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Showing results for 'Fed BC/BS'.
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Woo hoo, My surgeon's office has submitted everything to BC/BS, and now I have about a week of waiting to find out if I am approved . I know the office does not see me having any problems with approval, but it is still nerve racking.:paranoid On a fun note, I went out this week and got some comfy jammie-type pants and tanks for post-op. My brother works at Old Navy which now carries what I affectionately call "Fat girl sizes" and I got a 25% discount off some stuff. I am so hoping all goes well with insurance and I will have my band by the end of September! I am going to start a partial liquid diet next week to get myself ready for 4 weeks of liquids only. :phanvan
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New york (surgery 3/2017)
kristenmh replied to rabbit0722's topic in PRE-Operation Weight Loss Surgery Q&A
Hi there, I'm not in NYC but am a native NY'er now living in LA. I was banded at NYU in 2008 -- my revision surgery is scheduled for March 6th -- I'm also in month 3 of the 6 month diet. (Also, a fellow BC/BS). Where are you having your surgery done? -
My theory is that because we are on a low carb diet. Our bodies use up all the carbs which is the first line of fuel for aerobic exercise. So cardio is hard bc we run into a "wall" so much sooner than before when we had carb reserves in our bodies.
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First appointment scheduled... then what?
GreenEyedLady replied to derbin247's topic in PRE-Operation Weight Loss Surgery Q&A
I had my first surgeon appt today after waiting 5 wks to get in after the seminar. They gave me a big packet and told me to call my insurance which is BC/BS HMO and find out who they want me to see for psych and dietician. See them both 2 times, get lab work, go to 2 support mtgs., get a letter from my pcp that surgery is warranted. Have a follow up appt with the surgeon for Jan. and was told not to gain any wt. between now and then.:grouphug: They will then review everything and send it all into the insurance for approval. No discussion today about a surgery date.:grouphug: I will have my work cut out for me. It will all be worth it! -
Having Anxiety Over Approval Decision.
lisanj replied to LisaJane's topic in PRE-Operation Weight Loss Surgery Q&A
I was the same way you are.. Before my surgery was approved I was panicking they would not approve it. I have Horizon BC/BS and had no other medical issues and was approved (I have since found out I have sleep apnea though). You have other medical problems so it shouldn't be a problem for you to get approval. Just wanted to let you know you are not alone with the insurance approval anxiety. Good luck Lisa! Lisa -
Tunnel Vision (And Getting/keeping The Weight Off!)
vanishingvixen posted a topic in Tell Your Weight Loss Surgery Story
Tunnel Vision. Defined as: “the tendency to focus exclusively on a single or limited goal or point of view”. A lot of people view tunnel vision as a bad thing. And in some instances, it can be. But in the instance of my health and physical fitness? It’s an amazinggggg thing! I sorta-kinda had counted myself out of the 5k I had planned to do next month due to some health set-backs and overall apathy while dealing with some of life’s other BS. But I’m glad to say my "tunnel vision" goggles have returned (as it pertains to getting in better shape) See this pic? That's me. RUNNING (jog/trot is more accurate) across the Woodrow Wilson Bridge (MD to VA). The span is 2.-something miles. I did NOT run the entire length, but d@mmit, I DID it. 2 years ago - and 100# heavier - I could have never imagined this for myself. My 1st 5k race is in 3 weeks. I am determined to do it!! My inner athlete at work This weekend I headed out with my family for a traipse across the Woodrow Wilson Bridge. The span itself is a little over 2 miles one way. The trail totals 6 miles – there & back, including the bridge span. I hadn’t planned on running at all, but when the urge hit me? I took off! Like, didn’t even THINK about running. It just felt…NATURAL. For the first time. EVER. And I’m so incredibly proud of myself. I had nearly given up on the idea of being able to get in that 5k race next month, but this was just the encouragement I needed to stick to my plan. Like I said previously – even if I have to crawl over the finish line, I’m going to FINISH. #the end. My Sweetface...running like the wind! On another note: Who woulda thunk that my Sweetface 3 year old would serve as my biggest source of encouragement? Her daddy used to be runner, so I guess it’s in her genes. (damn shol aint in mine!) *shrug* But she knows it’s a struggle for me. At one point she said “See? Just like this, Mommy” – and took off running. Then said “COME ON, MOMMY! You can do it! Go Mommy!” How could I NOT find the energy after that?? I have exactly 3 weeks to get my bootay in gear. I have enlisted the help of Jillian Michaels and her “Last Chance” workout DVD to help amp it up a notch. So tonight, I will take my first 30 minute punishment. The REALLY insane part? I’m looking forward to it. That blows my mind. Not only that, but I’ve found another 5k race to get under my belt in October. Except this one is going to be funnnnn. (It’s a 5k obstacle course -entitled “Run for ya Lives”. Yeah – running from ZOMBIES! Presumable trying to eat my brains… *lol* Doesn’t get much better than that. Who thought I’d truly ever be excited to run – for any reason other than towards a cupcake truck?!?) Times, they are a changing. And so is my body. Y’all betta watch out… Size 12 is coming. -
Annoyed - In Halifax w/ No Fill Doctor
Doddie63 replied to lizzie_07's topic in LAP-BAND Surgery Forums
Know what you mean Argon. Until the BC WLS group and the TLBC helped me find Dr. W. Dr. W. is doing it as a favor to Dr. Yau. I was at a loss wondering how doctors can refuse aid because a fill is a medical proceedure NOT a visit to the doctor. I know that doctors can limit their patient list to as many as they like but that is for general care not for a procedure. So why are they getting away with it. Probably becuase no one has complained to their Medical Association. I don't know but so help me, even if I had to go back to Toronto for every fill and defill, I would gladly do it as I am feeling so well. Now off my third BP pill and 4th diabetic pill. -
Ideas: How to Save Money eating at Restaurants...
pumpkin07 posted a topic in Gastric Sleeve Surgery Forums
I have found that we eat out 2-3 times a week . We both work, so as much as we try not to eat out it just happens. Now with no fast food type food, wow, the food bills are high. So I decided to tackle how to eat out for less today. Today I ordered a bunch of gift certs online for gifts only at restaurants who give you back 20% in a bonus gift card. They seem to only offer this special at Christmas time, and last year I did the same thing but didn't get enough and ran out by March and really missed that 20% discount card. I did it in an organized fashion figuring how many times during the next 12 mos we could eat at that restaurant. I did it for Pappas (usually seafood), Outback Steakhouse, and Carrabbas Italian. I couldn't order some restaurants bc they didn't have a special, shame on them (no Red Lobster, TX Land & Cattle, etc). But then sort of by accident I found a website called restaurant.com that had discounted gift certs for so many restaurants. A lot of them were independent ones that we go to anyway, and others were new. But I bought like $300 of gift certs that will give me like $750 of free food at these restaurants. I don't know if this works in every area, but the norm was to pay $10 for a $25 gift cert and agree to spend $35 on food. Or like at a steak rest get a $50 gift cert for like $20 and agree to spend $100, which we could do at a nice steak restaurant if we had the whole family. I actually spent $120 at my favorite Chinese Restaurant and got $300 of food credit. It says you can't use more than once a month, so heh, I bought one for each month. Felt like a safe bet considering we've been eating there since my oldest son was born. I could use suggestions too on how to order at restaurants so that the family food bill is not as much, and wonder if anyone has suggestions. Between the cost of groceries and restaurants I feel like we spend too much of our take home pay on food, and I want to cut it down. I've never been a coupon shopper in grocery stores, but if anyone knows a good and easy way to do this I'd like that too. Please share your ideas. -
Tired Of Looking At Myself.
Raven21 replied to NDN_RN's topic in PRE-Operation Weight Loss Surgery Q&A
I get it. I'm still looking at 3 months of jumping through insurance hoops. Just keep thinking of the goal. Imagine yourself next summer! Every time I see someone I haven't seen in a while I wonder what I'll look like the next time they see me! 4 weeks is nothing compared to the amount of time you've probably spent being miserable bc of your weight. Concentrate on why you are doing this! Can't wait to hear your success stories in a month or two! Hang in there! -
I'm 50. Weigh 248 with a BMI of 37. I have high blood pressure, high cholesterol, sleep apnea and feel like I'm a heart attack waiting to happen. I can always lose my weight but it always comes back. I love to eat and I'm a volume eater. My diet is horrible. What I am hoping the lapband does for me is force me to get serious about getting healthy. I'm hoping it will be the tool that helps me stay on track with eating less, learning about heathy eating and making exercise easier. I know that if I don't change, my life will be shorter, marked by obesity related illness and just plain lethargic. I want to get active again. Right now the highlite of my weekend is a big lunch followed by a 3 hour nap. I know life has much more to offer and am excited with the prospect of getting active again.
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NEW INSURANCE...RENEWED HOPE!
MizzouFan1 replied to MizzouFan1's topic in Tell Your Weight Loss Surgery Story
Soooo, just as I was beginning to feel hopeful I found out they cover it....but you have to be with the plan for at least 3 consecutive years. WTF? What a load of BS. What does it matter? I am paying $350 a month regardless. I just can't believe it. I am so disappointed. :( -
5 days to go till I am banded. Woot! I am down 12 pounds since Nov 1st. I am currently on antibiotics for bronchitis. The cough is going away - slowly... I hope it is gone b4 I have stitches in my tummy. That could hurt!! My surgery is 2pm on the 30th. My parents are coming to watch my 7.5 month old so I get a 4 day break from him. I love him to bits, but who couldn't use a break after 7.5 months?? My husband and I have to fly to Vancouver, BC Canada for the surgery. I live in northern Alberta, Canada. We are staying at a hotel/casino - I figured that would be a good place for walking the gas out after surgery. I am doing really well on my pre-op diet. I am taking halls for my throat. and every other day I have a hard boild egg... I play a lot of sports and the extra protien cant hurt right?!?!! I am really excited about next Wednesday!!!!!
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Well, I just faxed over my packet. Let the games begin! My BMI is just a hair over 40, so they won't reject me for being too high - I'm sure they'll think of plenty other reasons to reject me though - I'm right handed, the planets aren't aligned, my birthday is during an odd-numbered month, etc. LOL I think sometimes the downfall of the internet is that there's TOO MUCH info available. I was on obesityhelp yesterday and there was post after post from people in CA who have BC and were approved within a week or two. Then you go someplace else, and just as many people have horror stories. I can't imagine what people did 20 years ago and there was no internet and you just have to take your doctor at his word!
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Blue Cross And Blue Shields Cosmetic Surgery Codes?
Sweetybabs posted a blog entry in Sweetybabs' Blog
Does anyone have the surgery codes for bc/bs? I have a friend who really needs them. Thanks! * I have UHC and have my codes... but I still need to lose about 75 more pounds before I consider those surgerys. -
Hiya all, I'm so happy to be on the other side, finally sleeved 4.29. Im curious if my experience so far is within normal. My surgeon used staples to ensure patients would come to week follow up. I'm pretty sore, but just on the incision to the right on my abd. I'm wearing a binder but when I stand up it feels like my guts will come out. I still need full help standing up. I cant fully stand upright bc of pain. Every sip of room temp water makes my stomach clench and spasm. I've had a low grade temp today 99.5 with a massive headache. Food smells are toooo much. Tried to sip Gatorade zero and it was to sweet. Sipped a little warm bone broth, that seems to be ok. I also had a moment where I had all these thoughts about being a failure, having to cut out parts of me to stop eating. Got really down on myself. Please someone tell me this is all normal. And thank you for listening. This place has been wonderful for support and info. Sent from my SM-N960U using BariatricPal mobile app
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Hi, I'm still in the planning stage but am thinking about it night and day. I'm trying to get in to see my regular doc to help me with paperwork. I'm 5'4, 230 pounds, type II Diabetic, recent BC survivor and know I have to have this done. I'm covered under my hubby's 1st choice but have no idea what they pay. Can you reccomend a doc. in Seatle, Edmonds, Bellevue area? I'm looking at differnet sites but I don't want to just pick one that way. Kat
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Quick mention, I was at WW onthe day after Christmas and down another 3 pounds. I hit my 10% and got my keychain too. Small milestones! Another 10 or so pounds and I will be lower than I have been in about 10 years!!!! Happy New Year to me! I cannot believe I am starting this year without the dread of another "diet" looming ahead. I don't have that major "last supper" mentality that I would normally have now in preparation for the diet that would inevitably start tomorrow (and fail by Tuesday). This is going to be an amazing year. This year I will become the healthiest I have been in a long time AND I will finish school. What could be better? I am very excited at my prospects this year. Sadly, I am couch bound this eventful night. I could not handle another get together and another food event that I would have to suffer through. I have had 5 of them in the past week and I havehad enough!!! I will say, I have done very well. Christmas Eve, I didn't eat a thing, Christmas day I had about a half cup of very runny mashed potatoes, Friday I had 2 crackers and my soup at my aunt's house saying I had a sore throat (again-I am sick of that lie!), then yesterday at Dad's. I had about 6 wheat thins over the course of the day with some cheese spread and totally skipped the dinner. It was tough especially since I have to be sneaky. I made up a plate and fed it to my husband like scraps to a dogand no one noticed. Hubby has no problem eating 2 meals anyway. haha. Today was a liquid day because I am feeling guilty for having the crackers. I have no problem at all eating them, since I chew them to nothing before swallowing, but I technically am not supposed to be eating them. I took my scar pic today. Since then I showered and my last bandage came off. I will take another pic later. I think the scars will heal well. The big incision looks a little pink and scary but otherwise I look like I have scratches. I am pleased. Off to ring in the new year with DH!
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Walk walk walk walk!!!! That's the best. I wore out a path in my house I think! Lol. I can't take gas x bc it has sucralose( Splenda) in it so I found other brands but not sure it really did much. Walking and small sips of water and a heating pad when I wasn't walking. I just started feeling better yesterday and today Is my 2 week bandaversary. two weeks seems to be the norm for feeling alive again.
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Surgeon Submission to Insurance Delays
shellyd88 replied to ryanadam's topic in PRE-Operation Weight Loss Surgery Q&A
I've seen many people saying this has happened to them as well I had some difficulty as well seems like they are very slow in getting things rolling and staying organized my issue was get this that or the other test or records from any Drs u see etc and it seemed they never " received" faxes so I got really sick of the BS so I went to each dr got my records and asked for copy's all reports tests CDs of any X-rays ultrasounds etc anything I had to get done I never gave them the only copy's of anything always had my own copy's I also made sure I brought with me to hospital the day of surgery a copy of everything in case they said oh we don't have this or that and it actually happened they said I didn't take the correct dosage of blood thinners etc I said ughh yes I did here's my receipt here's a photo of the bottle where's the lab I'll go tested right now well they decided it wasn't necessary I swear I think they slow things down on purpose they either overbook or can't for some reason get their shit together I work with attorneys so I have some experience with BS and their lack of focus and organization also time management makes one wonder how they ever got a law degree lol -
Hi everyone. I am in the West Kootenays of British Columbia. Surgery date June 12 and looking for anyone who might be getting a sleeve around the same time as me so we can support/mentor each other. Look forward to embracing this journey but I am
Empress 1974 posted a topic in Gastric Sleeve Surgery Forums
I'm from Castlegar BC Sent from my LG-H812 using BariatricPal mobile app -
I had my surgery done by Dr. Leung in Surrey, BC. Cost me $13,000.
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Ok, I've read a lot about it but with 5 days out, I've not experienced it, and hopefully never will but just in case, can someone give me their personal experience with it. Not the dictionary version but your own personal experience. I previously had the LapBand and I vomited all the time, a painful vomit where I had to go lay down afterwards. I just want to know if the two compares. I currently have the sleeve BC of too many complications with the Lapband. Also were there certain things that would trigger dumping syndrome and for us "newbies" must stay way from. Thanks for sharing!
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About a month and a half ago I was diagnosed with PCOS. Ever since my daughter was born two years ago I couldn't lose the weight. I would lose some, gain a lot, lose some, gain a lot. Before I knew it I was heavier than I was when I was 9 months pregnant. I feel like crap all the time. Body aches, chronic fatigue, constantly feeling sick to my stomach, hair growth on my face, hair loss on my head and oh god the acne. My periods were nothing short of a nightmare and when I went two months without getting it that's when I knew something wasn't right. I moved and changed insurance recently so when I made an appointment with an obgyn it took a month before they could fit in a new patient. She sent me for a sono and a blood test and it turned out PCOS was the cause of all this. Without really explaining much about the condition she sent me on my way with a script for provera(to induce a period) and necon(super strength BC). That's when I decided I really wanted to get the gastric sleeve done. Six hours into my day I eat for the first time when the nausea subsides, no matter what I eat or how little my body is storing fat like I'm about to hibernate for a decade and after five minutes on a treadmill I feel like I'm about to pass out. If I push through it and make it 30 minutes or more I feel like someone beat the crap out of me. I'm so easily winded. I wasn't like this before my daughter was born, I was at the gym 3 nights a week and walking 3 miles to work and back every day. It's frustrating and depressing. So I made an appointment with a PCP and explained the whole thing to him. He said he wanted me to come back in 3 weeks and 1 week before the appointment come in for a blood test. I asked if he would want my obgyn to fax the blood test I JUST had two weeks before and his response was "It's ok". Whatever. I was ecstatic. I got the process started. I did what I was told. I came back for my next appointment and the doctor told me he wants me to eat oatmeal every morning at 8am and a piece of fruit every hour until 12pm when I have a sandwich and again until dinner and also join weight watchers. I said "but.. Don't you think the sleeve will help me? With my PCOS symptoms I mean if I lose the weight my hormones will regulate and the PCOS can go away" He said "No that surgery stuff is no good. I wouldn't recommend that stuff to my patients. All it does is shrink your stomach and you can do that yourself by doing what I told you. These surgeries all they do is make you throw up and it's messy and you will have a miserable life". He went on to tell me some story about one of his patients who had 27 surgeries and I just stopped listening because honestly I could've just cried right there and then. Why couldn't he just have said that in the first placr instead of wasting 3 weeks of my time? He told me if I really wanted it I would have to call my insurance and find a new doctor. So I went home and called my insurance. I told the woman on the phone I was looking for a new PCP and please give me the number to every single one who takes Aetna in this town, the next one, give my the whole county and then some. She gave me three numbers then started saying "Hello? Ma'am? Are you there? I can't hear you" then eventually disconnected the call. The first number I called told me they weren't accepting new Aetna patients but they do recommend patients for the sleeve and if I change my insurance to Blue Cross they can help me. Second number said they weren't sure if the doctor recommends the sleeve because she's on vacation. They took my info and said the will call me in a week when the doctor returns. The third number was an answering service and they didn't even name the doctor that the insurance woman gave me. I felt so defeated, depressed and hopeless at that point I couldn't gather the strength to call the insurance company back and ask for more numbers. I'm not really sure where to go from here. I can keep calling doctors. If that fails I could try changing my insurance and hope that by the time I get blue cross that doctors office is still taking new patients. And also hope that I can find a good pediatrician for my daughter. I'm also not sure if I can get blue cross considering I get my insurance through medicaid. I feel so miserable now. My optimism deflated. I don't want to give up. Sent from my LGMS395 using the BariatricPal App
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Good Morning everyone...I need to ask some questions bc I am having trouble with the approval process....can everyone that has kaiser southern ca answer this please? 1. When did options class end and location? 2. Were u able to do your labs before the option class ended? 3. Were you able to chose the location you wanted you surgery done at? I am trying to see just how different the locations are from ours...mine was done at Corona and ended Sept 28th we had to wait til classes were over and to meet with a specialist then we were sent to do our labs...I am not able to pick were I go...kaiser said I would either go to Pacific bariatric or Crown. Thanks everyone!!
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Thank you for that info!! My surgeon is Dr.Coates in Modesto!! I looked up Anthem Blue Cross's Medical Policy online and it says they cover the sleeve if you are an eligible candidate. Here's the link: http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053317.htm It is listed in the first paragragh along with all the other types of WLS. It is listed as "Sleeve Gastrectomy" This may or may not be the info you need but DONT GIVE UP!! I would call your insurance directly and ask how you can view their medical policy online. They should be able to provide you with a link to your actual plan with them. And it is always better to see it in writing yourself rather than to be possibly told numerous things by different agents... Thank you so much for the advice about maybe having to be with them for a certain amount of time before the surgery is covered. That's a great question to ask my insurance lady when I go in tomorrow to possibly switch my plan!!! As far as Dr.Coates office having a contract with Anthem Blue Cross,I talked to about 4 ppl from their office yesterday that confirmed that Anthem Blue Cross does cover the sleeve with them,bc I kept calling back to make sure!! LOL. I would call Dr.Coates office and talk to them if you may still want to have the surgery done there. They are very helpful and have an awesome pre-authorization worker!! I'm sure if you give her your exact insurance info as far as what plan you are under with Anthem Blue Cross,she should be able to give you some valuable advice. Hope this helps-It would be awesome to go through this journey with someone local!!!