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Denied :(

Kelly1121

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Nymea    87

Nymea
Posted (edited)

Hope things go well for you from now on :)

Edited by Nymea

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SkinnyGalinFatPersonsBody    39

SkinnyGalinFatPersonsBody
Posted (edited)

These insurance companies deny everything all the time. Its the appeals and the squeaky wheels that gets this stuff approved. Good for you!!! My MD cant find ANYTHING wrong with me except BMI. Finally did sleep study and that did the trick. Still have to give to insurance company. Im ready to FIGHT if i have to. Its my life im fighting for. These insurances have a prior auth dept who has nurses making the decisions

If they are having a bad they deny everything. If it gets appealed it goes to medical doctor who then makes the final decision. Im a nurse and i can say we dont know everything. And i work for an insurance company and can say there are things i denied that i shouldnt have because i didnt understand the condition. Keep fighting!!!

Edited by SkinnyGalinFatPersonsBody

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Marissa.Ann.C    21

Marissa.Ann.C
Posted

i have been there. 2 years ago when i tried the first time my bmi was 37ish and i was borderline for high cholesterol, diabetes, and everything else was negative. i also have severe GERD and PCOS but apparently that doesn't matter. i have a VERY high family history for heart disease (heart attacks and heart failure), high cholesterol, and diabetes. still denied. i appealed, still denied. surgeon appealed, still denied. i gave up. now 2 years later and 20-30 lbs heavier my insurance requires a 6 month supervised diet and my bmi is almost 44. as horrible as this sounds, it seems to me like your only options are to switch insurance companies or to gain weight.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • BabySpoons

      BabySpoons

      Sometimes reading the posts here make me wonder if some people just weren't mentally ready for WLS and needed more time with the bariatric team psychiatrist. Complaining about the limited drink/food choices early on... blah..blah...blah. The living to eat mentality really needs to go and be replaced with eating to live. JS
      · 0 replies
      1. This update has no replies.
    • Theweightisover2024🙌💪

      Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
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    • Teriesa

      Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
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