!

My surgery date is set, for this I am excited! I already know that insurance will deny the pre approval but my surgeon and dietitian are confident they can get it approved on appeal. I have a hiatal hernia, due to my weight this is the only surgery recommended due to high rate of failure for the other options. Premera considers this treatment "investigational" which will result in the initial denial I am expecting. My surgery is scheduled in May (my surgeon is popular ), they are putting in the pre approval now. Does anyone have an idea as to how long I can expect the denial and appeal to take?

I've had a small hiatal hernia for many years, it now is joined with GERD and esophageal spasms. I recently had to double my acid meds just to keep discomfort manageable. My primary send me to consult to repair it. I was told there were other surgeries out there but with my weight they had a high rate for failure. My initial reaction to bypass was surprise, I wasn't really that big was I ..... well yes I am with a 39.8 BMI. As I stepped back to look at my situation I came to terms with it's necessity. I've lost weight before only to find it again, as I age the extra weight is taking a toll. My insurance does not cover "weight loss" surgery and they consider a bypass to repair my hernia "investigational". My surgeon and dietitian tell me they will put in for pre authorization, it will likely be denied but they are confident it will be approved on appeal. My medical clearance, EKG and blood tests are complete and ready for surgeon to review for the next step. How long does this portion take? I feel like a child at a toy store who must wait for the green light to get what they want.

I'm on 2,000 IU (50mcg) a day along with iron supplements. I agree it explains how tired I get, will re test in 3 months unless my surgeon wants sooner. So glad you are doing better!

I'm at 8 also!