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Recent Status Updates
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Good morning all, how long did it take insurance to approve you?· 3 replies
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Once it was submitted, not long at all. Just a few days, I think. But my surgeon's office didn't submit it until all my requirements were met, which included psych eval, dietician meetings, a certain number of visits, bloodwork, etc. As long as you've checked all the right "boxes" they require, the approval process should be very standard and easy. Your surgeon's office should know exactly what you need to get approved.
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good morning , I just need one more clearance from the insurance requirements which is my basic nutrition class , and that's on the 26th of this month. I have BCBSMI insurance. my surgeon said it usually takes 4-6 weeks for them to approve but can be sooner
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Once I completed all the insurance/program requirements - about a week. It seemed fairly quick, but I also contacted my insurance company several times to confirm all the requirements I needed to satisfy there paperwork machine and also nudge (nag squeaky wheel) them 😋 ! Also, my bariatric clinic is/was on top of it.
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I has my Ru &Y July 7, 2013. I was 389 lbs on surgery day. I am now 198. I feel so much better ! I can keep up with my grand kids ages 3,3,4,8 and 13· 0 replies
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Long whine alert - I'm really disappointed! I saw my primary Dr last month and told her I wanted WLS and she was all for it. Said that I had to do the 6 month supervised diet for my insurance and a boatload of other tests. Ok. I understand. She started my 6 month diet last month and sent a referral to the bariatric surgeon. MY plan was to do the supervised diet, then at the end of the 6 months in January, do all the other tests...sleep study, endoscopy, ekg, psych, nutritionist, etc. because all of that would get my insurance deductible met, then have surgery in February or March. Since my deductible would be met, I'd only be paying my 20% coinsurance by then. Got the call from the bariatric surgeon's office on Friday and was told that THEY are the ones that will do my 6 month supervised diet. I explained that my primary Dr already had me on it for a month but they said everything will go thru them. Ok. I understand. So I explain about wanting to complete the diet first, then do all the other testing (because I don't want to have to pay my deductible twice by paying for all that stuff now, & then it starts over in January) but she tells me that they do the testing while I'm doing the diet. That means that I cannot even start their bariatric program until January! They made my first appt for Jan 9th & that's when the 6 month diet will start with them & they'll submit to insurance for approval in June & I would have surgery in July. Man!!! That's almost a year from now! All because I don't want to pay $4500 now, than have to pay it again in January. I don't understand why they won't let me diet now & do the other tests at the end.· 1 reply-
Before you assume that the testing will take your full deductible, I would make some calls to your insurance. I have a 3k deductible and my portion of the bloodwork was nowhere close to that even though I assumed it would be. I think my copays ended up being around $1k or less for all the preliminary tests. And remember, you will have extensive bloodwork multiple times after surgery, so there may be no way to get it all into one calendar year. Also, you might look into financing options through your hospital. Mine allowed me to put the $3k I owed after the surgery (because yeah, that did max out my deductible for this year) on a 24-month no-interest payment plan. Depending on your options, it may be affordable enough that you can book your appointment sooner and get this whole thing going instead of having to wait almost a full year to have your surgery.
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Saw my PCP & officially started my 6 month supervised diet 07/26/24. She just told me to eat less carbs & sugar, use the air fryer and not fry my foods in grease, and to try to walk 30 minutes 3 days a week & if I can't do that (and I cannot), to walk 10 minutes daily. Told me to walk fast enough that my heart rate is raised. She didn't give me a number as far as calories though. A year or so ago I was doing low carb/sugar free and keeping my calories at 1800 or below. She said I should up my cals to 2000 at that time, so that's what I'm shooting for now.· 0 replies
Hubby walked with me today. He's in pretty bad shape so I was surprised he wanted to. We walked down the gravel road at a pretty good pace (for us LOL). 10 minutes walking and my heart rate was 115bps according to my Fitbit and 125bps according to his pulsometer. Either way, it was elevated and I was breathing hard. Doesn't sound like a lot, but it's a start. We'll do it again tomorrow. 😁
I should be hearing from the surgeon soon. She said if I didn't, to call him next week. Since I HAVE to do the 6 month diet & that's going to put me into January by the time it's done, I'm hoping the surgeon will let me do all my testing in January. I don't want to do it all now and have my deductible get met, only to have to pay the deductible again in January or February for my surgery. Praying that things go the way I hope. 🙏
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