EGD

Apr 07, 2008

I had an EGD today. It took three different nursed six sticks to realize they couldn't get an I.V. in before they called on the anesthesiologist. By the time he got to me, they had used up all the good spots and he had to stick me three times. So I was stuck 11 times including the two sticks for blood. I'm going to make sure no one touches me on Friday. I will wait for the anesthesiologist. He knows what he's doing!

All in all it wasn't bad. I did have to wait forever. But once I was in the room, the only thing I remember was someone spraying my throat, a nurse putting oxygen on me and telling me to roll over. The next thing I knew, someone was telling me to wake up.

Once I got home, I found a letter in the mail telling me Doctor's Hospital is having a pre surgery seminar on Thursday. I'm looking forward to going.

Liquid diet

Apr 04, 2008

Today is day 1 of my week long liquid diet. So far it isn't too bad. I have a feeling it's going to be a loooooong week.

I got a Date!

Mar 18, 2008

I saw Dr. Baker today and finally, after more than a year, have a surgery date. My surgery is on April 11th and I start my liquid diet on the 4th. I'm not looking forward to that. LOL

I still have to get my EGD and that will be on the 7th.

Tomorrow!

Mar 17, 2008

I go see Dr. Barker tomorrow. I really hope I get a surgery date. My husband is out of town for the next couple of days, so we went out and used our Red Lobster gift cards last night. I guess I'm hoping he will start me on liquids immediately. I doubt it, but it is nice to dream....

I have a new Best Friend!

Mar 06, 2008

Dale called this morning and asked if I could fax over copies from my visit to Dr. Lee [diet doc] from March of last year. I guess we discredited it because I missed the April visit and started over in May. He also said it would probably go to a peer to peer and hoped he could get it scheduled this afternoon. Well it never came to a peer to peer,because my new best friend, Dale, called me and said 'We did it!' Now all I have to do is get my EGD and I've done everything.  

How much more?

Mar 05, 2008

Dale called and said they are okay with my weight history, but are balking at my  6 month diet. He said they are wanting 180 days, and I only have 167. Even though I was in the doctor 6 different times. May, June, July, August, September, October. If I had waited and gone in on Oct 20th rather than the 12th, I'd be okay. 13 days!!!!

Will this madness ever end?

Packet completed!

Mar 03, 2008

As of today, my packet is complete. I faxed over the copy of Dr. Kennedy's letter. I'll be calling Dale later today to make sure he has it. So now all I have to do is wait and see. Dale felt it was a good packet and since I only have one year to prove with a photo, I shouldn't have too much trouble. I'm keeping my fingers crossed. But the really nice thing about Dr. Barker's office, is they handle the appeal. So different than Dr. Hamn! I wish I had started with them last year. I can't believe I have been at this for a year now. ...

Edit: I called Dale and he said he has everything he needs. I also asked about the change in weight history requirements. [From 5 to 2] He said he would ask them when they called for clinical information. He said insurance companies change requirements all the time and they don't ever get notification. So hopefully it is true that Aetna has changed their policy. It makes it even easier for me!

Changed doctors

Jan 23, 2008

I've had about all I can take with insurance and appeals. So I have decided to start all over with a new doctor. I went to Dr. Wade Barker in Dallas. It is a a bit of a drive, but well worth it. Dale, the benefits coordinator is so knowledgeable and helpful. He gave me a list of everything I need to be approved with a bmi of over 40. All I need now is a photo for the year 2005, cardiac clearance from Dr. Kennedy and a letter from my pcp referring me to surgery along with a corrected height. For some reason they have my height as 5'10", when I'm only 5'8". Both Dr. Barker and Dr. Lee have my heights as 5'8". That's helping a lot with getting my bmi over 40.

Good Grief...

Dec 14, 2007

On October 30th I faxed everything to Aetna and I mailed, certified, the hard copy. On November 14th I called to see if they had everything. A very nice lady told me they had nothing but the original submission, so I faxed it again on the 15th. I got a letter in the mail on the 20th saying they didn't have any records regarding my 5 year weight history. I faxed everything AGAIN on the 30th of November. I called today to see how things were going, and Lisa with Aetna said they were upholding the denial because they don't have proof of a five year history. That was on the 2nd of December. I told her that I faxed it on the 30th. She looked and couldn't find it. She said something come in on the 5th, but can't read it. Once her supervisor gets back from lunch, she is going to have him look at it, attach it and hopefully everything will be okay. I'm really tired of this. If it gets upheld...I'm telling Dr. Hamm that either he calls Aetna, or I am looking for a new doctor.

Appeal faxed to Aetna

Oct 29, 2007

I found out that my doctor's office sent Aetna 114 pages of records. I'm not sure if that made a difference or not but I cut it down to 32 pages. I pulled 5 years from the pcp records and I sent all six months from the doctor supervised diet. I included the results from my sleep study, the reports from my nutrition and psych evals. I'm hoping that I was denied because my records weren't very clear.

About Me
Dallas, TX
Location
27.7
BMI
RNY
Surgery
04/11/2008
Surgery Date
Feb 23, 2007
Member Since

Friends 16

Latest Blog 14
EGD
Liquid diet
I got a Date!
Tomorrow!
I have a new Best Friend!
How much more?
Packet completed!
Changed doctors
Good Grief...
Appeal faxed to Aetna

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