I would say: Why am I NOT losing but...

southernlady5464
on 3/15/11 1:23 am
I know better...I have hit my first stall. Yeap, I have and I am not freaking out over it. I know it happens to all of us. How long it will last, I don't know but after three days of weighing exactly the same, I came to the conclusion that the fairy godmother of weighloss has gone elsewhere for the time being and I would just have to cope without her for the time being.

Anyway, I had too much else to freak out over last night. Got a notice in my email box that my EOB was ready for viewing. Now I get them before the doctor/hospital/etc do so I'm usually 5 steps ahead of them. Anyway, I open it up late last night to find out that in spite of being pre-approved for my surgery. BCBSTN decides to deny payment to the hospital and surgeon for my surgery to the tune of a total of 50K! Since my secondary never approved me for surgery, guess whose pocket it supposedly lands in?

Well, this morning, after getting ideas from some poeple here on the DS board, I call the billing department at the surgeon's office and at the hospital. Neitheer of them have seen the denail yet so nothing they can do and yes they will appeal it. They want their money even more than I want it paid to them. The lady at the hospital even said as long as it was pre-approved (and it was), we are NOT responsible for any of the bill, denied or not.

So can we say stressed (or is that desserts?) 

Liz

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

Stacey N.
on 3/15/11 1:31 am - Chesapeake, VA
Oh wow! 50K is alot of money, hopefully they will get it fixed really soon.
RaggetyAnn
on 3/15/11 2:46 am
VSG on 02/15/11 with
Wow, Liz, I go bonkers over stuff like that.  You sound so calm.

I love your statement re: "fairy Godmother of Weightloss has gone elsewhere."  I think she's cowering in the corner worrying about the 50K!
tracey

RaggetyAnn  (I'm just a RaggetyAnn in a Barbie Doll world.)
hw: 216 sw: 200 cw: 156 dgw: 134 mgw: 124

southernlady5464
on 3/15/11 2:56 am
Tracey,

I learned LONG ago there is only so much I can do at one time about stuff like this. I do have my days...we were one of the ones who lost a house in the start of the foreclosure mess 18 months ago. That I cried, yelled, worried, screamed, and paniced over only to end up in the same boat I would have ended up in staying calm anyway. At this point, they can't get blood out of a turnip, others have tried. Remaining calm is easy when you know that.

Liz

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

RaggetyAnn
on 3/15/11 3:08 am
VSG on 02/15/11 with
oh, gee, that's a sad, sad thing about your home.  I cannot imagine.  My heart (not a turnip) bleeds for your loss.   I will try to remember to keep things in perspective.

Yesterday our accountant called and said our business taxes were ready and come and get them since they need to be mailed 3-15 (yeah, today).  So I sat down with them last night to review them and realized the accountant had made at least one HUGE mistake, and maybe several others, all leading to the fact that we will owe MORE than I anticipated.  I was standing in the accountant's office at 8:30 this morning, trying VERY hard to remain calm. Now they have to file an extension and fix the taxes.  And they haven't even STARTED our personal taxes, and it's been a month already.....

It's the first time I've wanted to EAT my way into oblivion since my surgery.  Reminds me that life is waiting around the corner, and I better have my new coping skills in good working order soon.....

RaggetyAnn  (I'm just a RaggetyAnn in a Barbie Doll world.)
hw: 216 sw: 200 cw: 156 dgw: 134 mgw: 124

Mama477
on 3/15/11 3:03 am
UGh, Liz!!!!  Shred that inovice and by the the time next one rolls around your stall will be broken for sure!  (hopefully there will be no future billings because the surgeon's office will be all over them)

**********************************************
  HW 236 / SW 224 / CW 164/ GW 135
        
lerkhart
on 3/15/11 3:50 am
Liz, my insurance company did the same thing.  I called them and explained I was pre-approved and they fixed it immediately.

Good luck and hope your stall breaks soon.  I'll bet those inches are still falling off!!

Linda
14.5 lost pre-surgery  5'1 1/2"                                      LW-Apple-Gold-Small.jpg image by PlicketyCat
Ladytazz
on 3/15/11 4:53 am
I have Medicare and they don't pre approve. When I arrived at the hospital for my surgery they had me sign something that said I would be responsible for around $47,000.00 if the insurance didn't pay. I figured why not? What are they going to do, repossess my surgery? Fortunately they did pay.
As far as the stall, I was prepared for that, too,, but it didn't make me like it. I hate stalls but I am going to have to get used to them because I am going to have to maintain at some point.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

southernlady5464
on 3/15/11 5:49 am
Medicare Advantage works like regular insurance in that you have to have pre-approvals but follow the rules of Medicare. I happen to have Medicare Advantage this year.

Yeah, the problem with stalls is I much prefer they happen at a MUCH LOWER number, LOL.

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

Price S.
on 3/15/11 5:39 am - Mills River, NC
I usually roll with the punches pretty well but that one would have toppled me over for sure.  Here's swinging that they get it straightened out.  Do you and Charles have the same insurance?

About the stall, I went from losing a pound a day to losing a pound every 3 days pretty religiously.  Then at 5 months, I only lost 4 lbs all month.  I think I am hitting another slow down, although for most of Feb I lost 2 lbs a week.  You may just be settling into a new pattern.

    LW-Apple-Gold-Small.jpg image by PlicketyCat  66 yrs young, 4'11"  hw  220, goal 120 met at 12 months, cw 129 learning Maintainance

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