MY SURGERY DATE!

well.........had my 2nd surgical consult with Dr. Holover. man i was was so nervous you would've thought i was getting operated on TODAY.  my date is August 20th with pre-op to be done on aug 9th i PRAYYYYYYYYYYYY that GHI approves me. they are a nightmare in approving. so any prayers you all have to spare would be much appreciated :-) :-) ~~Lisa

I am keeping my fingers and toes crossed for you and saying a pray.  I know what you are going through.  It took me a year to get approved. ( I have HealthNet) It took many appeals before they finally approved me. My BMI was above 40 and I had high blood pressure and sleep apnea.  I hope and pray you don't have to go through that.  Hang in there cause this is the hard part.  The waiting. 

what were there reasons for denial? what were your appeals like? how did u finally get them to approve?

First they didn't give a reason.  Then their reason was my BMI wasn't above 40 for 5 yrs.  But I had comorbidities - high blood pressure and sleep apnea and I am only 35.  I have a family history of heart disease also. My first appeals through the dr's office kept getting denied, then when I exhausted all of them I had to put in my personal appeal.  They denied my first appeal and then my second appeal went in and they approved me.  The appeals went before a board of Drs and nurses and they decided based on my paper work whether I was eligible or not.  The second appeal I was  supposed to do a telephone conference and be in on the actual decision.  But it didn't make it that far, they went over the paper work before they called me and decided that I met the requirements. They had changed their requirements because they were so outdated.  They changed the BMI to being 2yrs above 40.   I just kept at it and appealed everytime I got denied.  It was a battle for a exactly a year to the date that I started this journey.  It was exhausting and an emotional roller coaster but I stuck it out.  My Dr.'s office was great with this situation.  They kept fighting along with me and I almost gave up.  But Fern told me not to and I am glad that I did stick it out.

these insurance companies........i think sometimes they just deny because they are counting on the fact that people will give up and not bother appealing. (like i did 4 yrs ago) this time that is not going to happen.. i will fight and fight. if they come up with the BMI over 40 for 5 yrs bit i can give them evidence for 10.. between various doctors. i'll do what i have to do. i just have to try not to worry and whatever will be, will be.. then i will take the next needed step.

Keep a positive attitude, even though it can be hard to.  Don't get discouraged.  They do think you will give up and some ppl don't know about the appeal process so they think that it is over after the first denial letter.  Hang in there and you always have us to cheer you on!!! Oh and remember this saying "The squeaky wheel always gets heard!"  So be that squeaky wheel.... LOL 

Hey, I have lots of those to spare and will end a few up for you! Good Luck, Lisa!

Congrats and good luck.  I will keep my fingers crossed that you get approval.  Please keep us in the loop, too. Take care, Sue

Lisa ,  Never ever give up. I wont.. Just follow protocol and make sure EVERYTHING is done in the correct time frame. I know if i get denied my second internal i have till exactly Sept 1st to file my external.  I know that you will bwe approved as long as all paper work initally goes in correctly they will have no reason to deny. HANG IN THERE  I KNOW IT IS WORTH IT> Maybe i'll be approvesd and have my lap band this month too. `````Karen`````

Dear Lisa, Congratulations on getting your surgery date----Aug 20th.  Before you know it, it will be here. Hope all goes well with GHI this time around.  Anyway, thanks for the well wishes for my surgery. I can't believe it's been almost 2 weeks already.  Everything went well the day of surgery.  I must tell you---don't want  to scare you, but you should be prepared, recovery is tough---the most pain I've ever experienced in my life.  But, everything else is coming along nicely---I've been drinking my protein suppliments, eating my 3 small meals ----although I have to remind myself to eat, and drinking my water.  I'm doing everything they told me to do. Have a great evening.  Hope to hear from you.   Congrats again. Cathy