gogtigirlgo

I slept reclined on the couch for the first two nights and slept in bed going forward from there. I had surgery on Oct 26th, and am still having back pain - enough that my dr. put me on part time hours while my stomach heals. She believes the back pain is due to my back compensating for the stomach muscles that I can't use right now. I've been using the pain meds after I get out of work and head for bed at night. (I work 2nd shift)

I have bi-polar disorder as well. I am currently off meds and was during my psych eval too. I was still upfront with them about it and said that my being off meds was a decision made by myself and my psych. It shouldn't be a problem. If it is, I'd ask for a 2nd opinion. Good luck!

Hi Dixie, Here are a couple of sites that I found really helpful when dealing with my insurance company recently: About.com Guide for when Insurance won't Pay How to File a Complaint with Your State Dept of Insurance - this one provides a list of each states' dept. of Insurance. (which is free to do)

Also, you'll want to check with your employer's summary plan description if your policy is with your employer. Most times you can get an SPD from your HR/Benefits office, or they can at least direct you where to go to get it online. I haven't been approved yet, and ran into a snag when the Insurance Co. was not aware that my employer changed rules this past January. It didn't come up until everything was being submitted for approval and I did some digging through the SPD to find what they were talking about. In fact, if I were to call the insurance company tonight to find out what the requirements were they would tell me the only thing I need is a BMI over 40 or over 35 with co-morbidities.

Thanks all for the advice. I am already at goal for what I needed to lose to qualify to meet with the surgeon's office, and have been hanging out at the weight for about 4 weeks now. I was really hoping to start the pre-op diet below 300, but I feel so frustrated that I have to hang out at 310 until Sept 22 at least! I have a phone appointment next week with Optimum Health through my insurance company, Unitedhealthcare. It's been a freaking nightmare so far. I will ask the nurse next week if it's safe for me to continue to lose weight. My Dad has started working out, and I'm starting to get really envious that I can't get out and work out with him right now. That he gets to be active and I'm stuck entertaining myself in other ways. I got some literature from my insurance company yesterday and basically, the nurse at Optimum Health has complete control over whether to approve me for surgery or not! That makes me nervous! On one hand I want to be a complete b**ch about it, but on the other I know you attract more bees with honey than vinegar so I know I need to behave and just get through it. My view of insurance companies is that they should not have their hands in what's best for my body, that should be between my doctor and me only. It really pisses me off that they have all these requirements to meet for this. Ugh! btrieger - I know what you're saying about letting my surgeon's office deal with the insurance company, but their view has been, "well, it sounds like we just need to play it by the ins. co.'s rules, so just keep in contact with them and with us." So, it's definitely necessary that I be proactive in the approval process as well.

That's what I heard today from my insurance company in regards to the 6-month medically supervised diet! Has anyone else heard anything similar to this? Basically - if I can lose weight on the diet I'm showing my insurance company that I don't need to have the surgery and they would deny me for it if I lost weight. My Dr's office today said I could probably safely lose another 5lbs, but immediately afterward, I spoke with my insurance company and they basically advised me not to lose any more weight before my 2nd consult with the surgeon on Oct 1st. I was flabbergasted! I've never heard anything like that before! I said to the care coordinator, "SO, basically, you want to deny me coverage for something that will make me a healthier person overall and will cost you, the insurance company, less money in the long run? How does that make sense?" *facepalm* Sorry for a couple of negative posts the past couple of days - but I've never experienced anything like this before. I am so emotionally drained, dealing with these people. I thought when I first started reading the posts here, "God I'm so glad my insurance company is so easy to deal with..." I guess I thought too soon!!

I'm so glad I'm not alone. For me, it wasn't my doctors saying any of this - it came straight from the insurance company. So, I filed a formal complaint against them this evening with the State of New Hampshire dept of Insurance. It's not right that I can be told one thing time after time by them, and then when it comes time for the actual approval they say, "oh yeah, you gotta do this this and this." It's going to be November or December before I can have surgery now. I have an appointment tomorrow and another in september, then I have to start back at square one with the surgeon. It took me six weeks to get scheduled with her last time and surgery was scheduled 4 weeks out after I met with her. To say I'm bummed would be an understatement. I can't wait for the weekend just so I can have a good cry. I'm discouraged and disappointed. I'm going to work with the doctor's office and see if they can get me scheduled sooner with the surgeon rather than having to wait. I guess I'll just have to wait and see.

So, I don't know if it's my employer or my insurance company that sucks, but I am just growing more and more frustrated. In order to be approved for surgery I need to complete a program through my insurance on top of the program through the hospital. I called in January and asked what the requirements were so that there wouldn't be any surprises. My insurance company stated that all I needed was a BMI over 40 - sweet, no problem, can do. Well in submitting approval to the insurance this week, the surgeon's office found out that really I needed to be on 6 month medically supervised diet and I've only done 4, so my surgery date - which was scheduled for 9/16 - is now pushed out to God knows when. I'm so frustrated! AND! A nurse care provider called from my insurance company this morning and told me about that other program I have to complete. They stated I had to have the med. supervised diet, co-morbidities, that I have to work with a nurse before and up to 6 months after surgery to "ensure I get the best care," psych eval (that is only good for one year - WTH!?) and I have to review their documents and have a discussion with a nurse about treatment options before they will approve surgery. Meanwhile, I feel like it's just a bunch of BS. I am in a great program that is very thorough, and am so disappointed that all of this wasn't disclosed to me up front when I called to find out the requirements. I complained to my HR group at work today, but I want to make sure that if someone else has to go through this that they know what they're getting into, I don't know who else I should contact to complain. The good news is, the only thing standing in my way is an appointment tomorrow - and one at the end of September and then I can start the surgery stuff, so it should only really be pushed out an extra month. But it just feels like such a let down, that I had all of this set up and get it all taken away because the insurance doesn't know its head from its ass. The other bonus is I can keep losing weight and by the time I actually have surgery, I should be under 300 lbs. Keep looking for the positives, right?

I'm so disappointed! The surgeon's office called today and said that my insurance company changed the rules in the middle of applying for my approval. Monday, the surgeon called and stated all they would need would be a 5-year weight history and I got that all squared away. Today they called and said that I would need to be on a medically supervised diet for 6 months before I could be approved... and I've only been "officially" in the program since april so only 4 months! So, tomorrow, I guess I have to call insurance and work and see if I can fight my way through! Otherwise it looks like I won't be able to do this until October. What a bummer!! :mad2: :frown: :cursing:

I have been very selective about the people I've told. The one person that I thought would be super happy for me hasn't been... but everyone else has been really supportive - My extended family - Aunts and Uncles have all been very happy. My Dad - who is that one person - isn't unsupportive vocally, but I know from how he reacts about it, that he's not excited for me. He thinks I could do this on my own - because I have in the past... but the difference this time is I want to keep it off! The people you tell will all react differently - and not everyone will respond in the way you were expecting them to... but in the end, this isn't about them and how they feel about it. This is about you, so don't let the negativity get you down. You know what's right for you! And besides - you've already had it done! So poo poo to them, Spoiltmom :cursing:

Me too! Me too! Sept 16th! Been away for a month or so... back into the grind here, though. I'm starting to get nervous

I just found out today that my surgeon consult is for August 13! I did a little happy dance when I got the message. Thanks all for sharing what the process has been so far... it makes me feel much better to know others are in a similar boat/journey.

You can also trying calling the surgeon's office to speak with the admin staff. That's how I got started at the location I'm going through. They sent me out an information packet through the mail and answered a lot of questions over the phone. Maybe if you're on the phone you might find there's been a cancellation as well, so that you might get in sooner.