Recent Posts
Topic: RE: 1 week countdown until LapBand surgery
Thank you everyone. Had a great Holiday weekend. 
Tomorrow liquid diet
Weds surgery
Tomorrow liquid diet
Weds surgery
341lbs start journey weight / 325 lbs surgery day weight 
Realize Band Surgery preformed on 6/1/2011
My sharing here on OH is from my own experience, strength, & hope. I am not a medical professional. Doctors and medical professional know best and their directions should be followed.
Realize Band Surgery preformed on 6/1/2011
My sharing here on OH is from my own experience, strength, & hope. I am not a medical professional. Doctors and medical professional know best and their directions should be followed.
Topic: RE: cross post 19 days to go
I am more excite than scared. I have told my wife my wishes, just in case. But, the healthy longer life is much much better than the alternative. The things I will be able to do, that I cannot do now. I am only 2 days away now. I have built a great support system around myself. People here, local support groups, family & friends, and God.
341lbs start journey weight / 325 lbs surgery day weight
Realize Band Surgery preformed on 6/1/2011
My sharing here on OH is from my own experience, strength, & hope. I am not a medical professional. Doctors and medical professional know best and their directions should be followed.
Realize Band Surgery preformed on 6/1/2011
My sharing here on OH is from my own experience, strength, & hope. I am not a medical professional. Doctors and medical professional know best and their directions should be followed.
looking4hope
on 5/29/11 5:13 am
on 5/29/11 5:13 am
Topic: cross post 19 days to go
I start my 2 week diet Friday. My surgery is only 19 days away and I am getting scared again. I think this is just normal I am afraid of surgery. I am so excited but then I wonder what if ....... something goes wrong? What will my husband and children do without me? I also know I can't live this way my body hurts, I have no energy when I get home from work, and I am sure I will die an early death like my mother and grandmother if I don't do something. Hearing so many horror stories worries me. I am excited and nervous but i am 99% sure I am doing the right thing.
looking4hope
on 5/28/11 12:41 pm, edited 5/29/11 6:07 am
on 5/28/11 12:41 pm, edited 5/29/11 6:07 am
Topic: RE: 1 week countdown until LapBand surgery
good luck.... I will be going in three weeks
I deleted the below post because it was basicly the same post. I was sure I had posted but when I was on it wasn't there. so I posted again:)
I deleted the below post because it was basicly the same post. I was sure I had posted but when I was on it wasn't there. so I posted again:)
Topic: RE: what company do you work for that covered your surgery
HI Tom,
I love reading your posts. YOu are so knowledgeable about this whole experience.
At this point i am not fighting the insurance company. It is up to my husband's job. It always has been. It isn't in my plan. Period. That was why it was denied twice... "not in your benefits package".. Only HR can decide to cover it ... they are self-pay. The external review is set. If based on my doctors' notes, and other info i have sent (plus my endocrinologist is really putting up a fight for me), Highmarks' medical board agrees to the medical necessity of it..which they stated that it was in my 2 denial letters... then Cookson (my hubby's company) has to pay for it.
I truly do believe they will cover it. I think they just want to make sure i jump thru all the possible hoops.
I am going to keep all my crossable parts crossed and hope that all of the information i provided them and the numerous specialist notes and the second packet my endo is sending. she is at the point too where she is citing journal articles and closing with "she will not be held responsible should anything happen to me if they don't agree to the surgery" or somthing to that end.
Thanks again.
Have a fabulous weekend.
I love reading your posts. YOu are so knowledgeable about this whole experience.
At this point i am not fighting the insurance company. It is up to my husband's job. It always has been. It isn't in my plan. Period. That was why it was denied twice... "not in your benefits package".. Only HR can decide to cover it ... they are self-pay. The external review is set. If based on my doctors' notes, and other info i have sent (plus my endocrinologist is really putting up a fight for me), Highmarks' medical board agrees to the medical necessity of it..which they stated that it was in my 2 denial letters... then Cookson (my hubby's company) has to pay for it.
I truly do believe they will cover it. I think they just want to make sure i jump thru all the possible hoops.
I am going to keep all my crossable parts crossed and hope that all of the information i provided them and the numerous specialist notes and the second packet my endo is sending. she is at the point too where she is citing journal articles and closing with "she will not be held responsible should anything happen to me if they don't agree to the surgery" or somthing to that end.
Thanks again.
Have a fabulous weekend.
Topic: RE: what company do you work for that covered your surgery
Catherine,
If you did two appeals, DON'T GO FOR ANOTHER ONE. If you do 3 appeals, and they deny you - YOU'RE DONE FOR GOOD. Unless you get another insurance company.
What you want to do is two things (1) Speak to supervisor at Highmark and get EXACTLY what is and isn't in your plan. Denote their name (or ID), the time you called, and what they said. READ BACK to the person what you believe they are staying to you to make sure you have not misheard the information (2) Get a lawyer. There are plenty on this site which can help you make sure you don't get the run around, denied, and can be approved (if that what the supervisor tell you).
If you did two appeals, DON'T GO FOR ANOTHER ONE. If you do 3 appeals, and they deny you - YOU'RE DONE FOR GOOD. Unless you get another insurance company.
What you want to do is two things (1) Speak to supervisor at Highmark and get EXACTLY what is and isn't in your plan. Denote their name (or ID), the time you called, and what they said. READ BACK to the person what you believe they are staying to you to make sure you have not misheard the information (2) Get a lawyer. There are plenty on this site which can help you make sure you don't get the run around, denied, and can be approved (if that what the supervisor tell you).
Good Luck on your Journey !!
Tom
“Nothing I will ever eat will give me the feeling I get as when I lose weight” The views expressed are based on my own experiences - and should NOT BE FOLLOWED IN LIEU OF DOCTOR’S ADVICE/INSTRUCTIONS. Only your Doctor knows your condition, and make sure you talk to them before making any changes to your diet
Tom
“Nothing I will ever eat will give me the feeling I get as when I lose weight” The views expressed are based on my own experiences - and should NOT BE FOLLOWED IN LIEU OF DOCTOR’S ADVICE/INSTRUCTIONS. Only your Doctor knows your condition, and make sure you talk to them before making any changes to your diet
Topic: RE: Recommendations for VSG surgeons?
For mine I went to a master, Dr A in Omaha when Bertha and his professor at Cornell said i was too complicated, Dr A has done over 7000 DS/vsg, no problem. my procedure was painless. and trouble free. and a very complex revision.
Topic: RE: what company do you work for that covered your surgery
Verizon covers all four wls types, but not out of area such as omaha, they are a east coast company, so you have to have thier MCN not the mcp plan,
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