Waiting for Approval

[Sunrise 0]

hello everyone! I'm so glad to see this post and now I know somewhat to expect now. ajin: hang in there I know that these situations are not always in our favor.

I'm very moody too. my dietian released me on Tuesday, but I called Tuesday morning prior to the appt to see if she had everything she needed. oh was I heated....seems like she didn't really know what she was doing and she even said, "ok hold on...don't want to seem like I don't know what I'm doing. OHHHHHHHH, So, Wed I called and asked if she had received my Psych eval and she said..well she asked if I had paid it in full.....I said yes and I have the documentation. So I called Thurs to confirm again and finally she did. I called on Friday to see if she had even submitted it. I knew in my heart she had not. So, she says so I'm sending yours tonight before I leave......WHAT. She hadn't even started on my letter. I have Anthem BC/BS of Ohio. I have access to the site so I will watch everyday, all day for my approval. I have never been this MEAN...... The wait is on!!!!!!!

[4jin 0]

:smile:Welcome Sunrise,

thanks for the support.

as you can see these thread has been excellent support for me. The friends and support I have made here are unbelievable. AmyMT, StLouisGal, sghatl, motorcrossgirly, WaSabubblebutt, Chrisann, tweety63, Cynthia, among many other special friends have been my pillar throughout this process. I have learned so much from these folks. We are here for support.

As you can see when people reply and suggest our share the same experience at the same time is what makes it priceless.

What I am saying is don't be shy. Don't worry about being mean or evil. Be it, want it, say it and most definitely do it! go for yours!! no one else is going to do it for you! As you may have read my battle has been a fencing war with my insurance...but hopefully I will be at the other side and this will just be an experience to share with others and smile about down the road. Persistence...persistence...

hello everyone! I'm so glad to see this post and now I know somewhat to expect now. ajin: hang in there I know that these situations are not always in our favor.

I'm very moody too. my dietian released me on Tuesday, but I called Tuesday morning prior to the appt to see if she had everything she needed. oh was I heated....seems like she didn't really know what she was doing and she even said, "ok hold on...don't want to seem like I don't know what I'm doing. OHHHHHHHH, So, Wed I called and asked if she had received my Psych eval and she said..well she asked if I had paid it in full.....I said yes and I have the documentation. So I called Thurs to confirm again and finally she did. I called on Friday to see if she had even submitted it. I knew in my heart she had not. So, she says so I'm sending yours tonight before I leave......WHAT. She hadn't even started on my letter. I have Anthem BC/BS of Ohio. I have access to the site so I will watch everyday, all day for my approval. I have never been this MEAN...... The wait is on!!!!!!!

[StLouisGal 1]

hello everyone! I'm so glad to see this post and now I know somewhat to expect now. ajin: hang in there I know that these situations are not always in our favor.

I'm very moody too. my dietian released me on Tuesday, but I called Tuesday morning prior to the appt to see if she had everything she needed. oh was I heated....seems like she didn't really know what she was doing and she even said, "ok hold on...don't want to seem like I don't know what I'm doing. OHHHHHHHH, So, Wed I called and asked if she had received my Psych eval and she said..well she asked if I had paid it in full.....I said yes and I have the documentation. So I called Thurs to confirm again and finally she did. I called on Friday to see if she had even submitted it. I knew in my heart she had not. So, she says so I'm sending yours tonight before I leave......WHAT. She hadn't even started on my letter. I have Anthem BC/BS of Ohio. I have access to the site so I will watch everyday, all day for my approval. I have never been this MEAN...... The wait is on!!!!!!![/quote

Welcome!

I agree with this 4jin, this site has been invaluable to me the last few weeks. Waiting is the hardest. Unfortunately you have to keep on them at every step of the way. Even when you get the approval it is sometimes waiting again. I am trying to console myself that the wait is good because it means that my doctor is in high demand and that is a good thing. Don't rely on the web site. My approval still isn't on the web site but I have the letter in my hot little hand.:smile: Call them and ask a lot of questions. I am dealing with Anthem Blue Preferred in MO. They will try to stonewall you at every turn, just hang in there and keep calling.

4jin, I'm keeping my fingers crossed that you will get good news today!

[4jin 0]

Thanks StLouisGal,

I called the insurance this morning. She received the fax from the psychologist. Info was forwarded to the nurse reviewer again and it is back in her hands again. She assured me there isn't anything else that has been asked for or that is needed. It is all a waiting game. I can't speak to her...it su$k$!!!!!!

All I can do is wait for the surgeon's office to call me with info once the isurance company calls them.

ain't that some major BS if you ever heard any for stalling?!

But I am still hoping that it is within approval guidelines within the next couple of days...darn BC/BS of Georgia!....

[AmyMT 0]

Hi 4jin,

I have been thinking about you all weekend. I am keeping up the prayers that you hear good news very soon!

I am struggling through the liquid diet now. But the good news is after 4 days on it, I had lost 6 pounds!! I am on day 7 now so I hope it is still working that well.

Keeping up good thoughts for everyone else waiting for approval. :smile:

~Amy

[StLouisGal 1]

4Jin, At least they have everything they need now. Like you said in an earlier post, if they were going to deny it they probably would have done that a long time ago. It is a stalling tactic to see if you will give up and go away. BC/BS is good at BS. :frown:

Amy, congrats on six pounds.:smile: Every pound you lose now, you won't have to lose after the band and you will be that much closer to your goal. You are doing great! Hang in there with the liquid diet. I've forgotten, do you have a specific brand of liquid you have to use or are you on your own to pick something that is tolerable to you? :Banane42:

[AmyMT 0]

StLouisGal,

My doctor's office suggested Low Carb Slim Fast, but I can hardly gag that down. They did say that substituting another brand with similar calorie count and Protein grams would be acceptable, so I am using Atkins Advantage shakes. I am even beginning to like those. They have a few less calories and 5 grams less protein, but I try to make up for that by using some Unjury. I am glad that I have only one more week on this before getting banded. I really hope that I won't be hungry afterwards like I am now. :eek:

~Amy

[4jin 0]

Hi 4jin,

I have been thinking about you all weekend. I am keeping up the prayers that you hear good news very soon!

I am struggling through the liquid diet now. But the good news is after 4 days on it, I had lost 6 pounds!! I am on day 7 now so I hope it is still working that well.

Keeping up good thoughts for everyone else waiting for approval. :eek:

~Amy

that is so sweet of you. thanks...

Just think of my perseverance just to get an approval and that should help you a bit when you feel weak and need the motivation to keep on the liquid diet...LOL...

My surgeon & dietician suggested some but can substitute until I find the one I really like. I have tried GNC Isopure low carb...pretty decent if you add some vanilla extract...unjury is pretty good and the Adkins Advantage are as well. Slimfast make me too hungry after an hour of drinking them..I think it is the sugar content in them.

Excellent 6lbs down!!! You are off to a better than great start....!

I appreciate you all for sticking around with me for an answer from the insurance(praying it is an approval)...well when is it 30 days...I submitted on 12/17/07....calendar days almost at 30 business days because of holidays I think 15 or 16...darn...

[4jin 0]

ok....so I got to thinking.....

submitted on 12/17/07...

regular calendar days it has been 26 days since submitted(excluding xmas eve and xmas and newyears day).

Business days it has been 18 days (excluding weekends, xmas eve, xmas and newyears day).

Does anyone know which one should I be keeping track of...?!

[4jin 0]

4Jin, At least they have everything they need now. Like you said in an earlier post, if they were going to deny it they probably would have done that a long time ago. It is a stalling tactic to see if you will give up and go away. BC/BS is good at BS. :mad:

Amy, congrats on six pounds.:eek: Every pound you lose now, you won't have to lose after the band and you will be that much closer to your goal. You are doing great! Hang in there with the liquid diet. I've forgotten, do you have a specific brand of liquid you have to use or are you on your own to pick something that is tolerable to you?

thanks for the quick pump me up.....BC/BS for BS they do stand!!

[Chrisann 0]

Ask your benefits Administrator to contact their direct rep at BC/BS. I knew about my approval from my rep before the doctors office even told me.

Don't let the BA bullshit you either. They can call the Employer Helpline and get an answer alot faster than you calling customer service. They may want you to fill out a HIPPA form, which is used to give permission to discuss someone elses medical issues, but at this point, who cares if anyone finds out you are fat.

[Sunrise 0]

Thanks everyone for the encouragement!

I called today to see if they (Anthem) had received ALL information. The first lady came on rude,,like she didn't like her job. She told me to call another number so I did. That lady acted as if it was her last day and just didn't care...good news is that they did receive it and that it's pending view. Also, while waiting on hold, I heard the information on e-reveiw....what a joke...so i asked the lady about it and she said: I don't know anything about it but I will trans...and that's all I heard because she transfered me so fast it cut off the end of your conversation. I just want to go to the building and start firing rude, over-worked, burnt out employees.........................talk about moody...I had to sleep on the floor last night because my husband would have moved out this morning. i don't know if I should cry or laugh!

[4jin 0]

Thanks everyone for the encouragement!

I called today to see if they (Anthem) had received ALL information. The first lady came on rude,,like she didn't like her job. She told me to call another number so I did. That lady acted as if it was her last day and just didn't care...good news is that they did receive it and that it's pending view. Also, while waiting on hold, I heard the information on e-reveiw....what a joke...so i asked the lady about it and she said: I don't know anything about it but I will trans...and that's all I heard because she transfered me so fast it cut off the end of your conversation. I just want to go to the building and start firing rude, over-worked, burnt out employees.........................talk about moody...I had to sleep on the floor last night because my husband would have moved out this morning. i don't know if I should cry or laugh!

If that is not the stalling tactics I encountered I don't know what that is!!!LOL....I feel you Sunrise....that's exactly how I was treated....just be syrupy sweet....you get to them more when you are sweet and happy as sunshine...than when you get angry...

Follow up with them everyday if you have to....

My paperwork went to their coordinator-who makes sure all the required docs are their- well she had sent it to the nurse reviewer and the nurse reviewer sent it back because my psych eval did not have the doc's license number on it...then it became my job to do the coordinator's job and get the psych doc to fax her the info

Now it is back to the nurse reviewers hands...awaiting its turn in line...

so follow up..follow up....don't by shy to call everyday if your gut instinct tells you to!

Now what is up with sleeping on the floor....I don't get it...

he's moving out...or you were so restless you slept on the floor to keep from tossing and turning?..?:smile:

[4jin 0]

I know this has nothing to do with our topic but I came across this a few weeks back...I tried it as well as some friends and we saw results in a little as 1 to 2 days....here it is..

How to break a plateau:

• Do this for 10 days to break a plateau
  
• Drink 2 Quarts of Water a day
  
• You must have 45 grams of Protein supplements and take all of your vitamins/mineral supplements each day
  
• You may consume up to 3oz of the following high protein foods 5 times a day

Beef

Pork

Chicken

Turkey

Lamb

Fish

Eggs

Low-fat cheese

Cottage cheese

Plain yogurt/artificially sweetened

Peanut butter

Beans/legumes

You may also have:

sugar free popsicles

Tea or coffee

Sugar free jello

Broths/buillon

Crystal Light drinks

• If it is not on the list don’t eat it!
  
• Keep a food diary and try to get up to 30 minutes of exercise per day!

Between us I and some friends have seen the scale change within 2 days…some take a little longer but it works!!!

[Sunrise 0]

4JIN...lol...I slept on the floor for 3 reasons...I was too moody and I know if had touch me..he would have hit the floor. Second, I'm just too stressed and my bed doesn't not feel good right now. Third, he's up and down alllllllll night which breaks my sleep.< /p>

I think it all broils down to me being very, extremely moody.