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approved after 2 denials!

KSTUZ

By KSTUZ, in Insurance & Financing

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Bobbe Schu    53

Bobbe Schu
Posted

I wish you a very speedy recovery and good GOOD health!!!!

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peteyrulz    82

peteyrulz
Posted

Thanks so much! I am sure the Ls will be successful for you. Kerp in touch!

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aslcertified    86

aslcertified
Posted

oh wow I found the perfect forum, I am working with lindstrom as well. I hired them jan 2016 to help with my case to overturn my denial, but just last week they denied my appeal but lindstrom is not giving up without a fight they are an awesome team. The reason they are saying my surgery was denied bec of net weight gain 1.5 lbs and my surgery was not scheduled within 6 months of initial date. we questioned them over and over again , " when was I suppose to have scheduled the surgery if you already denied right after the 3 month pre-op requirement" ?. all Aetna could do is read my policy to us 20 times UGHHH! . I was so hurt and disgusted by this I could not believe it and I was going over it in my head about everything asking myself, where could things have went wrong? no way 1.5 lbs gained would be such a big deal bec you cant calculate 1.5 lbs as a major weight gain. So many factors can cause a 1.5 gain. clothes , time of month anything etc....... at this point , I was confused and I started to do a little digging on my own today 7/27/16. so, I called my dr office and asked what were my weigh in's which I should have been monitoring and keeping track of everything from insurance coverage to all my weigh in info.
/initial start date 6/2015 240 , 7/2015 245 , 8/2015 242, finial weigh in 9/2015 239.5 .. MY MOUTH DROPPED! ok so where is this 1.5lb weight gain they are talking about, what was the real reason for denial???? so I am thinking the ball dropped with someone or am I missing something here ? has anyone experienced this before?

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Amurillo04    109

Amurillo04
Posted (edited)

C

Edited by Amurillo04

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KSTUZ    438

KSTUZ
Posted

Received call from Aetna and I am now approved for surgery !!!!! ????????????????

Sent from my iPhone using the BariatricPal App

Congrats!! That's the best news! They are amazing and wish you the best of luck!

post-220851-14717250970098_thumb.jpg post-220851-14717250970098_thumb.jpg

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aslcertified    86

aslcertified
Posted

Omg! You look awesome!!! Thank you for the encouragement. Were you nervous before the surgery , How was the first few weeks? @@KSTUZ

Sent from my iPhone using the BariatricPal App

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aslcertified    86

aslcertified
Posted

I am now thinking of a surgery date and the holidays are approaching so maybe End of December or just make the sacrifice and do it end of September , first week of October so it will not be so hard for me during the holidays with family. I just don't know !!!

@@KSTUZ

Sent from my iPhone using the BariatricPal App

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KSTUZ    438

KSTUZ
Posted

Omg! You look awesome!!! Thank you for the encouragement. Were you nervous before the surgery , How was the first few weeks? @@KSTUZ

Sent from my iPhone using the BariatricPal App

Terrified, but it has been the best thing I've ever done.

Just remember this, first few months while your on liquid , purée and soft foods...u will be able to eat ANYTHING you want in a few months. Do not eat what your not supposed too and risk hurting yourself. I kept telling myself this is only temporary. And it was. I'm over a year and a half out.

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KSTUZ    438

KSTUZ
Posted

I am now thinking of a surgery date and the holidays are approaching so maybe End of December or just make the sacrifice and do it end of September , first week of October so it will not be so hard for me during the holidays with family. I just don't know !!!

@@KSTUZ

Sent from my iPhone using the BariatricPal App

I was terrified. But excited!!

I had mine done Jan 5th.

It was the soonest I could get it done.

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aslcertified    86

aslcertified
Posted

Jan is a great month to start and I have 6 months to have this done from yesterday date. Per my advocate , do not have it done at the turn of the year to risk the chance of my ins policy changing and it be excluded Bec I was thinking Jan as the perfect time.

Oh well I guess I have to do what I have to do.

Sent from my iPhone using the BariatricPal App

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aslcertified    86

aslcertified
Posted

Yes I am terrified of the what if's but I must stay positive. I was not so concerned when it was getting denied and trying to fight it Bec it was like i was pushing it off to give me more time to really think about it and now it is actually about to happen , I'm like omg !! This is really going to happen.

Sent from my iPhone using the BariatricPal App

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Go To Topic Listing Insurance & Financing

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