Donna's Surgery is Finally Scheduled

Boy what a ride the last year has been -- my wife, Donna, began this journey a long time ago. Right before she was ready to submit everything to the insurance company, her employer changed to Coventry, which meant an automatic denial. I have Aetna through my employer so we added her to my policy. We submitted to Aetna and were denied in May. Donna did everything Aetna required and then some. We re-submitted in early October. We checked in November. The rep I talked to said, "nothing is on file." Lisa - at Dr. Haung's office - went to work. She had all the information about when she faxed the stuff and really advocated. Aetna then acknowledged they had the information - they just hadn't entered it into their system yet. They advised they would make a decision within a month after it was entered into the system. Sure enough, one month later, Lisa got a call from Aetna that Donna was being denied. Lisa really advocated again. She was greaaaaaaaaaaaaaatttttt! I also called the company. The rep told me we had filed our "appeal" too late. I argued that it shouldn't have been treated like an appeal but a new claim with new information showing that Donna had completed all the steps required. The next morning we were still feeling pretty down. Then Lisa called. Aetna called her to acknowledge that it had made a mistake in treating Donna's case like an appeal. Donna indeed was approved. Her surgery is set for Jan. 16 at St. E's in Lincoln. We're both very excited although. Just want to say that one should never give up--there's always a way.

Hello, is Donna having Lap band.? I am having the lap band surgery on Jan. 15th with Dr. Raymond Taddeucci, at St Elizabeth's surgical center. I start my slim fast diet on Jan. 1st. Wow.. I am also kicking my diet pop habit also. Needless to say, I will have a big headache for a week for so. It will be worth it. I am so tired of being overweight and FAT. I can't wait for the surgery. Any advice on a protein drink for after surgery? Audrey Lincoln Nebraska

Audrey, I had my surgery last Jan. 17, 2006. I had an open RNY/Duodenal Switch with Dr. Anthone in Omaha. The one thing I do for protein each day is drink Slim Fast for breakfast. I found some at Sam's Club that has 20 gr. of protein. Easy way to start the day and very good in protein too. You will be amazed as you watch the labels how different protein counts are. Good luck to you!! Joyce L.

Thank you for the advice. I am going to Sam's tomorrow. The slim fast sounds like it may be a good plan.

Well we would like say congragulation to Donna for her determination and staying after the insurance company and getting approved for her surgery. My wife is also a Donna and she had the lap band surgery in Febuary of 2005 and is doing good. Well way to go sounds like you will have a nice New Year present. jimmy

Hi Chuck, I am so happy for you and Donna. I wish her the best of luck on her surgery day. Persistence DOES pay off. Let us know how she is doing. Mona

My daughter has been fighting the insurance "bit" for over 4 years and she finally took it to the state insurance commission in lincoln. she also had Atena, they approved the rny but not the banding and thats the only one she can have because of all her intestinal problems. Good luck and keep fighting.Pennys is to change companies this month to united so maybe there is still hope for her. Beth in North Platte

Chuck and Donna, I will see you at the hospital as I work closely with the weight loss surgery patients. I am a band pt from 2005 and also a nurse. I am glad that you got through the insurance process. I can relate to the frustration as I went through 2 denials and finally after a year and a half got approved. I will see you and Donna with some great information and teaching to prepare you for the journey into a healthier, lighter life! There is a good support group in Beatrice as well that I can put you in touch with if you are interested. See you soon, Shelly