elifritz
I received a call from Sue at the surgeons office and it seems the hospital will let me sign a letter stating that if insurance won't pay I will pay!!! I DON'T NEED A PRE-APPROVAL!!! Sue is taking care of everything and I will be schedualed for a new appointment with Dr. Gomez because it's been over a year since my first visit, and my pre-op testing. I'm HAPPY HAPPY HAPPY!! (Do I really have an angel?) My Dr's office just called me today to tell me that she FINALLY got a pre-authorization for my surgery!! I HAVE A DATE!! February 5th! No backing out now!! My Darling insurance company took (drumroll please) 92 weeks, count'em, NINETY TWO WEEKS to give me a Pre-Authorization for my surgery!!! HOLY MOLY, thats a L O N G T I M E!!! Actually, this is how long it took them to finally tell the hospital what was required for my surgery to be covered! Geez... and I thought my 15 year old was slow!! HALALUUUYAHHHHHH!!! I later went downstairs for my chest x-ray. The technician happened to be a man around my age, decent looking. I walked into the room and he asked what my surgery was for. I told him I was having weight loss surgery. He asked me how much I planned to lose and I replied that I'd like to lose 150 pounds. He said NO WAY!! There is no way you have 150 pounds to lose, so I told him how much I weighed. He went on and on about how there was no way I held that much weight. Kept telling me how beautiful I was and what a wonderful figure I had. Wanted me to turn around so he could see. Beautiful eyes, hair, figure, whatever else he could think of. Asked me if I was married. Heres the kicker.... then he said to strip from the waist up and put on the gown. I was feeling pretty uncomfortable by then! I said NO WAY!!! You can take these thru my shirt! Im NOT taking my clothes off!!! Needless to say, I had my x-rays done with my clothes on!!! *grin* He finished the session and had me wait while he checked the x-rays, then said he needed another. Took me back in the room and went about the flirting once again. geeezzzzz.... here is a 300 pound woman all but getting chased around the room by the x-ray tech!!!!! When I got home I told my hubby all about this. He asked me if I reported the guy to the hospital and all I could say was, "noooo, I kinda liked it" *smile* I'm going for my 4th and hopefully final dialation today! I wouldn't wish a stricture on any of you. They are a miserable thing that happens to only the best healers!!! The procedure is fast and easy but its also a pain in the buns!!! Each one in the beginning was 2 weeks apart but I have made it 4 weeks this time so It's improving. We'll see how it goes from here! After six dialations of my stoma I've finally gone eight weeks stricture free!!! AMEN! Insurance decided to cancel the checks they sent to the hospital and deny my claim. Wasn't that special of them! I appealed and it was also denied. I plan on hiring Walter Lindstrom to fight my claim. I love my life now and have more energy then I could imagine ever possible. I hang out in the chatroom here if you ever want to talk to me. My nick is "MissAmerica" (Isn't that fitting) hehehe.... Have a good one!
THINGS I WILL MISS ABOUT BEING FAT
1. The shelf on my belly I use to sit my icecream bowl!
2. aaaaa.... ummmm... thats all I can think of!!
Can I borrow a TV Table??
Hi! Thanks for visiting my profile. On February 5th 2002 I had Laparoscopic RNY with transection and 100 cm of intestines bypassed. I had a starting weight of 311 the day I came home from the hospital. I hang out in the obesityhelp chatroom under the name MissAmerica! Come chat with me anytime!!
8/21/01
My insurance company is Indiana State District Council of Laborers and Hod Carriers Welfare Fund. Upon submittal of letters for approval they stated that they will not provide any Pre-Authorization of any kind. It would be reviewed after the surgery. My hospital refuses to set any operating room date without this pre-authorization or a 25,000 dollar deposit. OH I happen to have that handy, let me pull that outta my *** (never mind)
8/22/01
I spoke with the Insurance Commision of Indiana and they told me that my insurance company is a private company and isn't required to do any Pre-determinations. They are within the law for this matter. I also spoke to obesitylaw.com to confirm this and they said they can't do anything for me. Im so disappointed. I thought there was hope for me.
9/04/01
I spoke with my PCP today about waiting for WLS and what the insurance company was doing. She told me to not be discouraged and that it would still give us time to get all my medical records in order. She made notes on my chart of all my co-morbid conditions and updated my prescriptions. She also once again gave me some adipex diet pills and schedualed monthly weigh-ins to keep the physician weightloss going for when I can get surgery. I have begun to walk as often as motivation will allow to get fit before I can have surgery.
10/18/01
What a wonderful this day has been. I wrote a fabulous letter today with a plea for help in getting a pre-certification. I sent this letter to the Board of Trustees, the attorney, and to the administrative manager of the insurance company.
Not bad eh?? Let's see how it works!
11/22/01
So much for the letter. I got a response from the insurance company that said NO WAY. So here I sit, clueless as to what to do, once again. The hospital won't budge, the insurance company won't budge. I have an angel sitting on my shoulder, I'll just sit back and let her take care of me.
12/04/01
Another glorious day in my life.
01/07/02
I HAVE JUST MADE THE GUINESS BOOK OF WORLD RECORDS!!!!!
01/22/02
I went for my pre-op testing today and it wore me to the bone! I had to have my hubby pick up the kids from practice. I don't think i've been that worn out in years! I was able to ask the Dr lots of questions that I have been wondering about. I asked him how many stomas he has had to dialate and how many bowel obstructions he's had. His answer was ZERO to both questions! I was very impressed. I asked Dr Gomez how many cm he routinely bypasses and he said 100 cm. I was hoping to have 150 bypassed and asked him if he would consider that, he replied that he wasn't comfortable changing a procedure that he has had such good success with but he would allow an extra 4 or 5 cm if I wanted him to. I respect him for his honesty about that. He has only done 100 weight loss surgeries but I feel he does a wonderful job. Im confident I have chosen the right person.
01/30/02
My hospital called me today and it seems my insurance company is making one last attempt in trying to get me to not have surgery. I'm 6 days away from crossing the line and the insurance called the hospital to tell them this isn't medically necessary for me! This wasn't a denial, but my hospital needs the authorization code to let me into the OR on Tuesday. Sue at my Dr's office told me to write a letter today (which I did) to convince the Doctor at the insurance company that I needed to have this. I faxed it to them this afternoon and they now have 48 hours to decide my fate. My insurance company is a private one, so they don't have to comply with state laws reguarding this surgery. It's been a nightmare for TWO YEARS! I want my life back!!! *sigh*
03/25/02
I'm officially a post op and among the living. They wheeled me into the OR and I saw about 10 people preparing things for my surgery. I sat up and said, "I need your attention for a moment, we need to have a little meeting before we start" They all stopped what they were doing and gathered around me and I explained to them that Dr. Gomez had made no promises about being able to finish me Laparoscopicaly. Here's what I said to the surgical staff. "It's your job to talk him out of opening me up! Ok you can begin now." Needless to say, Dr gomez had problems with my liver being in the way and a huge layer of fat surrounding my organs and wanted to open me. They talked him out of it. My surgery was finished Lap in a little over 3 hours, twice the estimated time.
When I got to recovery my oxygen was so low that they put me in the Progressive Intensive Care Unit for two days where the staff was excellent! Then they moved me to a regular room, where the staff and room SUCKED! I was released after one day there to go home to my recliner where I would spend the next 5 nights! I had sooo much pain in my tummy after surgery, I felt as though he had beat me up with a sledge hammer!!! I'm a wienie anyway!! Well.... Thats my story and I'm sticking to it!!!
05/16/02
STRICTURES!! UUUGGGG!!!!
08/12/02
It's been six months since my WLS now and I'm down 102 pounds and feeling like a million bucks! Everything in the world is easier to me now. When I wake up in the mornings I'm ready for the day!! My body doesn't hurt, my head is clear, and I feel as though I'm 20 years younger.
Today is my 2 year anniversary for my surgery and life couldn't be better. I have regretfully gained 8 pounds, which my PCP made me WELL aware of! Before that would have been 100..... All I can say now, is, THANK GOD FOR WLS.
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