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I HAVE SUBMITTED MY INFO 2X NOW AND BOTH TIMES I LOST MY JOB BEFORE THE SURGERY DATE. THAT WAS IN ILLINOIS. I WILL BE MOVING TO GEORGIA IN AUGUST, 2004 AND WILL START THE PROCESS ALL OVER AGAIN. SINCE I AM NEW TO THE AREA I REALLY DON'T KNOW WHERE TO BEGIN
July 25, 2004
This time next week I will be living Georgia. I will be so glad. I called Dr. Smith office on Thursday. They advised me to call them back once I make a decision on my insurance. She also advised me that it should not take as long for approval or submission of my info since I already have all my medical records and I have had all my test results. She said that even though I have been to several seminars, I will still be required to look at the hour long information video. It is good to know that once I get settled into home and job I won't have to wait another year. Once I start work on the 9th of August I will know exactly where things are. The real bottom line is when will my STD pay at 100%. I will keep posting.
I have been communicating with Tami a little bit. She has had her surgery about 2-3 weeks ago and has lost 20 lbs. I can't wait to get to that point. I broke my computer chair last week. This is my 4th chair. It is so depressing. My back, hips and knees are starting to bother me more and more everyday. It could be from the physical and mental stress on your mind and body from moving. We are moving 2 households and my D/H works about 12-16 hours 6 days a week. So all he does all day when we are packing is wine, wine, wine. If he was a kid you would tell him that it is nap time.
Anyway, I start work on 08/09/2004 and will know more about my benefits and will keep posting. This is somewhat theraputic.
AUGUST 8, 2005
Well, I have been in Georgia now for 1 year. My insurance does not cover WLS. I've tried everything. They do not cover it. I went thru some depression at first. Now I am okay. I guess. It was hard when I first got here. No family, no friends, and no surgery. Georgia is so different from where I moved from in Illinois. The traffice is awful. I come from a small town in IL and their was hardly no traffic. It took getting use to.
My weight has gone up to 364 lbs at one time. That was the height of my depression. I am back down to my normal 350-355. yeah that's my normal weight at this time in my life. I have gone on the internet trying to find some kind of assistance with WLS. I found a site that would allow you to make payments. However, it is in another country. Gotta do some research on that. If anybody has any info on it, I sure would appreciate it.
Well, this is my update. I will try to update more often.
April 24, 2006
I can't believe it has been 8 months since I have jotted down anything. So much has happened since I last updated. I started Atkins in October, 2005 and lost 40 lbs. by January. HOWEVER, I gained back some and I now weight 340. I have been so depressed since my sister past in January. It is hard to stay focus on eating right when food has been your friend since forever.
The good news. The company I work for changed Insurance. I once had AETNA and now I have BCBS of GA. Medically necessary WLS is covered. I submitted my paperwork and all of my medical records from IL to Dr. Smith's office on 04/21/06 by FEDEX. I rec'd an email at work from FEDEX stating that my paperwork was rec'd. YAHOO!!!!!. I will call the doctors office on 04/26/06 to verify receit. I know I have to have a psyc exam. I hope and pray this time is it. I have been trying for about 5 years now. Anyway I am very excited.
April 28, 2006
Well, I did call Dr. Smith's office on 04/26/06. I spoke to the nurse by the name of Neal. She was very nice. She informed me that they had received my paperwork and as soon as the doctor looks at it she will give me a call and set up an appt. It should be no later than next week. If I don't hear from her by Tuesday, I will call her again. I am trying not to get my hopes up and just go thru the process and see what happens this time. I hope and pray it happens.
May 13, 2006
Today is Saturday. I have my consultation with my surgeon on Monday. I am so excited. This step is a requirement with my insurance company. Once I go, then I can start making the appt for the other requirements. I figure I can get them all schedule in May and the first part of June and have my paperwork submitted no later than June 15th....sounds like a good plan. Gotta make it work. I am going home(IL) in July for a week and hopefully I will have an approval before I leave and can come back to GA and have the surgery. I pray that everything goes great this time around. I really don't think I can take it if it doesn't. Really I don't think I could.
Until next time
05/15/06
Had my seminar/consultation today. Since it was my 3rd one, it was very boring, as far as information on the procedure and information related to it. I do however like Dr. Smith and all of his staff. Their were people their who wasn't sure and I think I was the only one that had already submitted their info and was already informed by Dr. Smith that I qualify for the surgery. I have submitted almost everything with my original paperwork except the Psyc Evaluation and the Nutritionist evaluation. I will schedule one this month and one the 1st of June. I will fax the results to Denise(she had the surgery and lost 185 lbs) at Dr. Smith's office myself from my fax at home so I will receive the confirmation. The fax machine at work it is available to anybody and the confirmation is so slow, I may never receive it. Anyway, if she gets everything by June 15th(that's my plan) I have to submit the 150.00 administration fee and then she can submit it to BCBS of GA. OMG...I am really starting to get nervous, anxious, excited and truly grateful to GOD
Until next time
May 25, 2006
Well, It seems as if everything is going according to my plan. Somewhat anyway. I have an appt with my PCP on 05/26/06 for a complete physical that will included a pulmonary test, CBC, EKG and a few other small test that are required by my surgeon and my insurance. My insurance company requires the pulmonary testing. My surgeon requires the rest. Which is okay. I rather be safe than sorry. I have an appt with the dietician on 06/01/06. I call the day after I left the doctors office for an appt with the psyc that Dr. Smith's office recommended. They have been giving me the run around. First, they said that the person who does the insurance verification would not be in until the next and she would call me. I call back 2 days later and then they said that she has been so busy...blah, blah, blah and would call me back. I call back 3 days later and she said your name is on my list to check insurance and that she will do it today and call me back. No call. I called her back yesterday and left a voicemail message. This willbe my final attempt and then I will find another doctor thru BCBS. The doctors name is Dr. Weinstein. Anyway, my plan is to have everything required submitted to my doctor by 06/15/06.
Also, in the packet I received for the surgeons office, it states that they required all WLS patient to lose 10% of their weight by surgery. I started Atkin on Monday, 05/22/06. I weight 346.5 lbs.....OMG!!!!!I knew I had gained some weight back, but I did not think I had gained that much back or that I was that close to 350. My highest weight ever was 365 and I swore I would never get back to 340 again and here I am almost 350. Anyway, I have lost 7 lbs so far. That's 2%. Well, it is 5am GA time and I have to go to work. I will keep you posted. I almost forgot. My insurance company does not cover the Nutritional evaluation. It cost me $92 by credit card to lock in an appt.
Until next time
July 11, 2006
It has been so long since I last updated. Nothing has gone as planned. I have not had any of my pre-op exams or consultations. I have gone to IL to visit my family for about 10 days and before that we went to NC. All that traveling has cost a fortune. Now it is time for Football camp for the boys and back to school. Anywho, while reading profiles, I came across a profile from someone in GA. I emailed her to find out who she went to for her Psych exam. She gave me the name of Connie D. Hill who is in my network and I will only have to pay for the $20 co-pay. She also advised me that she has BCBS of GA and that since they don't have a contracted dietician in our area, I can get reimbursed for the visit. I am at work typing this so I can't remember her last name. But her first name is TAMMY. I almost cried when I read her email response.
THANXS SO MUCH TAMMY!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I had started to go into a deep depression trying to figure out how I could get this taken care of by the end of the year. Also, I have gained so much weight it is unreal. I am at 352 lbs. I started ATKINS again on 07/10/06. That seems to work for me. I will try to update more often.
Until next time
July 22, 2006
Well I really don't have much to report today, We are finally getting our finances together after 2 vacations this summer. I will now begin to make my required pre-op appt. My new date to have all my test and evaluations done will be September 1. I have gained so much weight. I will start working out again on Monday. My knee has started to bother me again. Somedays I can barely walk.
Anyway, I don't have much to report just want to update.
Until next time
August 25, 2006
I had the Psy exam on 08/23/06. It was somewhat depressing. She asked so many personal questions that made you think about things you want to forget. Anyway it is almost over now. I have to go for the second part on 08/29/06. It should be simple. It is a questionaire of about 200 questions done on the computer. I have left a voicemail message for the Dietician. I want to schedule that appt for one day this week. Since today is Friday, I guess that wont happen. Hopefully, one day next week. Once that is done, I will send my $150 administration fee(that is some BS)so she can submit my paperwork.
Me weight is down to 343 and I am starting to feel better. My knees still have some pain, but nothing like before.
Until next time
September 22, 2006
Well it has been almost a month since I last updated. So much has happened. I have had ALL of my pre-op test and evaluations completed. And verified that they were received by my surgeons office. I submitted my administration fee of $200 dollars(was $150 but changed mid stream)They have submitted my paperwork to BCBS of GA. Now I am playing the waiting game. I will call BCBS on 09/29/06 to verfied that they have received it and to see if approved. I am so emotional about right now. I don't think I have ever been this close. I am walking around looking like a refugee because I don't want to buy any new clothes or shoes because it will be a waste of money. I wear a 30/32 now and I refuse to buy another piece of clothing in that size.
Until next time
October 02, 2006
Well, I called BCBS to verify if they have rec'd my paperwork from Dr. Dennis Smith's office. They have not. I had the rep check with the nurses in the pre-cert department and to check if anything had been scanned in. The rep checked and nothing had been rec'd. She also informed me that their was no correspondence from the surgeon office. So I called Denise at the surgeon's office and she had the receptionist tell me that she submitted it and spoke to someone name Stephanie and got a transmission number. When I asked the receptionist for it, she put Denise on the phone. Denise stated that she would call and check on it and give me a call back this afternoon. They are so full of Dill Water. I will call her back this afternoon. I figure since you increased the administration fee to $200, expect me to get $200 worth of administration work. It was so depressing. I just thought when I called they would have at least rec'd it by now. Also, I called on my short term disability benefit and found out it was best to file a claim as soon as I get a date. That way I won't be without a paycheck. My job pays 100% salary for STD. What a blessing?
In the meantime, my life is a wreck. My marriage is going nowhere fast. I am gaining weight by the minute. I am back up to 350.4 exactly. My knee gets worst with the more weight I gain. I walked around my complex with my boys this weekend and when I woke up on Sunday I was in so much pain in my knee. What is amazing is that it is just one knee that bothers me.
Hopefully, I will get approved within the next 2 week and will have a date scheduled for somewhere around the first of November. If you are reading this, please pray for me. Between my marriage and this surgery approval process, I am so depressed. I need some good news and alot of inspiration right now.
I also want to thank Kim Dent for the encouraging email she sent me yesterday. I really appreciated and needed it.
***************THANKS KIM DENT*******************
Until Next Time
October 05, 2006
After calling all week to BCBS and my surgeons office and being lied to by my surgeon office, BCBS finally has rec'd my paperwork. At one point Denise at Dr. Smith's office told me that she would have called me back but she got tired of hold for me. I have a direct line to my desk. The only person that would have put her on hold would have been me. She claimed she was put on hold by out phone system....WRONG!!!!! Not possible. Then she gave me a bogus 15 digit case # that she claim she got from BCBS. BCBS stated that their case numbers aren't that long. It should be 6 digits. Anyway, I called this morning and was informed that it was rec'd and to allow 30 business day for processing. I will call again next Tuesday. 30 business days. I will call no less than twice a week. It took my surgeon office 7 days to fax my information once they rec'd everything they needed. I figure you should be able to move a little bit faster for a $200 administration charge. Again they are full of dill water.
That's all for now
Until Next Time
October 09, 2006
************************I AM APPROVED****************
I got an email from Denise at my surgeon office stating that I have been approved. It was rec'd at BCBS on 10/05/06 and approved by 10/09/06. I can't express how happy I am. I got the good news at work and was sitting at my desk crying. This has been one long journey. Well worth it. I really needed this today. I am such a bad day. This is great. Denise stated in her email that I have a cardiac clearance, pulmonary clearance, chest x-ray, EKG, Gallbladder Ultrasound, upper GI series and all remaining lab work. I will try to schedule as many as possible on the same day. And then we can start working on a surgery date....This is so great.
UNTIL NEXT TIME
I was approved on 10/09/06. However, when I will have surgery, who knows. I am having issues with my Iron. I have been taking these pill for about 4 weeks and they really haven't done anything. The surgeons office stated that it has improved but still not enough. I have to continue taking them for another 2 weeks and hopefully it will be at an acceptabe level. If not, then I will have to get an iron infusion. I was so upset. I stillhave to get an Upper GI, Gallbladder Ultrasound, Pulmonary Test, EKG, some other lab work and go to 2 support meetings. MY GOODNESS. I am working towards getting all this done on one day, 10/24/06. That is the plan. I have expressed to my surgeon that my concern is to have a surgery date in 2006. I don't have the money for another deductible and co-insurance out of pocket.
On a lighter note. While lurking on the GA board I found Tami. She was the very first person I met on OH 2 years ago when I lived in IL. I went back and looked at her journey and read her profile. She has really worked this tool. She looks great and seems so happy. So I emailed her and she remembered me and invited me a get together in November at Juliians(its like a Dave and Buster)I plan on being their.
UNTIL NEXT TIME
About Me
Before & After
rollover to see after photo
