Insurance approval question

(deactivated member)
on 4/28/17 4:47 pm, edited 4/28/17 4:48 pm
RNY on 05/05/07

My surgery is scheduled for next Friday, yet I haven't received approval from my insurance company yet. I called them the other day because I was worried and they said they have the claim and they have 14 business days to get back to the doctor. I'm so nervous I did all this for no reason. Any one else have GHI/ emblem health for insurance and know the process. If they deny it I'm not appealing it I promised my husband I would take it as a sign from god not to get the surgery. (He doesn't want me having it) so I am hopefull they approve it but it's literally 7 days from now and I haven't heard anything.

Gwen M.
on 4/28/17 6:21 pm
VSG on 03/13/14

That seems like a bad promise to make - I'd just take it as a sign that the bureaucratic process with your insurance sucks and they're trying to get out of paying for surgery.

When was the request submitted?

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 4/29/17 2:45 pm
RNY on 05/05/07

April 21st. It's making me crazy I wish the doctor would have submitted it sooner.

Gwen M.
on 4/30/17 5:31 am
VSG on 03/13/14

I would recommend rescheduling your surgery for the following Friday (May 12th) because that will be outside of the 14 business day period.

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 4/28/17 7:07 pm
Benfungiso4
on 4/28/17 7:08 pm

As the OP said already. Looks like they had bad promise with you. I had the same issue but my insurance company did everything for me what was the agreement.

CJ On Orcas
on 4/30/17 8:54 am
RNY on 09/09/16

Oh my, I would not give up... this was such a great decision for me. Insurance was just a horrible process to wade through. For me, they required 12 dietician visits AFTER I had already had the surgical consult, the endoscopy, the psych eval, and had already seen a diabetes nutritionist for six months. I had to start over again, and it took almost a year from when my doctor approved me. I finally got an advocate who helped me get through the paperwork and requirements.

I am now almost 8 months out from rny. Down 86 pounds. My diabetes is gone. My blood pressure is normal. I still need new knees but walked more than two miles the other day without sitting down.

The bureaucratic process is a nightmare but you can get through it. Sham on them for setting your timeline up with too short a window... they can and should reschdule for an appropriate window.

Good luck.

White Dove
on 4/30/17 12:01 pm - Warren, OH
NHPOD9
on 4/30/17 1:18 pm

Interesting. I consider insurance agencies the antithesis of anything holy.

Are you sure you are ready or even want surgery? You made an odd promise, especially since insurance companies look for any reason to deny procedures. Were you looking for a way out? WLS is a huge change and if YOU are not ready (husband be damned), it would be good to wait.

No offense to your husband, but we are talking about your health and your life, and while it would be nice if he were on board, at the end of the day, it is your decision.

~Jen
RNY, 8/1/2011
HW: 348          SW: 306          CW:-fighting regain
    GW: 140


He who endures, conquers. ~Persius

(deactivated member)
on 4/30/17 3:14 pm
RNY on 05/05/07

White Dove. Not sure what you're speaking about regarding photoshopping. As for calling myself and my husband an idiot. The only idiot here is you for thinking I wouldn't know how to check the message you posted and deleted. I came to this site for advise. Not to be called names.

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