Recent Posts
Topic: RE: New and angry: 12 month diet!
It is probably not in your best interests to wait 12 months and you are able to fight a denial sooner than that, assuming your surgeon's office is willing to submit a request for surgery right now (as opposed to waiting 12 months). This link to our site might give you some more things to think about when it comes to either fighting this unfair criteria or just going through with a year of dieting:
wlsappeals.com/common-bariatric-denials/common-denials-insuf ficient-supervised-weight-loss-efforts/
Hopefully this helps! Good luck.
wlsappeals.com/common-bariatric-denials/common-denials-insuf ficient-supervised-weight-loss-efforts/
Hopefully this helps! Good luck.
Walter Lindstrom, Jr.
[email protected]
LINDSTROM OBESITY ADVOCACY
WWW.WLSAPPEALS.COM, 1-877-99-APPEAL
VSG on 10/15/12
Topic: RE: Insurance won't cover so I need $25,000

Thanks everyone for the feedback. I decided to look around and found that Abington Memorial Hospital in PA has self pay rates. I have the 2012 rates for a VSG, it will be $7000 hospital fee, $1736 Surgeons Fee, plus the cost of Anethesia. A lot less than $25000. They also have self pay rates for the other surgeries and I highly recommend them.

I am walking 60 Miles in 3 Days to fight cancer! Donate today!!
http://www.the3day.org/goto/igomes
Surgery 10/15/12 - HW-263lbs GW-150lbs CW- 170.8
Topic: New and angry: 12 month diet!
Anthem Blue Cross / Blue Shield COVA (state of VA) requires 12 months of diet (WW, Jenny Craig) before covering bariatric surgery. And they only pay 50% of the weight loss program for employees, not spouses, and this my husband's policy. If I can get through a year, I may or may not be approved anyway. SO MAD.
Topic: RE: BCBS NJ Direct Question
Hi
I have Hoizon BCBS-NJ not sure if that is direct or not...
I just had the VSG on 7/24/12 and had to do a 6 month diet. I finished my 6 month diet on 5/2/12 and the insurance took almost 7 weeks to approve the surgery. I was worth the wait.
I hope all goes well for you.
I have Hoizon BCBS-NJ not sure if that is direct or not...
I just had the VSG on 7/24/12 and had to do a 6 month diet. I finished my 6 month diet on 5/2/12 and the insurance took almost 7 weeks to approve the surgery. I was worth the wait.
I hope all goes well for you.
Topic: RE: no longer needed
So far insurance has paid for the consultation so we are going forward...just hoping that come time to file for approval, it goes through.congrats on your success and thanks for responding.
Topic: RE: no longer needed
No, I browsed these forums and did a lot of internet research but I just don't have the money to do it. So, I found something that is actually working and am losing weight the old fashioned way . . slowly but steady. I've lost 40 lbs since the end of March using ViSalus. Figured I'd end up on shakes before/after a surgery anyhow. lol
Topic: RE: no longer needed
I am having the same problem. Did you ever find a resution or get approved for the surgery?
Topic: RE: Aetna Appeal Letter
Hey NAN~
i did go on there website last night and saw that it has to be @ leasat 2 years of bmi over 40. and then bmi 35 w/ hypertension. but from the letter that i will be receiving stats that my hypertension is being controlled. I dont know its frustrating. My surgeons coordinator told me that I should appeal. But then again, i dont know what records my PCP sent them. Thanks for your help. I will PM you my email address. And just hope for the best. I was reading all your post and they gave me alittle hope. all i can do is appeal. And go from there. Thanks for your time.
Paige
i did go on there website last night and saw that it has to be @ leasat 2 years of bmi over 40. and then bmi 35 w/ hypertension. but from the letter that i will be receiving stats that my hypertension is being controlled. I dont know its frustrating. My surgeons coordinator told me that I should appeal. But then again, i dont know what records my PCP sent them. Thanks for your help. I will PM you my email address. And just hope for the best. I was reading all your post and they gave me alittle hope. all i can do is appeal. And go from there. Thanks for your time.
Paige
