Insurance denial day before surgery :(

[Rncbarbie 33]

So I did all the testing, nutrition, counseling, two week pre-op liquid diet and the day before my surgery I got call from dr office that insurance company will not approve my surgery. Seems the insurance company wants me on three meds for my hypertension even though I'm on two and its uncontrolled. Oh and pre-diabetes doesn't count anymore. I'm so upset. So here is my question, in starting this journey I was 240 lbs, this morning I weigh 205. Do I just keep going? My dr office put in appeal but I'm just tired of being sick and tired. I feel lost... I learned all about the sleeve and changes to make and I was so ready. Any advice?

[bikrchk 1,313]

Appeal. I don't get clinics that will actually schedule a procedure without insurance approval if the patient is not self-pay. I had to have my 6 month diet, 2 support meetings, nut and psych DONE before they would even see me for consult so that the paperwork could be submitted that day. EGD and pre-op testing came after approval, then when they knew I was a good candidate, THEN they scheduled surgery. It's so not right to dangle this is front of a hopeful patient and the yank it away at the last minute!

[LauraVSGinNZ 10]

See it as a positive...

Wait for what happens after the appeal and regardless, know that you are still losing. Whatever you lose before the sleeve is weight that you don't have to loose after the sleeve. Try to see the light x

[ab123. 90]

@Rncbarbie@Rncbarbie

So I did all the testing, nutrition, counseling, two week pre-op liquid diet and the day before my surgery I got call from dr office that insurance company will not approve my surgery. Seems the insurance company wants me on three meds for my hypertension even though I'm on two and its uncontrolled. Oh and pre-diabetes doesn't count anymore. I'm so upset. So here is my question, in starting this journey I was 240 lbs, this morning I weigh 205. Do I just keep going? My dr office put in appeal but I'm just tired of being sick and tired. I feel lost... I learned all about the sleeve and changes to make and I was so ready. Any advice?

I'm so glad you are on here this morning!On January 25th I was 247, I'm 5'4". I've died down to 215. I'm on Day 5 preop. My whole family has permanently adopted healthy eating and exercise and are of nornmal weight and and supportive. I'm thinking of backing out. Do we need this surgery? Twelve more pounds and I dont even qualify anymore.

[beachgurl84 456]

WOW I can't imagine that heart break. I would appeal. You never know. In the meantime definitely keep up the great work! 35 pounds is AWESOME!!!! I agree that I can't believe they would schedule you without approval! I had to have all my testing done before the office would submit my request. Good luck to you, you're already a success!!

[alwaysvegas 702]

I'm so glad you are on here this morning!On January 25th I was 247, I'm 5'4". I've died down to 215. I'm on Day 5 preop. My whole family has permanently adopted healthy eating and exercise and are of nornmal weight and and supportive. I'm thinking of backing out. Do we need this surgery? Twelve more pounds and I dont even qualify anymore.

That's going to be your own personal choice whether this surgery is right for you. I lost about 50 lbs before surgery (stats below), but I'd lost that before. The sleeve is a tool for both weight loss and long-term healthy weight maintenance. Don't forget that they remove the part of the stomach that generates the hunger hormone, which I've found to be hugely beneficial. I see the sleeve as a long-term solution, but still requires my effort to make it happen.

I can tell you that eating 4-5 oz meals as just as satisfying as eating 4 cups of food in one sitting and I'll never regret having the surgery.

Whatever you decide, best of luck to you!

Edited March 20, 2015 by AlwaysVegas

[Elode 8,093]

@@Rncbarbie APPEAL! But keep working as you are just incase it doesn't go through. It looks like your doing great on your own!

[#9grammy 274]

My surgery was scheduled and done before my paper work was sent to insurance! Yes the doctors insurance lady said you submit after surgery. Well now they are eating the bill, I have Medicare and Tricare. Tricare doesn't pay for wls and Medicare you have to be pre approved. I had the 6 month nut appointments, did all the pre-ops they requested and had the surgery back in Oct 14. Since it wasn't pre approved Medicare won't pay and says I'm not responsible for their bills either. Haven't heard a thing from hospital either!

[Rncbarbie 33]

It was appealed, and now it's approved. New date is March 25, so I am to start back on liquids tomorrow. I'm so happy but I need to wrap my head around that this will happen. Thanks for all the support.

[LauraVSGinNZ 10]

Bingo!!! Good luck ????????????????