insurance not covering my surgery

Sparklekitty, Science-Loving Derby Hag
on 6/29/15 1:27 pm
RNY on 08/05/19

Who said you were "covered and qualified?" The surgeon? The insurance company?

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

(deactivated member)
on 6/30/15 5:54 am

Both! isn't that stupid.

Sparklekitty, Science-Loving Derby Hag
on 6/30/15 8:21 am
RNY on 08/05/19

I'm guessing the surgeon meant that you qualified medically for surgery (pre-op tests, weight, etc.) and had nothing to do with the insurance.

An insurance company may say that you're covered based on the off-the-cuff info you give when you call their customer service line. They don't actually approve anything until your surgeon sends them your whole packet of info, and then approval is given to the doctor's office.

Most surgeon's offices won't schedule surgery until THEY have heard from your insurance company with the go-ahead. Did they not do that, and just proceed on your go-ahead?

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

(deactivated member)
on 6/30/15 10:51 am

I remember calling the surgeons office asking if I was approved for surgery and was told yes. so this is all very frustrating for me. I will see what happens bc they just resubmitted a claim, As I said b4 if they don't cover it, they will ge $10 a month. Not my mistake. insult to injury I am the slowest loser on the planet. sucks.

Gwen M.
on 6/30/15 12:10 pm
VSG on 03/13/14

At least you know why you're losing slowly - it's due to your poor food choices. 

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

(deactivated member)
on 7/1/15 5:09 am

poor food choices. gave up luna bars, nuts. Can you give me suggestions. It's very challenging when I can't have dairy, egg white protein, hemp, soy, whey. What would you eat? please give ideas for 3 day meal plan and 2 snacks.

Gwen M.
on 6/30/15 10:11 pm, edited 6/30/15 10:12 pm
VSG on 03/13/14

Fish, chicken, cow, pig, lamb, egg yolks if you can't eat the white, beans... There are lots of great whole food protein options you can eat!  Are you allergic to eggs and hemp?

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

(deactivated member)
on 7/1/15 5:13 am

thanks. I'm getting on it. (that was fast reply, thanks)

Gwen M.
on 7/1/15 6:33 am
VSG on 03/13/14

I recommend that you check out Paleo blogs/recipes. Paleo avoids dairy and soy, so you'd be able to find a lot of recipes to fit your restrictions. 

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

(deactivated member)
on 7/1/15 1:15 pm

thank you so much for the info. I will look into it as soon as I get back from bible study tonight. Be well.

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