Anyone from Rochester, NY?

[Nicole 2013 44]

I just love him he's so nice and he's very down to earth good luck with everything <3

Thank you same to u wish i was this week keep me posted

[pandabear 39]

Got my surgery date for may 7th. I am about 40% certain that I am going to be accepted by insurance. They said my insurance is really tricky to get this surgery put through and accepted. I have lost weight by being good so I am now at a 36 bmi and it almost feels like I am going to be punished because of it. I am just a big bundle of nerves right now.

[pandabear 39]

I'm from Rochester having my surgery at Rochester General by dr. Gandhi on march 6th

Hope all went well!

[petra1124 33]

Got my surgery date for may 7th. I am about 40% certain that I am going to be accepted by insurance. They said my insurance is really tricky to get this surgery put through and accepted. I have lost weight by being good so I am now at a 36 bmi and it almost feels like I am going to be punished because of it. I am just a big bundle of nerves right now.

What insurance do you have?

[pandabear 39]

What insurance do you have?

Blue cross blue shield of South Carolina. The biller at the drs office said the company I work for's plan is tricky to get approved. They already had someone denied two weeks ago. Just holding my breath now, still gonna go through the pre op stuff and go from there.

[Nicole 2013 44]

I'm from Rochester having my surgery at Rochester General by dr. Gandhi on march 6th

How was surgery?

[pandabear 39]

Been denied.... Now after going to the doctors since August, I have to start a 6 month supervised diet. Doctor supervised. I am... Beyond angry and gone into kinda numb about it. It isn't in my policy. But when you get pre authorized then it is. So I have to cancel all my appointments, And after moving heaven and earth to get help at work to cover for me now I have to go in and say "just kidding.. Boy did I get Punked into believing that they knew what they were doing". And I spent about two hours on the phone with insurance and there is pretty much nothing I can do. I am trying to be all "oh... Well I wasn't expecting to be actually approved." And "what is another 6 months?" But really I am just about crushed and I don't want people to say "oh! But you are doing so well right now, you can keep it p! You don't need the surgery". And I don't want to back slide and gain, but what if I lose too much weight? And what if I gain it back? GAH! Sorry for my little rant..

[petra1124 33]

Been denied.... Now after going to the doctors since August, I have to start a 6 month supervised diet. Doctor supervised. I am... Beyond angry and gone into kinda numb about it. It isn't in my policy. But when you get pre authorized then it is. So I have to cancel all my appointments, And after moving heaven and earth to get help at work to cover for me now I have to go in and say "just kidding.. Boy did I get Punked into believing that they knew what they were doing". And I spent about two hours on the phone with insurance and there is pretty much nothing I can do. I am trying to be all "oh... Well I wasn't expecting to be actually approved." And "what is another 6 months?" But really I am just about crushed and I don't want people to say "oh! But you are doing so well right now, you can keep it p! You don't need the surgery". And I don't want to back slide and gain, but what if I lose too much weight? And what if I gain it back? GAH! Sorry for my little rant..

I am so sorry that you have to go through the 6 month supervised diet, but what Highland told me is that any work that I have already done with the NUT would count towards the 6 months if they wanted me to do that. Did your doctor not put on their info sheet that you have tried other diets for 6 months?

[petra1124 33]

Got my surgery date for may 7th. I am about 40% certain that I am going to be accepted by insurance. They said my insurance is really tricky to get this surgery put through and accepted. I have lost weight by being good so I am now at a 36 bmi and it almost feels like I am going to be punished because of it. I am just a big bundle of nerves right now.

Do you have any comorbidities?

[moonlitestarbrite 902]

was it your insurance company or the docs that didnt approve you?

what hospital are you with? a friends housemate has been turned down a couple of times at RGH. she has switched to highland and is much happier. not approved yet, but at least she doesnt feel like she is being treated unfairly.

[Nicole 2013 44]

My primary dr is the one who wrote letter saying I had done 6 months of diets i was approved quickly with Dr.Gandhi through RGH I'm.now 1 week post op.

[pandabear 39]

I have been denied by the insurance. I need 6 months of documented weight loss with doctor and nutritional supervision. Weight watchers doesn't count, (been there done that) my own fitnesspal doesn't count and I missed a month I between two of my appointments so now the 9 months I was going are null and void because they have to be consecutive. I am trying to wrap my mind around the bullish:t. Now I am at a 36 bmi after I lost the weight needed to get approved for the surgery so I might now not even get approved because they don't know if my previous weights will count, I might have to start over at the weight I am now. I don't want to gain the weight back just for this. I know it will happen sooner or later but I just want to fool myself and think that this weight has come permanently off. It was only 20 pounds but still... I feel better, and I look better. I just want to eat a large pizza and drink a few bottles of wine in a dark room and hide under a blanket watching really horrible romantic comedies or dr who, perhaps with a gallon of ice cream. But, I made a hummus, arugula pita instead, still contemplating on the wine though and the dr who is a given.

[petra1124 33]

I have been denied by the insurance. I need 6 months of documented weight loss with doctor and nutritional supervision. Weight watchers doesn't count, (been there done that) my own fitnesspal doesn't count and I missed a month I between two of my appointments so now the 9 months I was going are null and void because they have to be consecutive. I am trying to wrap my mind around the bullish:t. Now I am at a 36 bmi after I lost the weight needed to get approved for the surgery so I might now not even get approved because they don't know if my previous weights will count, I might have to start over at the weight I am now. I don't want to gain the weight back just for this. I know it will happen sooner or later but I just want to fool myself and think that this weight has come permanently off. It was only 20 pounds but still... I feel better, and I look better. I just want to eat a large pizza and drink a few bottles of wine in a dark room and hide under a blanket watching really horrible romantic comedies or dr who, perhaps with a gallon of ice cream. But, I made a hummus, arugula pita instead, still contemplating on the wine though and the dr who is a given.

I have Excellus BCBS based out of Rochester, NY and I was told by Highland that my 6 months of weight watchers did count because my PCP knew I was doing it and she added it to the paperwork that she had to sign off on....is this not the case for you, or just that your insurance is not accepting it?

[pandabear 39]

I have Excellus BCBS based out of Rochester' date=' NY and I was told by Highland that my 6 months of weight watchers did count because my PCP knew I was doing it and she added it to the paperwork that she had to sign off on....is this not the case for you, or just that your insurance is not accepting it?[/quote']

My BCBS is out of South Carolina, and as much as my PCP did know and note that I have tried many weight loss regimes I did not weigh in with my PCP at the same time and get a "write up and evaluation" each time, each month for six months straight. I have my PCP note about my weight loss attempts, 8 years of my weight records and pretty much very doctors records that weighed me and I have been told this is a done deal and they won't accept anything but me going back to the drs and getting weighed and evaluated by the nutritionist for 6 more months. This is happening to a few people who work for my company that are going for the procedure. It took the doctors office by surprise I think, or are least I HOPE so and they didn't just get lazy and not check. I am trying to be as pleasant as possible to the ladies there but really just want to flip a table.

[pandabear 39]

My primary dr is the one who wrote letter saying I had done 6 months of diets i was approved quickly with Dr.Gandhi through RGH I'm.now 1 week post op.

Congrats on being post op.. How are you feeling?