X POST: My IMR is closed and...

Lori F.
on 11/16/11 12:48 am, edited 11/16/11 4:09 am - Chula Vista, CA

...THEY WON'T TELL ME ANYTHING ON THE PHONE DAMMIT. What does that mean?? Is that bad news, or good news?? Actually the rep said she can't even open my case- only the head dude can tell me. I requested a call back from my clinical reviewer but who knows when that will happen? Anyone know how this works?? I am freaking out.

EDITIED 12:10pm: They just called- DENIED.

Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW: 260 (yes, with the band!)

Current Fill: 5cc in 10cc band
BMI: 49

Toy T.
on 11/16/11 5:53 am

DS on 02/22/12

I am so sorry can you appeal?

plp1988
on 11/16/11 11:34 am

You should appeal, I was denied at first to then my Dr. summit document saying why I needed the surgery and they approved me. Insurance was BC/BS of NJ.

Band to DS
on 1/12/12 5:48 am, edited 2/3/12 11:14 pm

Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Lori F.
on 1/12/12 11:10 pm - Chula Vista, CA

Lap Band on 07/06/07

Hi Shelli! I've been thinking about you. I have no plan. I've been AWOL from OH too. I just can't think about it anymore. I'm doing meal replacements and exercising. We all know how that's going to end up though, don't we? What's your plan B?

Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW: 260 (yes, with the band!)

Current Fill: 5cc in 10cc band
BMI: 49

smileyjamie72
on 1/13/12 10:39 pm - Palmer, AK

DS on 12/29/11

Lori,

Please do not give up!!!!!!! Keep plugging away!!!!!!! I wanted to "throw in the towel" so very may times, to just give up & walk away. I understand your insurance & my insurance are 2 totally different things. I am just trying to gve you some positivity.

I started (granted I am in another state, and different insurance) my journey -- when I finally made my decision to pursue revision -- in January 2009, and had finally made up my mind, and came down off the fence in March 2009. Almost 3 years later, I have had my revision from RNY to DS around 3 weeks ago.

I have been home in Alaska 7 days today & it is 15 below!!!!!!

-Jamie

**Don't give up!!!!!**

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

Lori F.
on 1/14/12 3:26 am - Chula Vista, CA

Lap Band on 07/06/07

JAMIE!!!!!!!!!!!!!! I am so happy for you! I've been AWOL for some time... but I've been thinking of you! That's GREAT! How's it going?

I just can't deal with any of the fight right now. My band is filed up again and I'm doing meal replacements and working out and I've lost 13 lbs.since Thanksgiving. We all know where this story is headed, but at least the next time I fail, I can apply again. I'm doing EVERYTHING I POSSIBLY CAN- so that I can't again be told I am non-compliant.

Thanks for the pep talk...and I am THRILLED to hear you're on the dark side. That does give me some hope, actually!

Lori

Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW: 260 (yes, with the band!)

Current Fill: 5cc in 10cc band
BMI: 49

smileyjamie72
on 1/14/12 7:30 am - Palmer, AK

DS on 12/29/11

Lori,

This is a LONG HARD ROAD.

Keep you EYE on the PRIZE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
-Jamie

p.s. At least it sounds like you will have a second chance. Don't give in & DO NOT give UP!!!!!

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

Band to DS
on 1/16/12 12:06 pm, edited 2/3/12 11:15 pm

Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

MARIA F.
on 1/16/12 1:46 pm - Athens, GA

Hugs! I was just reading your post on the other forum earlier today. Make sure you try the appeal resources I listed. Good luck!!!

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