Mrs Husker

I have thought about using an attorney, but if insurance does not accept LA Weight loss as a medically managed diet, then I don't believe that even an attorney will be able to help.

Just what I needed to "hear" today. What an inspiration. Thank you so very much.

This is one of my DH's fav's! Chili-chicken Stew Recipe By : Serving Size : 12 Preparation Time :0:15 Categories : Main Dish Amount Measure Ingredient -- Preparation Method -------- ------------ -------------------------------- 3 chicken breast without skin -- cubed 1 cup chopped onion 1 cup chopped green pepper 2 cloves garlic -- minced 2 14.5 oz pinto Beans -- drained 2 15 oz stewed tomatoes 3/4 cup picante sauce 1 teaspoon chili powder 1 teaspoon ground cumin Cook chicken, onions, green pepper and garlic in dutch oven until chicken is no longer pink. Add remining ingredients and smiier for at least 20 minutes. Yield: "1 cup" Start to Finish Time: "1:00" - - - - - - - - - - - - - - - - - - - Per Serving (excluding unknown items): 333 Calories; 2g Fat (4.6% calories from fat); 29g Protein; 51g Carbohydrate; 18g Dietary Fiber; 34mg Cholesterol; 185mg Sodium. Exchanges: 3 Grain(Starch); 2 1/2 Lean Meat; 1 1/2 Vegetable; 0 Fat. Serving Ideas : Optional Toppings: Shredded cheese, green oinions slices, diced avocado or sour cream.

What about the e-mails that state "If you don't send this to at least 10 people you don't support our troups/believe in God/am my friend".

This sounds like fun, please sign me up!!

2 & 3 are just plan nasty:puke:

Did "Post of our Lives" get canceled already?

Want to chime in, Did you know that Polar Bears skin is black?

Happy, Happy, Happy, Happy, Happy Anniversary!!!

Congrats harlito!!! I am not banded yet, hope to be soon (waiting on insurance). I love LBT and have found many, many answer to questions I didn't even knew I had!!

I went into a Victoria Secrets and the shop girl came right up to me and without asking if I needed help just said “We don’t carry your size”. I was so embarrassed.

Love this thread!!!!! I want to be the mysterious gloved hand that is peeking around the corner whenever something naughty is going on. No one knows who I am but I have all the dirt on everyone else. Who will I take down first?

Waiting is the hardest part. I have been playing this game since about April or May. I am trying to use this time to get into good band habits to make the transition easier. Go luck.

Congrats!!! I have to wait until December to find out if I get my approval. Can't wait to join the "Band-Wagon".

I just read the thread about the garage and the fire. How are your legs looking now? Did you get burned anywhere else or just your legs?

Congrats!!!:clap2:

This is an article that appeared in the paper today. Maybe with studies like this insurances might like to take another look at how they classify WLS as Not Medically necessary or experimental. http://www.omaha.com/index.php?u_pg=1642&u_sid=2209182

There are quite a few people here who have gone to Mexico and would do it again in a heart beat. There are also a lot of thread on just that.

When I talked to my insurance company, they informed me that LB would be covered. They even sent me a new book outlining my benefits. In the book it states under Noncovered Services: Tretment and monitoring for obesity or for weight reduction, regardless of diagnosis, excluding surgical operations. I wanted to make sure that I understood that statement, so I called again. The person I was talking to said that they would not cover anything other than surgery. I asked again just to make sure that I understood her correctly "So Lap-band surgery is covered?" She said, "Yes". Well, today I got a letter in the mail that states: Benefits are not available for those services which have been determined to be not medically necessary per physician review. Therefore, no benefits are available for laparoscopic bypass surgery (LAP band), as this has been determined to be not medically necessary, as it does not meet medical policy criteria, as there is no documentation of two years of medical management.:girl_hug: So now I have to start the appeal process. I just find this very depressing. Does this mean that I have to pay out-of-pocket for "two years of medical management" because they will not cover that? I just went and and got on the scale, I'm 224 lbs, I am 5'1", that puts my BMI at 42.32, I have sleep apena and joint pain. I realize that I don't have a lot of medical problems YET, but I was hoping to get it under control before I did. But even with the few problems that I have, my doctor, not a bunch of people who have never even spoken to me, beleives that the surgery IS medically necessary. Dam it, I just don't want to wait two more years. I'm even quiting smoking this Saturday, June 10. Not only will my surgon not do the LB is you smoke, I decided that if I plan on getting healthier, I need to do everything to get healthier. I will have to call my doctor tomorrow and see what they have to say. Thanks for letting me vent, I know some, if not most of you will understand.:think

[ GEEE I wonder what from???? Just Wondering Terry:) Mark Hughes, Herbalife's Founder, Dead at Age 44 Stephen Barrett In May 2002, Herbalife founder, chairman, and chief executive officer Mark Reynold Hughes, was found dead at his $27 million oceanfront mansion in Malibu, California. In a series of articles about the death, David Evans (Bloomberg News) reported: Hughes died after a 4-day drinking binge, apparently from an overdose of alcohol and the antidepressant drug doxepin. His blood alcohol level was 0.21% (more than double the "drunk driving" level). He was being treated by a psychiatrist for a drinking problem. Hughes said many times that he had been inspired to start his company after his mother (Jo Ann Hartman) died from taking diet pills. However, Hartman's autopsy found that she died of an overdose of Darvon, a narcotic painkiller. At the time of her death she was 5-foot-6-inches tall but weighed only 105 pounds.

Bumped for kellbelle

Me: CYPRESS TREE (Faithfulness) -- strong, muscular, adaptable, takes what life has to give but doesn't necessarily like it, strives to be content, optimistic, wants to be financially independent, wants love and affection, hates loneliness, passionate lover which cannot be satisfied, faithful, quick-tempered at times, can be unruly and careless, loves to gain knowledge, needs to be needed. DH: HAZELNUT TREE (Extraordinary) -- charming, sense of humor, very demanding but can also be very understanding, knows how to make a lasting impression, active fighter for social causes and politics, popular, quite moody, sexually oriente d, honest, a perfectionist, has a precise sense of judgment and expects complete fairness.

I enjoy the act of giving him pleasure; I love how “silky” it feels. I just hate the end product. It’s not the taste, it’s the texture of it. It feels like a mouth full of, sorry to say, snot. Good Head is great for the gag reflex and depending on how long he takes, it help with the taste. But is there anything to help with the texture? That makes me gag no matter what I use.

I just got back from vacation and low and behold, my second denial letter. This one also states that it is not medically necessary. But they did give me something to work with. This one states: Our Medical Policy states: The screening criteria listed below should be utilized before any surgery would be considered medically necessary: 1. The patient must have morbid obesity or a BMI of 35-40 plus significant co morbidity. My BMI is 43+; I also have sleep apnea, diabetes and joint pain. I also have other medical condition that would be improved with weight loss. 2. The duration of obesity must have exceeded five years. I have been fat for a long time and have the weigh in to prove it. 3. No identified treatable medical causes. Nope, just fat. 4. Age >/= 16 years of age. I’m 39. 5. Evidence in medical records of nonsurgical obesity treatment over a minimum of two consecutive years of at least four face to face discussions with MD/DO physician or physician substitute with a documented treatment plan (diagnosis plus diet at every visit and exercise recommendation at least once). This might be tricky. I have my records from LA Weight Loss from 2005. Really they are in my medical records because LA would not send them to me. And I know that I have talked to my doctor about exercise at least once in the last year. I met someone at a support group meeting who has the exact insurance as I do (we both work for the state) and she was approved without any medical problems. I am trying to get intouch with her. I also have a call into our "person" who sets up our insurance contracts and hope to shed some light on why I keep getting denied. My doctor is out of town until next week, so I will have to wait until then to talk to him and get his help. If they will take the LA Weight Loss, then I only have to wait until December to get approval. Please pray that they will accept it, I can’t go self pay.

Not banded yet and still have mine. I have had pain in that area for years though. I have been tested for years and my gallbladder is just fine, but at times it works in reverse. Then I found out about Sphincter of Oddi dysfunction. This can replicate gallbladder pain in those who have had their gallbladders removed or have been tested and everything seem to be fine.