Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Not very patient.. SMH!



Recommended Posts

So sorry @Cocoon2butterfly. They cannot stop your inner butterfly from emerging my dear. What insurance do you have? Before you go in on 3rd appeal be prepared. Browse this site, there are so many awesome stories and tips, even appeal letters that others used to finally get approved, that have been posted here on BP to help all those in the process. I have learnt a lot through them. You will be in my thots n prayers.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

This is my fear. My BMI is the only thing that qualifies me for the surgery. I have no co-morbidities. My surgeon and his team are far more optimistic than I am. They said the insurance companies have requirements and you meet them or you don't. They can't and shouldn't deny based on anything other than their requirements. But that doesn't make sense because we see it all the time!

Not Medically Appropriate.

Cocoon to Butterfly

My Doctor submitted to insurance last Tuesday and I was approved today The only thing that qualified me also was my BMI. Stay positive and best wishes to you and your journey!

Sent from my SAMSUNG-SM-G935A using the BariatricPal App

Share this post


Link to post
Share on other sites

@"YaneR321"Thank you. Congrats on your approval.

Cocoon to Butterfly

Share this post


Link to post
Share on other sites

I called my surgeon's office today to see if they have heard anything since today is two weeks since my last appointment and they said it typically takes 10 days...

It hasn't even gone to insurance yet! I was told it will go over today and they will call soon to set up a tentative date for surgery, but what a bubble buster. I thought I was at the end of waiting for an answer and instead it is just beginning.

Share this post


Link to post
Share on other sites

I called my surgeon's office today to see if they have heard anything since today is two weeks since my last appointment and they said it typically takes 10 days...

It hasn't even gone to insurance yet! I was told it will go over today and they will call soon to set up a tentative date for surgery, but what a bubble buster. I thought I was at the end of waiting for an answer and instead it is just beginning.

Wow... Thats rough... Keeping fingers crossed for you.

Sent from Dee~Dee via BariatricPal

Share this post


Link to post
Share on other sites

I called Aetna on Thursday & found out was approved. Waiting for surgeons office to get electronic letter and then hopefully a date!

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

I called Aetna on Thursday & found out was approved. Waiting for surgeons office to get electronic letter and then hopefully a date!

Sent from my iPad using the BariatricPal App

Congratulations.

Cocoon to Butterfly

Share this post


Link to post
Share on other sites

I just got the call from my surgeon's office - Aetna approved today by phone. It went over Friday. Possible surgery date 11/29!

Share this post


Link to post
Share on other sites

I just got the call from my surgeon's office - Aetna approved today by phone. It went over Friday. Possible surgery date 11/29!

Congratulations

Sent from Dee~Dee via BariatricPal

Share this post


Link to post
Share on other sites

I just got the call from my surgeon's office - Aetna approved today by phone. It went over Friday. Possible surgery date 11/29!

Congratulations

Cocoon to Butterfly

Share this post


Link to post
Share on other sites

This is my fear. My BMI is the only thing that qualifies me for the surgery. I have no co-morbidities. My surgeon and his team are far more optimistic than I am. They said the insurance companies have requirements and you meet them or you don't. They can't and shouldn't deny based on anything other than their requirements. But that doesn't make sense because we see it all the time!

Not Medically Appropriate.

Cocoon to Butterfly

I meet all my requirements. The doctors office thinks a code they put on they don't like. I am now in pending not denied. I heart sunk when I received that letter. I still have a chance.

Cocoon to Butterfly

That may have been what happened with mine. It took over 2 weeks and when I called they said they had resubmitted because of a code. A couple of days later I had a surgery date and am currently 1 week post op.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

This is my fear. My BMI is the only thing that qualifies me for the surgery. I have no co-morbidities. My surgeon and his team are far more optimistic than I am. They said the insurance companies have requirements and you meet them or you don't. They can't and shouldn't deny based on anything other than their requirements. But that doesn't make sense because we see it all the time!

Not Medically Appropriate.

Cocoon to Butterfly

I meet all my requirements. The doctors office thinks a code they put on they don't like. I am now in pending not denied. I heart sunk when I received that letter. I still have a chance.

Cocoon to Butterfly

That may have been what happened with mine. It took over 2 weeks and when I called they said they had resubmitted because of a code. A couple of days later I had a surgery date and am currently 1 week post op.

Sent from my iPhone using the BariatricPal App

I received my second denial

Cocoon to Butterfly

Share this post


Link to post
Share on other sites

Sorry @Cocoon, are there any other options. Maybe a peer to peer? I have Aetna too and I don't understand how that insurance works. There doesn't seem to be much rhyme or reason to their approvals or denials. Maybe have your surgeons office go over all your documentation again and make sure they have everything entered and submitted correctly. I had a lady who got denied 3x and they couldn't figure out why, come to find out they had entered her starting weight wrong and it looked like she gained over 20lbs during the process instead of losing 20lbs. Her surgeons office corrected the error and she was approved. I am keeping my fingers crossed for you.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×