kcollier84

Well, After EVERYTHING I went through, all the procedures, all the stress, it turns out BCBS misquoted my Provider and the treatment of obesity is an exclusion. BCBS told my provider that yes wls was covered, yes the sleeve was covered, and here are the things that need to be done before pre auth (endoscopy, dietitian appointments, upper GI, psyc eval...yada yada yada). :scared0: I was about a month away from surgery when I was looking through our plan docs for chiropractic information. All of a sudden I was bit in the face with an obesity exclusion! What!!! OMG, I called my provider. She called BCBS and sure enough, excluded. BCBS said don't worry, if it s a misquote it will be covered.... I waited a month for a misquote review only to find out that their denial reason was "A misquote of benefits has been reviewed and denied as there are no claims on file for this provider." Well of COURSE there are no claims...you told my provider it was excluded in the second call! :cursing: I am having my provider actually do a pre-auth so that I can get a denial letter. Hopefully I can appeal somehow. :001_tt2: During all of my testing, I found out I have a moderate hiatal hyenia, high blood pressure, and acid reflux. Has anyone had any luck getting approved using these diagnosis codes? My insurance has an exclusion for any treatment of obesity but not the surgery itself (hence the misquote I think.):confused1: Any help would be appreciated. I am also considering contacting the Insurance Commission regarding the misquote, what do you think?

Thank you for the advice. I actually work in the benefit office and we didn't choose not to have WLS, it was just part of the insurance package. Specifically tailoring a plan is expensive for the company! I am thinking about Mexico, but it seems as if that is going to be about $6,000. I think I may be SOL....

Hello Everyone! I had my endoscopy done, pretty easy. I had some heartburn when I go there, I think it was from the nerves. Now, I have SERIOUS heartburn. They gave me a script for it and I am going to pick it up now. Did anyone experience this?

Upper GI endoscopy is a procedure that uses a lighted, flexible endoscope to see inside the upper GI tract. The upper GI tract includes the esophagus, stomach, and duodenum—the first part of the small intestine. My doctor requires that they complete this before any gastric surgery. They make your very sleepy and I don't remember a thing.

Sorry for the ominous title, I didn?t know what else to call this post. So as my surgery date approaches, I am beginning to reach the reality that I am going to undergo major surgery. Death is currently the main topic on my mind. I know that 1 in 1,000 people die from WLS but does anyone know if there are any ?reasons? for the death?for example, not following the pre surgery diets, family history, etc. The clinic that I am going through has had 1 death in the last 10 years. He was having gastric bypass and had heart issues and never came off the ventilator. If there is anything I can do to prevent death, I am going to do it. I know that the percentages are low but I want to make sure that I come out of this surgery. I also found out that my Doctor has never had a leak from Gastric Sleeve so that is awesome! Thanks for the help!

Hey Everyone, So maybe I am a vain germaphobe or maybe I have just been embarrassed too many times by having my goodies hanging out of small hospital gowns but I have been thinking about bringing my own hospital gown. There are a couple of websites I have found that offer plus sized gowns (most of these are for labor and delivery). BYOG and Dearjohnnies both offer stylish gowns that no one has worn before and look freaking adorable! I know they won't let me wear one in surgery but I will be recovering in ICU (clinic policy) and I just can't imagine wearing a regular old gown. Is anyone considering doing the same thing? Has anyone done this? :001_tongue:

Thank you for all the great responses! TiffyKins, I am with you...I will be putting makeup on as soon as they give me the okay! I guess I was worried about the back being open and all that mess. I tend to be uncoordinated and really don’t want to show the whole hospital my hinney while walking down the halls! I am also worried about sleeping in ICU. Once of my co-workers had bypass and she said that you are so dopped up that you could sleep through a tornado! Is that everyone's experience as well?

I guess its really less about size but more about style.....

Does everyone need a drain? What is the purpose of the drain? Sorry for the multiple questions, seems icky.

If you look at the top posters they are all post opp...so I dunno! LOL! Ditto to hoping to get addicted to exercise!

Darling, I am in the same boat too...totally OB-sessed! I think about it all the time, talk about it all the time, plan all the time. I was flipping through Vogue and all I could think about is...I want those shoes WHEN I am skinny! I used to have to say, gosh I wish I was skinny so that I could dress like that! My partner is uber supportive and wants the surgery herself, so it makes it a lot easier. Just hang in there, we are all hanging on the side of the boat with you!

I am so sorry to hear that...my thoughts and prayers are with you.

Hi, My name is Kate and I am in the verrrry beginning stages of the process. My doctor expects me to be sleeved late September or early October. I am nervous, scared, and full of questions. I would love someone who has been there, done that, and got the bumper sticker too :biggrin0:! If anyone wants to chat and provide some support, I would greatly appreciate it. I am 26, live in Houston, and have been with my partner Alisha for 1.5 years (she is hoping to have the surgery after me). I would love to talk to either someone around my age or a parent-type mentor. Basically, anyone! I have Facebook, yahoo, AIM...the whole nine yards. Thanks for reading! Lots of love, Kate:001_wub:

Thank you everyone! Does anyone have any experience with the Single Incision process? I noticed that Carla's Dr. offered it. Any pros/cons? I have having my EDG next Wednesday, how was that process for everyone?

Hola! I went for my first consultation today and found out I can have my surgery in as little as three months! I have to go through testing and the like but my insurance is on board! I cannot believe it! I only found out about the sleeve on Monday (I was considering LapBand) and I cannot be more excited. I have been researching like a maniac and have loved reading all of your posts! I am ready to get healthy! If anyone has any wisdom they would like to share, please feel free!

Right now I am most worried about pain, people who have used my doctor, what in the world I am going to eat post surgery, if I am going to have a catheter and/or drain, if my hair is going to fall out, how I am going to learn to sip water without chugging, how fast is the weight going to come off......ahhhh okay I am breathing I promise!

Amazing! This answered soooo many of my questions. Thank you so much!

Hi! I am in Houston (West U/Rice Village area). Anyone been sleeved by Dr. Nowzaradan? I met with him the first time and really liked him! Let me know if you have heard anything about him or his practice. I am a little nervous because it seems like he has several practices. Is that normal?

I am 26! Don't feel alone! I think that the Lap Band ads all over facebook is one of the reasons that so many people our age are going that route! If they only did some research first!

My doctor told me that BCBS-TX said it was "billable" which means it should be covered. I have to go through three dietician appointments, have a psychological workup, and a ton of blood work! I will let you know if I find out more. I was told I would only have to pay my out of pocket maximum and even then that would be billed to me and I can make payments! Good luck!

Thank you for your warm welcome! I have so many questions running through my head right now. Things like how/what to tell work, if anyone has heard of my Doctor (Nowzaradan) besides on TLC , and how to prevent hair loss. I do not know why but that is the thing I am most worried about! Thank you again everyone!