kimberly84

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I can't sleep thinking about what they are going to tell me tomorrow...I'm trying to leave this up to God, but my mind is spinning...My mind has been flooding with reasons why they would deny me, after this new change made July 1st. Then I fingered through all my documents and came across the mental health evaluation I never read, but assumed I passed because the surgeon decided to go ahead. Take in mind I’ve never met this guy, and I sat down and talked with him for 30 minutes! Patient is describing a poor diet that does not appear to be in compliance with her diabetes or the recommendations from the dietitian for helping her pending gastric bypass clearance. I am concerned about the patient not controlling her diabetes and also her ability to adhere to the dietary recommendation pre-and post surgery. There is no psychiatric contradiction for the patient to have the procedure but as mentioned above I am concerned about her ability to follow the recommendations. Will leave it up to the surgeon rather or not he wants to proceed with the surgery. But recommended that she show a significant period of time adhering to the proper diet prior to surgery.- He asked me what my diet was and I didn’t lie. I told him I ate pizza and  the occasional candy bar, then he quoted me saying that I eat “ whatever is close”  Excuse me for not lying and saying I don't fall into temptation I'm human. If this idiot has caused me to not get approved for this surgery I’m giving this guy a piece of  mind.

 I Called today to check that status of my appeal, she told me that I was denied  once again because I needed to send in the hand written copies of my 6 month diet- I called the hospital and they told me that was a bunch of *%#@. So I called back the insurance company and they told me that they needed the 2 months of my missing 6 mo diet to complete it. And 2 years of medical history which I sent in yesterday. So, hung up and said*@^*& I'm not taking this run around anymore so I called back and finally talked to someone while I was talking I was looking at the website and it said As of July 1 2009 Blue Cross Blue Shield IL no long requires 5 year medical history or 6 month supervised diet it is now 3 months!!!! But they do still require at least (2) co Morbs! I told the person this and she said yes your right I'm going to resubmit this right now for you, and call back tomorrow I'm sure you'll hear something. So now I can't stop thinking about it and I'm freaking out I'm just so happy because it seems like it's getting easier now for people seeking WLS and it almost makes me wanna cry..even tho I'm not approved. Silly I know but, it's just a blessing.Hopefully tomorrow I will be writing that I have been approved!

I got denied today for insurance approval because of lack of documentation. Incomplete 5 year Medical History, Incomplete 6 month supervised diet.  (Which I have) It was my second denial letter  and the office will not send out again after 2 denials. So I took it into my own hands and called the insurance company and faxed in the information myself...they are now reviewing my file….I feel bewildered this has been a 2 year journey trying to get approved. If I find out I was denied a third time- I’m going to throw in the towel. And look for other means of controlling my weight.  I just feel really sad…I have a appointment with my PCP Friday...hopefully I’ll find out if I was approved or not by then if not I’ll talk to her about other means of weight lost. I’ve just come to the terms I guess that this might not just work out for me. I guess I'll have to accept whatever god's plans for me are.   I'm going to keep calling hopefully I can find out within the week ,the deadline for an approval for my surgeon to do it is within this week. I found out today that the surgeon actually hasn't been doing the surgeries for two months is but willing to do mine because I've been seeing him for 2 years, so hopefully I'll be posting an approval soon.

I Started at EMMC 2 years ago, mother got sick so,couldn't travel down to meet the surgeon started seeing a surgeon in local area instead.  He wouldn't accept EMMC appointments and history so I started over with him and saw him  for 1 year finally sent out for insurance , got denial letter because insurance didn't accept 6 month diet plan I did with him.

Started  another, 6 month diet to match  insurance requirements by a T. ..I  called the doctor this morning to let him know I'm finished, they tell me he no longer does wls, hospital pulled program. Called EMMC  to see if I could get a referral from him to see one of their surgeons they tell me I would need to start the program all over again because my file is 2 years old. . So now I have all my paper work, 2 years worth of appointments  2 passed psychologist evaluations, 20 nutrition visits, 2- 6 month supervised diets and no surgeon. did I mention the chance that my work place could drop our current insurance  as of Jan. 2010!? So I would have no idea of knowing if it'd even be covered?

 Well..I called the center director of the hospital and told her, everything and she told me that they didn't have my complete file and didn't realize that I had been an on going patient so she said she would give the ok for me to resubmit and have him do my surgery if he is still willing to. She said she would give me a call back next week because he was out of the office. So next week has come and gone 2 days ago I called and left a message with her secretary Tuesday and she hasn't called me back. So now I'm waiting until Monday and if she doesn't give me an answer I'm going to go see the surgeon and bring him my paper work..Man..this has been a real fight!

Well, I had my visit with my PCP on Wednesday, I’m down 17lbs by his scale, 20lbs on my scale! In 5 months  I just started eating 4 meals a day with healthy snacks.

It was my 6^th visit which meant he sent out for  insurance. When he said he was sending out my stuff, I didn’t look too excited because I know that I don’t have enough information to be considered for a 6 month supervised diet. I know I will not be approved, which is expected and kind of saddening. I’ve looked into getting another insurance it’s an individual coverage that covers WLS and does not require a 6 month diet.

The thing is that the premiums are so expensive so I’ve started looking into getting a second job to pay for the premium. I’m hopping to get all this done by next month before my next visit with him. A second job would also help clear up some bills. I'm still going to start a 6month diet with my doctor incase things don't pan out the way I'm planning. We always make our plans but in the end God's got his plan of us.

I started this weight loss journey June 2007; I’ve gone through 3 potential surgeons, 2 hospitals and 5 different insurances, now after 2,000 dollars worth of co-pays and uncovered insurance bills. I now have to start a more detailed 6 month pre op diet. I’m stressed, depressed, beaten, broke and angry I feel like saying &#$ it, and just giving up. I don't know..If I start a 6 month I won't be finished until January. And I'm working at a job which I can't stand only for the insurance

It’s been a while since I’ve updated I’m still in the lingo process. It will be a whole year in June since I started this process. Which makes me wish that I would have started it sooner but there is no time like the present time. I believe now I am ready mentally than I was even 5 months ago. In my mind I was thinking that this surgery would solve all my problems and I’ve come to the realization that I have to work on me too. Nothing will ever be perfect but hopefully it will get better.

            I have a meeting with  my surgeon this will be my 5^th visit. The visits usually consist of the same thing. My weight is taken and they tell me that they are gathering things to send out which has been the last five months.  People are telling me that I look good but. As flattering as it is I’ve only lost 5 pounds and my clothes are still tighter as ever. I’m hopping to lose some more before my next visit with the surgeon. Before when I was pre op cloud 9, I had put my life on hold until after the surgery, I’ve started living again going out with friends and buying clothes getting my nails done and wearing make up . As silly as it sounds the surgery is no longer an obsession and the months have been going by quickly. I’ve been given a unconfirmed date for a surgery in May/June which seems like forever but in a way is right around the corner. I’m going broke paying for 2 insurances but I really want this surgery. You see I’m covered by my work and I also have an individual policy. The work insurance was a must and doesn’t cover the surgery and the individual policy covers. Anywhoo I’ll be updating after my visit with the surgeon.

With a possible surgery date coming closer I thought I’d do the famous “List” of my 10 fears of having surgery. 1 being my biggest fear.
10.Not dressing like a skank once I lose weight. I can remember saying (if I had a body like that,I'd walk around naked)

9. Missing Food

8. Not recognizing myself in the mirror

7  Losing my boobs.

6. Dumping

5. Losing too much weight 
4. Not losing enough weight

3. Saggy Skin Needing Plastics

2. Complications

1. Dying

I got my scheduled date to meet my surgeon!! I wasn’t expecting it because I had 8 weeks to do diet to lower my Alc (diabetic number) But they scheduled me in hopes that I would get it under control which is great and exciting so my surgeon appointment is Jan 15! Yay! I’m going to try to lose 8 pounds until then! I have a new surgeon Dr. Toder, the wait is 3 months. But I’m totally ok with it!

Well…I went to my “last” pre op appointment. It went well we reviewed information and my other appointments. I didn’t get clearance to meet the surgeon, which was a bummer. I have to do a 8 week diet to get my blood sugars down, which is a must so I have a minor set back. My insurance is changing as of January 1^st   to Harvard Pilgrim, not sure if they cover weight lost surgery so I’m also dreading that. Or if they do cover weight lost surgery if I have to do a supervised 6 month diet which will suck, because it’ll set me back another 6 months. So I decided to go vegetarian/vegan diet for the next 8 weeks after thanksgiving and start exercising. 
So Here it Goes!
Clocks at WishAFriend.com