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asherby85's Blog
My Ramblings


Denied... Denied... Denied...
on July 2, 2008 7:18 am
This was expected, but it still sucks. Doctor's office called me yesterday. Gave me some info for appealing, but I'm so unsure where to start and I really wish I had someone that cared enough to help me. 

I've posted what happened on the LW, Insurance, and TX forums, but I'm not expecting a miracle. 

My mom called yesterday and told me she really wished I would do this on my own. I got upset, because I have tried this on my own. Several times. I need something to hold me accountable, and I know it may sound weird but the lapband seems like a helping hand.

To make things worse I found out that my insurance that my mom holds on me runs out at the end of November. The month I turn 23. So this may never happen.

I just wish I had someone to help me.........
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7/30/08 Surgical date..Wait! What?!?!
on July 1, 2008 8:56 am
So, I called the insurance company yesterday just to make that they recieved all of the information and the rep that I spoke with said. "Yes, it looks like they have everything. It doesn't look like it has been approved or denied but I'm showing a surgical date of July 30." 

My stomach did a a flip and I suddenly got really nervous. I thanked her for the information and hung up. I felt a little sick. You know, that sick feeling you get when you get really nervous? 

I don't know. Hearing her say July 30 was the surgical date they had put down made it seem a little bit more real. I mean I know I'm not approved yet, but still. 

I went and spoke with my boss. I've been keeping on her updated on what's going on. She said "That's fine, your schedule is flexible, just let me know how things go" So at least I don't have to freak out about getting time off from work.

Just re-living all that by typing it has gotten me all nervous again...ugh.
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Insurance and Waiting...
on June 27, 2008 7:27 pm
I called Dr. Stewart's office on the 24th to find out if they had submitted my information to the insurance company. Leah said that they submitted all info on June 19th.

Now I've just got to wait for my approval/denial. I'm really wanting an approval, but I fear I will get a denial. But the Dr. expects that so I'm just going with the flow. We will see what happens.

Leah gave me a reference number but I'm afraid to call the insurance company and besides I would have no idea what questions to ask.
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Nervous...
on June 17, 2008 7:02 am
Well, I had another appointment with Dr. Stewart on June 10. I got an EKG, which was unexpected and a little embarrassing. The docotor said that he was going to go ahead and get one done for the insurance even though sometimes they don't need it, and I was like "OK!"

A little later a nurse knocks slightly on the door and pushes it just barely open.
Me: Hi!
Nurse: Oh, I didn't know if you had started to get undressed yet.
Me: Undressed?
Nurse: Yes, you will have to take your top off for the EKG.
Me: (as I started to take off my top) ooooook, um, do I have to take off my bra?
Nurse: Yes, the wire in your bra will mess with the EKG.
Me: Oh, Ok, well this was unexpected.
Nurse: (puts a big cloth on bed) Just cover yourself with this and lay down.
Me: Ok

The nurse was very sweet throughout the entire process. I was just really glad that it was a woman doing the procedure. I don't like showing my boobs to just anyone. On a side note I'm glad I shaved my pits that morning..lol

So after the EKG Leah, the insurance coordinator, came in and said that she had everything but my psychological evaluation. I was a little confused. I told her that I had my evaluation on May 19. She should have had it by now. Leah told me to call Dr. Conte to find out what was going on.

I called Dr. Conte the next day and she said that she had already given my evaluation to Dr. Stewart's office. So I called back Leah and left her a message. She called me the next day and told me that they had everything they needed and she would be writing the insurance a letter and send out all my info! 

So, I'm excited, but I'm trying to get too excited because there is a very good possibility of a denial. But this is expected. My BMI hasn't been over 40 for 5 years, so the office expects a denial the first time around and then we will fight the denial. 

My mom told me yesterday that she thinks my insurance coverage ends when I turn 23, which is in 5 months. I need to call the insurance company and verify because I thought it was 24. That makes me nervous. So, we will see what happens.......


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Pysch Evalution
on May 22, 2008 9:21 am

Monday I had my Pysch Evaluation on Monday. 3 hours long and very tiring. I first had two tests to fill out. 165 questions on 1 of them and 567 on the other. My fingers hurt so bad once I was finished from bubbling in the answers. That part took 2 hours. Then I spoke with her for 1 hour, she asked me about my habits, past, and family. I was glad to go home when it was done. Hopefully she will forward the info to Dr. Stewart soon so they can submit it to insurance.

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My Story

**June 27, 2007** My dad calls and offers to pay for me to have WLS

**June 28, 2007** I made my first appointment with Dr. Wade Barker

**July 2, 2007** Visited my PCP for info, and got my blood drawn - weight 233

**July 9,2007** Called to see if there were any cancellations and there were! Appointment tomorrow!

**July 10, 2007** Appointment today, doctor says my BMI is not high enough, sleep study appointment made

**July 16, 2007** Sleep Study appointment, more info to come

**July 26, 2007** Sleep Study people called, no sleep apnea ... stalled

**April 3, 2008** Visit with new PCP, very supportive, blood drawn - weight 251

**April 15, 2008** Dr Stewart's free seminar for lap band

**April 22, 2008** Consult with Dr. Stewart, must gather 3 years of medical records and pysch evaluation

**May 19, 2008** Appointment with Dr. Conte, Pyschological Evaluation 
 
**June 10, 2008** Follow-up appointment with Dr. Stewart, say they are missing pysch evaluation

**June 12, 2008** Leah calls from Dr. Stewart's office says that she has everything and she will write a letter and submit to insurance!

**June 19, 2008** All information sent to insurance company. Waiting for approval/denial.

**July 1, 2008** Denied for lapband procedure

**July 10, 2008** Doctor's office gives me application packet for obesitylaw.com

 


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