Sunbunny064
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Everything posted by Sunbunny064
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Look out Hef, there is a new group of bunnies in the making. All the beautiful women who will be banded in April 2009! Hang tight bunnies! April is only 90 short days away.:Yawn:
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Thank you,
I am so stressed out by the wait for the insurance approval. My BMI is only 38 but I have 2-3 of the comorbidities. Do you think the lapband is worth the fight? I am almost ready to just give up.
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I am overwhelmed by the vast range of differences for every person who gets this surgery done. As if the nightmare of waiting to hear back from the insurance company is not stressful enough, then you have to pay program fees on top of it all. I hope it is worth all this. I am waiting for my insurance company to make a decision. My surgery is scheduled for 2/18.
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If every insurance policy is different, how can you post the requirements UHC will accept with such certainty? Do you have UHC? Are you banded?
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Congratulations! My summary plan description does not say a thing about 5 years of history. All it says is that there must be a medical necessity in order for morbid obesity to be covered. I am not morbidly obese yet, my BMI is only 38. But if they deny me don't think I won't put on that extra 10 pounds that will bring my BMI to 40! If the insurance company denies me, I will file an appeal because I have hypertension, hyperlipidemiam, non insulin dependent diabetes just to name a few. Having this surgery could save my life. I have done every diet known to man and even taken prescription diet pills. Everything goes ok until I go off the pills and then the pounds return with their cousins. Insurance companies only care about the cost associated with the proceedure. I wish they had to live in my body!
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United Healthcare is a PPO, it is illegal for your doctor to charge you a dime other than your co-pay prior to billing your insurance first. You are smart to question this practice.
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I have United Healthcare. I received a letter today asking for all the medical records to substantiate what my surgeon had listed in his pre-authorizaion summary. They did not ask for 5 years or say I needed any specific BMI. All the letter asked for was medical records supporting my diagnoses, including all lab reports and physician's notes. They asked for a list of medications I am taking. The letter said they will attempt to expidite my request but it can take up to 45 days. My surgery is scheduled for 2/18/09 so they had better hurry. I am going to take this response from my insurance company as a postive step towards my surgery.
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February Dates for Banding
Sunbunny064 replied to JulsJourney's topic in Tell Your Weight Loss Surgery Story
Hi, I have United Healthcare Plus and I have a surgeon that is in network. I too have been at this process for about 8 months now. The doc sent my info to the insurance company on 1/23/09. I confirmed they received it and it is scheduled for review on 1/26/09. I don't have my approval letter back yet. My sister works for the hospital where I am going to have the proceedure done and she said I am on the roster to have surgery on 2/18/09 @ 10:30am. So, I am crossing my fingers the doctors office knows something I do not. -
Hey Banster Bunnies, I just received word today that my surgeon has sent my file to the insurance company for a pre-authorization. Cross your fingers for me, I might be a February Bunny! I can handle being Miss February some day. (ha ha) Now that I think about it, I would be happy to just be able to fit into a pair of Levis.
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Hi Misty,
I have the same insurance you do with UMR being my third party administrator. My doctor is sending everything over this week in hopes of getting me approved. I have done a 6 month visit. Your post has given me hope that they will approve it. Thank you!
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Hey Gabi,
Don't give up, believe it or not if you get a copy of the AETNA requirements from your insurance policy or your HR department, AETNA can be pretty good to work with. They are sticklers about the 6 consecutive months of office visits with your doctor, if you miss one month they will deny you and you will have to start over.
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Hey, Dont give up.. I am boarderline insurance approval also, I have a BMI of 37 with two comorbidities. We are sending everything to the insurance company for approval next week. If all goes well, I might get banded on February 18. If not, then I will be an April bandster because of the 6 month clause in my insurance. My insurance is sticky because they ask for 3 years medical documentation that I have fought with my weight. Until about 2 years ago, I didn't even know a person could go to the doctor and get help with weight issues. I had never heard of bariatrics. Doesn't it just frost you that insurance companies have to make this process so difficult? Makes you wonder why you pay for insurance in the first place. Hang in there and don't let AETNA off the hook. I do know that they require the 6moth continuous office visits with the surgeon so what ever you do, find a surgeon pronto and don't miss a single appointment.
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Wow!
125 pounds, you are doing amazing. I got some good news yesterday when I went to see the surgeon, he thinks we have met the requirements and want to do the surgery on 2/18/09! I have to see the exercise therapist on tuesday and then he is sending all the documents to the insurance company for approval. I am keeping my fingers crossed. I am amazed at how effective the lap band is. I wish the insurance companies would recongize it's value and potential.
Keep up the great work!
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Hi Buck,
You look great! Congratulations on your success. I am scheduled to be banded on 4/8. Can you tell me when you were banded? I am curious how long it took you to lose 100 pounds.
Thanks!
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Congratulations on your success, you look amazing. I am scheduled to be banded in April after I meet the 6month insurance requirement and I cannot wait!
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Which free tracking site is best?
Sunbunny064 replied to Band_Groupie's topic in LAP-BAND Surgery Forums
Hi, I was reading your blog, did you have to do a 6th month diet before the insurance company would approve your surgery? I am going through the same thing only my doctor is not really making me diet, he is however encouraging excercise. -
Well.. Ill make the first post:)
Sunbunny064 replied to christine313112's topic in LAP-BAND Surgery Forums
I thought I was going to be an April 09 banster, now it looks like I might be a March banster. No complaints here. -
6 days post op and hardly able to eat...help!
Sunbunny064 replied to teacherica's topic in POST-Operation Weight Loss Surgery Q&A
AGHHH, Thank you for the warning, I have never heard of Mastication before. I do not want to do anything to mess up my surgery success. -
6 days post op and hardly able to eat...help!
Sunbunny064 replied to teacherica's topic in POST-Operation Weight Loss Surgery Q&A
Thank you for sharing, I have no idea what it is going to be like after my surgery, I just know I don't want to do anything to mess it up. If I can chew a chip and then spit it out, I am cool with that. I see you are going to get your first fill on the 19th. Please post and let us know how that goes for you. Hang in there, this time next year, you will be a hot 100lbs lighter! -
Will I need someone to take care of me after surgery?
Sunbunny064 replied to Britalian's topic in PRE-Operation Weight Loss Surgery Q&A
Hi, I don't know what your starting weight is but you should be able to bathe yourself after surgery. It is my understanding that you will be very gassy after surgery, the best way to relieve the gas is to walk it off. (Check with your doctor.) My surgery is scheduled for April 8, 2008 so I can only tell you what my doctor has shared so far. My doctor said one of the most important aspects of this surgeries success is to try to keep your life as stress free as possible. If you and your mother don't get along, maybe a really close friend might stay with you at your house. Good Luck! -
6 days post op and hardly able to eat...help!
Sunbunny064 replied to teacherica's topic in POST-Operation Weight Loss Surgery Q&A
Thats cool! Congratulations on getting banded and losing so much in the first week! It is encouraging to hear the weight does come off if the program is followed. My new surgery date is scheduled for April 8, 2009. I cannot wait!! Keep up the good work! E -
To Be Banded In March of 2009
Sunbunny064 replied to DM Chef's topic in Tell Your Weight Loss Surgery Story
Hi, I was originally scheduled to be banded on 12/23 and then found out my insurance had a 6 month clause in it so I had to postpone the surgery until April. Like you I am nervous and excited. My doctor told me the secret to success is to begin working out lightly now, no heavy weights but rather walking daily, swimming things that prepare your body for being more active. It is my understanding that if we prepare our bodies in advance of the surgery, it helps the weight come off even faster. Best of luck to you! E -
6 days post op and hardly able to eat...help!
Sunbunny064 replied to teacherica's topic in POST-Operation Weight Loss Surgery Q&A
What is a realistic amount of weight to loose in the first 30 days following surgery? I was scheduled to be banded on 12/23 but because of my insurance requirements I had to change the date to 04/08/09. I can't wait to have the proceedure done. -
Hi Nicci,
How was the holiday season for you? 4 days before my Dec 23 surgery date the insurance company came back and said I had to see Dr. Korn for 6 consecutive months. I was bummed :crying: now I have to wait until April to have my surgery done.
How much have you lost to date?
E
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Bad news, insurance company waited until 4 days before my 12/23/08 surgery date to come back and play the 6 consecutive month card. Now I have to wait until April 2009 to be banded. This is so wrong. When will insurance companies realize obesity isn't caused because people sit in front of the television all day eating nothing but See's candies. This is a disease and the harder they make it for obese people to get treatment the more lives they are putting in danger. Sorry guys, I had to get that off my chest. Dr. Korn is wonderful though, so encouraging and supportive, it is not a matter of if I will get my surgery, now it is a matter of setting a date!
Peace!
E