Kelkie

I got approved through BCBS of North Dakota on first appeal! They sent it out to an external reviewer, and they said yes!!:scared0: I am soooo stoked! So, everyone who is denied the first time... fight back! It is possible.

Good luck KabinKitty! If there is anything I can do to help let me know. I live in Oregon, but have BCBS North Dakota, PPO. I got approved on appeal, due to a lot of issues with auto immune disorders and the medications that go with them. I also pointed out in my letter that the sleeve had been performed safely for decades for many conditions. When I was originally denied, my surgeon's office wasn't going to do the appeal, they said I was on my own. The insurance coordinator typed up a letter from the surgeon stating his reasons for it being my only option, then added my letter to it. It was my letter that won the appeal. Good luck to all of you out there fighting your insurance companies. Don't give up. That's what they want.

My employers anc coworkers all know the truth. I work in a small vet clinic, where there are only 11 employees, and most of us get along and support each other. For people that I don't know well, or its really none fof their business, I said I had hernia repair, which was actually true.

I completely agree with Cheri. I was after the band when I started my journey a couple of years ago. I did a lot of research and changed my mind. My husband forbid me from having the band because of the potential complications, and the constant fills and unfills. I am so glad I opted for the sleeve. Don't let that nutritionist discourage you from what you want. You can do this, we all did, even though most of us thought we couldn't. Good luck!

No inside info, but lots of people are winning on appeal. I think that BCBS is just telling people no hoping they will accept it. Most of the people that are getting it covered are appealing, and if you do your research when writing your letter, there really aren't any grounds to say no. Good luck.

I didn't have any issues with falling out of the gown. They only allowed me to stand at bedside the first night. As soon as the catheter came out the next morning, I put on my comfy jammy pants to wear with the gown to walk the halls. To be honest, as long as my butt was covered, I didn't care.

Don't take no for an answer. I think that is what the insurance companies are after. Imagine how many people don't belong to forums like this and the others out there. They would never know they could appeal, and get the procedure they wanted. For and example, I was the only person at my pre op class that had heard of this site, and obesityhelp.com. There were 8 or 10 people there. Of course, I was the only one that had ever heard of the sleeve too. Anyway, hang in there and fight for what you want. If you don't get it on first appeal, do it again. Every state has an insurance commission of some sort that you can appeal to as well, if all else fails. The only way the insurance companies are going to quit fighting us, is if enough of us fight back and win. Come up with all the evidence you can to back up your reasons for wanting this surgery, and only this one. Find every reference out there to back up any medical issues you have that would make this a medically necessary procedure for you. Good luck!

It took about 3 weeks. PM me your email, and I would be happy to share my letter with you. Attached to it are a lot of references that you can check out, and may be able to tailor them to your needs.

You could at least try to appeal. Many of the insurance companies (especially BCBS) are saying no just because they know that people won't appeal. I had BCBS North Dakota. I submitted and was denied. Then my surgeon's office wrote a letter of appeal, and I wrote my own letter to go with it, outlining that this surgery has been performed safely for decades, and that it is a viable option for weight loss. I also told them in the letter why I felt it was medically necessary for me (you could list your families health history as reasons). I got approved. The insurance companies want us to just take no for an answer. Good luck in whatever you decide to do.

I am 7 days out today. My husband and I have been cooking for him and the kids the last few days. I am missing food soooo bad. I have been on clear liquids the last week, and I get to start full liquids today. I made chili yesterday and am so tempted to magic bullet some into oblivion so I can taste it:drool5: ( I may have cheated a little yesterday by tasting the liquid off of it). I need to go make a protein shake and get some nutrients into me. That will probably ease some of the cravings. Good luck and stay strong.

You will be fine. You aren't that low. Take the pills they give you, and you will be where you need to be soon. Take care, and good luck.

I have BCBS North Dakota. They denied me first because of it being investigational. My surgeon filed and appeal, and I wrote a very detailed letter to go with it, saying why I thought it was the best procedure for me, and therefore medically necessary. BCBS reviewed the appeal, and then sent it, on their own, to an external reviewer. Three weeks later I was approved, three weeks after that I was sleeved. I have read of a couple of people on here that had basically the same experience with BCBS Il. Other than the waiting it was a relatively painless process. Good luck, and don't give up on what you want. It's not impossible.

What about joint pain? Disc disease in your back? Anything like that? Does your state have an insurance commission you could contact and find out what your rights are? Good luck.

Very nice! Congrats on your victory, and here's hoping for a date soon!

I am 4 days out and gurgle a lot! I agree that its gas. Not really a problem now, but hopefully it quits before I have to go back to work.

Good luck to you. I had a dream that I went in for the sleeve and came out with the RNY. I told my doctor when I saw him right before surgery about this dream, and that it would be completely unacceptable if that were to happen. Of course we had a laugh about it, and I did come out with a sleeve, and hernia repair. You will do fine.

Good luck! You will do fine, and be on to your new life soon.

I am getting nervous with my surgery coming up on Wednesday. I had my pre op appointment this last Thursday, when I asked my surgeon how many sleeves he's done. Now, keep in mind that the hospital where I am going is in Boise, Id, a relatively small, rural city. They have a wonderful bariatric program for a small place. My surgeon has done 3 sleeves, I will be number 4:svengo:. He has done more than 500 RNY's though, and countless gall bladders, and other abdominal surgeries. I have full faith in him, I guess I just expected a higher number. I should have known when I went to my pre op class, nobody in the room had heard of VSG, and the class was totally geared for RNY patients. I didn't learn a damn thing! Sorry to ramble... just working things out in my head, and writing it helps.

Good luck. Give 'em HELL!!

I've had mine for 2 years or so, and I love it. The kids use it to make sugar free "slushies", and I use it to mix my shakes, and other pre op diet liquids.

Way to go. You have to be on the ball with the insurance companies. I can only imagine how many people out there take no for an answer and don't know they can appeal, or simply lose hope.

Yep, my husband stops short of rolling his eyes at me when I bring it up. He is very supportive, but I don't think he completely understands.

Feel better soon!

Congrats on making it through! Hoping you will feel better soon!

One week and one day left to go, and I am here and over on OH more than ever... I talk to my husband about it multiple times a day, even finally told my boss (who I wasn't gonna tell until after), probably just so I could share, Hopefully it will get better after. My other net surfing is totally suffering! :cursing::lol0: