Approval & Surgery Date

Hi All,
I got approved for my revision surgery and it is scheduled Sept. 2nd.

Deanne:

Congratulations! I have been reading day after day about your wait on a decision....Good Luck, I know you'll do great....

J Rolfson

I AM SOOOOOOOOOOOO HAPPY & EXCITED FOR YOU DEANNE!!  I said this in my private email to ya too....but......CAN'T SAY IT ENOUGH!!  CONGRATULATIONS SWEETIE!!  You have worked HARD with JEN to get this APPROVED!!  You have shown that being PERSISTANT & HOPEFUL is a GREAT THING!!   There may be hope for me in an approval yet!!!

My gosh.......you ARE ON YOUR WAY!!   Hopefully see you on Sat. at Dr. Schlesinger's support meeting!!   Take care!! 

Hugzzzzzzzzzz,
Gwynn

Congratulations!!!  I know how long you've waited!  Was this the 1st time it was submitted - or had you submitted before, it was denied and so you appealed?  And you got a surgery date right around the corner!!  I wish you all the best.  I'm working on it as well.  Jen is about ready to submit to insurance.  I'm just hoping it doesn't take so long - or deny it!  How exciting for you!!!

Well, we won on the first appeal, since UHC-State of Arizona did not have revision criteria.  I got a call this morning from a case manager, who had been in contact with me for other health issues, she got the denial letter and she was the one who called me this morning to tell me it came across her desk that I was approved, so she called to tell me.  No one else had received a call or letter yet.   I did hire a lawyer and it was worth every $ that I paid.

We knew in November of 06 that I had a problem and it took this long to get someone to really believe and help me to act on a solution.  Thank God for Dr. Schlesinger. 

Jen and Dr. Schlesinger have been great in helping me get everything together.  I hope your appeal doesn't take long either.   It took me a month to get the stupid denial letter and once we got that and resubmitted it all took about 1 week to get approved.

Just be patient and it will happen, don't give up.
Deanne

How wonderful !  In case I do have to appeal - can I ask the name of the attorney you used?  Just in case I need to I would appeal immediately!  Dr. Schlesinger is certainly a Godsend!  It was this forum that led me to him!  I'm trying to be patient - but I'm sure you know how it is - just so anxious!  Good Luck to you!  When is your revision?  Thanks!!  Carolyn

Hi Carolyn,
I used Walter and Kelley Lindstrom at Obesity Law & Advocacy.  They were great.  I got to see Dr. Schlesinger in action yesterday and his bedside manner is as wonderful as when you first meet him, truely a genuine and caring Dr.  I am a little anxious now, I start the 2 week liquid diet on Tuesday.  My revision will be on Sept. 2.
Deanne

Did you have just 1 appeal?  After the insurance first denied you, how long did it take for the atty to file the appeal?  And then how long before the insurance approved it?  Can I ask how much they cost? I just want to have everything in place (I just know my insurance is going to deny it).  I didn't know you had to do a liquid diet before a revision.  I know before the RNY you have to (back when I had it - 5 years ago - we didn't though).  What's included in the liquid diet - any creamed soups, or yogurt, protein drinks or just like an optifast?)  Well the 2 weeks will go fast.  How long are you going to be off work (6 weeks?)?  How exciting Deanne - keep us posted!!  Carolyn

Hi Carolyn,
I only reached the 1st level of appeal.  There are 3 with ERISA.  I paid extra to get them to file the appeal in 3 days after they received everything.  I couldn't get the denial letter out of the insurance company for over 30 days.  Once the lawyers were hired, they were able to get it.  Cost depends upon what you want them to do.  Ranges from 450-1100 I think.   Best money I ever spent.  You can contact Kelley and Walter and get the informtion from them, they can send you an information packet with all their rates and levels of appeals they do.  If you don't have copies of all your medical records, medical necessity letters, etc. make sure you get them all, so you can send a complete package to them.  I suggest that you get your PCP to write an appeal letter as well as you writing one yourself.  This way you can write down how the weight is affecting you.

Dr. Schlesinger wants a 2 week diet to help with shrinking the liver fat and in case he finds hernias, it makes repair easier.  You can have as many protein drinks that you want and you can also have chicken, turkey, tuna, egg whites, jello, broth.  No yogurt or creamed soups. 

I will be off of work for 6 weeks.
Let me know if you have any more questions.
Deanne