Five DENIALS ABOUT TO TRY W/ UNITED HEALTHCARE /CORI CENTER.

Hello Everyone I am Angie and I have been reading and replying to this website on and off for over three years. I had fought for three years with BCN to have the WLS and no matter what I did including the 12 month diet plan they denied me! A total of Five times. I am 32 I am single never married although would love to be and have kids, My health is bad diabetes up and down like a yo you really severe back problems herniated disc crushed sciatic nerve on both right and left sides, djd in both knees major sugery on right knee that now needs to be re done cause of weight I weight 350 lbs and have bounced from that to 329 trying every diet program , book meal plan nutritionist under the sun!!!! I was out of work for a year due to a really bad car accident I have migraines and muscle spasms 24-7 I am off work again and this job insurance covers the surgery if medically nessecary but I the process with Cori is taking for ever!!! I need to get in to see doctor and have the surgery asap before I loose the job and wont have the insurance I call and talk to amy the dr's assistant but it seems to get me no where. I have a consult on 1/31/06 but that day dr wood will probably be telling me to loose weight I have tried everything to loose weight If I could do it on my own I would not be seeking the tool of surgery. I have am in such deep depression and in so much pain from my back and head they put me in the hospital for three days but had to release me cause they cant keep me for pain management. I am at the end of my rope I need help can any body help me I need a friend to help me get through this I am babaling and I am willing to be just as good of a friend and listener back I just really need some support. I am freaking out and dont know what to do?? Do I let dr wood tell me to loose weight or do I seek another surgeon who would work faster!!! I cant even get help setting up my psch eval and nutritionsist eval which they require before they will request pre cert??? I thought they were the best place cause of all the compliments and success stories on here??? Can anybody help me and give me some advice?? Sorry to sound so whinney but I am at my whits end and I am on tons of pain meds, not sleeping not eating or throwing everything up?? Thank YOU for listening hope there is someone who can help? Angie Paschall Desperate in Berkley HUGS TO ALL on HERE!!!!!!!

Hi Angie, You and I went to Roseville High School together. I graduated in 91 under the last name Canty. I had my surgery on October 2, 2004. I have lost over 185 and feel wonderful. Try and get a hold of Liv Lite. They are in Warren and are based out of Bi-County hospital..They really work with you to get things moving. I started my process in July of that year and was approved in September of that year. At the time of my surgery, I had M-Care. Liv-Lite does everything for you. If you aren't getting the rsults you wanted of expected, give them a call. Email me if you need any help. Take care. Sue

Hello Sue Thank you for responding and its great to hear from you how do you remember me my pic isnt on here? But its great to hear that some one from my home town had surgery and is doing fabulous. I am grateful for your advice but I am not able to go through Bi county I have had to many very close people to me die in that hospital and I refuse to step foot in that hospital I know that might sound crazy but I just cant go to that hospital and that is the only hospital they use right??? You look great tell me about your journey and up date me on how your life has changed was it hard to get used to the surgery? Did you have plastic surgery or do you have to? Please email me and lets catch up. Angie Paschall

If you are willing to travel Hurley Hospital is pretty quick with insurances and getting a date, and they also understand that if you could have lost the weight on your own you would have. But for any insurance approval you need to document weight loss attempts at least a couple of years worth and where you failed and how much lost and regained. Start a diary now of attempts and failures and also get your pcp on board with a letter documenting your medical problems and any diets they know about, it will be much quicker. Wendy

Hi Wendy I have five years of medical weight loss attempts and failures. My doctor already wrote a letter for cori of medical necessity with my several co morbidities. Where is Hurley Hospital? My PCP is 200% on board with the sugery and has fought BCN five times for me. Thanks for the reply. Angie

I do not live in the Detroit area but I have heard people talk about Henery Ford hospital with Dr Carlin and William Beaumont hospital program plus the new program at St Johns Riverview. I have done alot of research in facilities around the detroit area because of complications and I was loooking for a new surgeon. Plus look at the bariatric surgeons on the website there might be another one who could get the process rolling faster for you. I understand your frustration because I just lost my insurance coverage and now I can not get my corrective surgery. So keep your head up because you will be able to have your surgery in no time and keep fighting your insurance company if they are sending denials because you deserve to have a better life pain free and healthier. If you every need a friend you can always email me if you are feeling down I am a good listener even though I live three hours away from the detroit area but I always like to make new friends. Hugs Tricia

Hi Angie , What a mess!! If I'm understanding your post correctly you no longer have BCN, you have United Health and are basically having to start all over with getting approved. You do have all of your documentation and the support of your PCP, so that's GREAT ! Now the issue has become getting CORI to step up and get things moving, right? Hurley Medical Center is in Flint, and the bariatric surgeons they work with are at Hurley Bariatric Center, also in Flint. Dr. Dabideen was mentioned, I had Dr. Obeid who was wonderful, and I think there are 2 others. All of them are extremely experienced, caring and motivated surgeons. The staff at Hurley Bariatric Center are EXCELLENT and will work with you and your PCP to get things done. I highly recommend them and Hurley Medical Center...best care I've ever had at a hospital. The # to Hurley Bariatric Center is toll free 877-648-7539, in case you want to check them out. I'll be praying for you, something has to work out here...don't give up hope! Peace and blessings, Lizzie B

Hi Angela, I am sorry you are having such a hard time getting approval. I am still waiting for BCN to approve me should be any day now that I hear a yes or no. Have you tried Dr. David Chengelis through Beaumont? Someone on here had suggested that I try his office and I have and he is an excellent surgeon. You can call Laura at 248-288-1660 he meets with bariatric patients on Wednesday mornings give them a call and see if you can get in tomorrow. Good luck. Licia

Thank You all for responding I am so grateful for the replys! I received a call from amy at cori center, I was not trying to cause problems for the her but I am being told by a neurologist that if I do not have gastric bypass surgery so I can have back surgery I could become paraylyzed. Amy is telling me now that I cannot see dr wood with out my psch consult and my nutrition eval. Amy is working with me and I am keeping my options open there are too many doctors for me to sit here and do nothing I absolutly had my heart set on Dr Wood but if he requires me to loose weight after trying to loose weight for 20 years its not going to happen now with my pcp telling my metabolisim has shut down. I will do what I can but I am not rich and cannot pay four hundered dollars to see a psch dr and nutrionist out of my own pocket that is what I pay 120.00 a month out of my pocket for insurance and that is not with the amount my work pays out of their pocket. I am really want the cori center to perform my surgery and I really really want to have my surgery as Harper Hospital. I hope that the cori center can help me to quickly get the pre cert processed and surgery preformed. Any and all feed back is welcomed and appriciated. Thank You to everyone for you advice and support! Angie Paschall

Just a thought but if you have been denied already by BCN 5 times I would think you would have already been through the process of seeing the therapist and the nutritionist, correct? If not how did you ever get to the surgeon to get rejected?? This may not be what you want to hear but please dont shoot the messanger, in this case its me!!, but there are very specific reasons why the doctors have these hurdles that we have to jump through to have this surgery, it does rule out people who may not really be ready for surgery or may possibly be rushing into something as a last ditch effort. I recently counseled with someone who will admit that she just told the therapist what she thought he wanted to hear to get through the exam and now regrets ever having surgery. So not every process is fool proof, but it is a necessary evil, I guess the best bit of advise I could give you is just be patient and if it is meant to be it will be. All things in good time. Having been where you I had a spinal injury, neurological disorder, being obese, and in constant pain I can tell you it is not easy but I took up swimming as a means of pain relief during the time frame where you are at this time, anything to get my mind off of the state of my condition. Today I swim laps, do ballet, pilates, and even jog on my lunch hour, it is amazing the difference 10 months can make in ones life. You are in my thoughts and prayers, Jill