Sheila J.

Send Message

Block

Add Friend

Christina B. 20 years, 11 months ago

Hi Sheila, INsurance Companies Suck And that is with a Capital S... Now SIt down , take a breath (As like most of us I am sure that you have been holding yours to see if you are approved or not) cry for a few minutes if you want, then get tough.... Start by finding exactly why you were denied, and dont deal with little peons go to the supervisor, andf work up the chain of command, get it in writing, keep a list of names and phone extensions, Write an appeal (Mine was 26 pages long)include when the weight problem began, what you have done to lose it (Even add the odd things you have done- Mine was to rub Bengay on my stomache to see if it would shrink it I know Not a smart thing to do) Family history of co-morbids, eVERYTHING. Print out a BMI chart that shows how it is calculated and what yours is and where it shouold be (You would be surprised how many dont know this) and any information about the surgery you have, Letters from Drs, Etc.... Send one copy via Fax to one person, then make a photo copy and send it Return receipt requested, And keep fighting. Remember the squeeky wheel gets the grease. Good luck and God Bless. CHristina Bathan

Kathy H. 20 years, 11 months ago

Hi, Sheila. I once was denied by Aetna because they felt I didn't have sufficient documentation of physician supervised diets and weight loss attempts. I had tried Xenical, Weight Watchers, Atkins, Mayo Clinic, NutriSystem, etc. I suggest that you contact Aetna and ask them exactly what it needed. If you can get them to send you a letter stating exactly what they have to have to approve this, that's so much the better. Then gather your info and file your appeal. If they still find some grounds to deny you even though you've provided what they asked, at least you have grounds to go to the insurance commissioner. I really hate insurance companies. I used to work for two, and I feel like all they do is look for loopholes to get out of their committments to their customers. Good luck, and don't give up with Aetna. I did, and now I wish I didn't.

Stephanie T. 21 years ago

Sheila, Hang in there girl! You will be on the loosing side too!! If you are close with your Dr., ask him to write the insurance company a letter stating that all records older than 1 year are archived for storage reasons. Also, if you need it, I have a letter that I made up for my insurance just in case they questioned the request for surgery. I will be glad to share it with you and you can make ajustments. They may be giving you are hard time because your BMI is under 40 ( I know barely!), which is not considered morbidly obese. Did you ask if there were exclusions? I will be glad to help in anyway...please feel free to email me!

HelpMeRhonda !! 21 years ago

Shelia hang in there I know all the things they need or frustrating, but the outcome is so glorius.. 7/10/02 -post-op OPEN RNY

Naes Wls J. 21 years, 1 month ago

Hi there, I just want to say Best wishes to you on your wls. May you have a speedy recovery and NO complications what so ever. You hang in there, remember each day do get better, Also remember everyday is a Blessing. Hugs

Carolyn L. 21 years, 2 months ago

Hi Sheila, From one Ohio girl to another, Best wishes for a very easy surgery and a speedy recovery. Take care. God Bless. {{{HUGS}}}

tmcgee 21 years, 2 months ago

Sheila, Thank you for your kind words. I wish you the best of luck on your journey as well. Take care, and I'll see you soon on the losing side.

Sharon Neva 21 years, 2 months ago

SHEILA~~BEST WISHES ON YOUR WLS JOURNEY~~ May the world hug you today with its warmth, and love.....Pray it whispers a joyful tun e in your heart.....And may the wind carry a voice that tells you there is a friend sitting in another corner of the world wishing you well!~

cheri123 21 years, 2 months ago

Hi Sheila I bet your excited about your consult!!! I know I was. This site has been a treasure of information for me. If you look up above you will see a library link that is searchable, also in the gallery link there are numerous other links that are very informational.. not to mention all the wonderful people here that respond to emails and are so willing to share their experiences. Blessings to you! Cheri*

MommaAngel 21 years, 2 months ago

HI SHEILA I just want you to know that I am praying that everything will go smooth as you journey to the losing side. LORD BLESS