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12-11-2007, 06:46 PM
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#1 (permalink)
| | Guru In Training
Join Date: Aug 2007 Location: North Royalton, Ohio
Posts: 207
Weight Statistics June 4, 2008 Surgery Date:
5' 1"
Height:
214 lb Start Weight:
198 lb Current Weight:
125 lb Goal Weight:
16 lb Weight Loss:
73 lb Lb Left to Lose:
7.47663551402 % % Lost:
Body Mass Index40.4305294276 BMI Start:
37.4076861059 BMI Current:
23.6159634507 BMI Goal:
Weight Loss MethodPhysician Prescribed Diet/Exercise
|  I just want to cry...
I was denied today...a SECOND TIME! I haven't really shared much of my story with anyone...but here's a brief synopsis...
My first denial was received January 2006. Immediately after that denial for lack of six months of clinical documentation of weight loss attempts I made an appointment with my primary care doctor at the time to pursue the six months of required clinical documentation. My first appointment was February 2006. In the following six months I paid for my Meridia prescription out of pocket which cost me approximately $100/month. I also paid for a Basal Metabolic test out of pocket during those six months to determine how many calories my body naturally burns. Additionally I purchased two different pieces of exercise equipment totalling approximately $800 between the two which, of course, was out of pocket. After paying for all of my co-pays for the six months of clinical documentation, my Meridia prescriptions, my Basal Metabolic testing, and my exercise equipment, I tried to continue losing the minimal amount of weight I had lost in that time. I was unsuccessful and I've gained everything back in 2007. In September 2007 I decided to try to pursue gastric bypass again. I completed all of the requirements prior to having my information submitted to Medical Mutual again by doing all the necessary tests, seeing a nutritionist, and meeting with the surgeon and psychiatrist. Again, I was denied for the same reason as before even though I had my six months of clinical weight loss documentation from 2006.
I'm heartbroken and frustrated. At first I wondered if Medical Mutual didn't receive my notes from 2006. According to the financial chick at the Cleveland Clinic who contacted Medical Mutual when I called her in tears earlier today, they have them... The nurse at Medical Mutual is going to have the doctor re-review things in the next couple of weeks and point out to him the 2006 stuff. The nurse and financial chick are thinking the doctor may not have realized there was stuff from 2005, 2006 AND 2007... I pray to God that's the case. Otherwise, I've been officially denied a second time. At this point I will lose all hope...
I just want to cry...
__________________
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12-11-2007, 06:49 PM
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#2 (permalink)
| | Seasoned Veteran
Join Date: Jun 2007 Location: North Texas
Posts: 5,236
Weight Statistics I've lost/gained my whole life!!! Start Date:
Aug 1, 2007 Surgery Date:
5' 8"
Height:
280 lb Start Weight:
154 lb Current Weight:
150 lb Goal Weight:
126 lb Weight Loss:
4 lb Lb Left to Lose:
45 % % Lost:
Summer 2008 Goal Date:
Body Mass Index42.5692041522 BMI Start:
23.4130622837 BMI Current:
22.8049307958 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I'll keep you in my thoughts.....think positive and maybe you will have a different answer after the doctor reviews it!
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12-11-2007, 06:49 PM
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#3 (permalink)
| | Seasoned Veteran
Join Date: Apr 2007 Location: NY
Posts: 10,174
Weight Statistics 4/19/2007 Surgery Date:
5' 9"
Height:
260 lb Start Weight:
152 lb Current Weight:
165 lb Goal Weight:
108 lb Weight Loss:
-13 lb Lb Left to Lose:
41.5384615385 % % Lost:
Body Mass Index38.3910943079 BMI Start:
22.4440243646 BMI Current:
24.36357908 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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dont cry.  stay strong. it's not over yet  you are in my thoughts and prayers. please keep us posted.
__________________  KenyaR.  Lap RNY 4/19/07 | |
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12-11-2007, 07:36 PM
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#4 (permalink)
| | WLS Mentor
Join Date: Oct 2007 Location: Minnesota
Posts: 1,427
Weight Statistics On and off my whole life...Highest weight was 326 Start Date:
November 20, 2007 Surgery Date:
5' 9"
Height:
287 lb Start Weight:
210 lb Current Weight:
170 lb Goal Weight:
77 lb Weight Loss:
40 lb Lb Left to Lose:
26.8292682927 % % Lost:
August 2009 Goal Date:
Body Mass Index42.3778617937 BMI Start:
31.0081915564 BMI Current:
25.1018693552 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I will keep you in my prayers, hang in there, keep positive thoughts and keep us updated.
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12-11-2007, 07:55 PM
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#5 (permalink)
| | Super Moderator
Join Date: Nov 2005 Location: Tokyo, Japan
Posts: 24,786
5' 5"
Height:
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((((((HUGS))))))) Sounds like you've got the nurse and coordinator in your corner so you may hear good news yet with the review.
Stay positive, stay strong, and please don't turn to food because of this glitch.
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12-11-2007, 07:55 PM
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#6 (permalink)
| | Seasoned Veteran
Join Date: Jan 2007 Location: Smiths Station Alabama
Posts: 4,363
Weight Statistics 07/23/2007 Start Date:
July 23, 2007 Surgery Date:
5' 2"
Height:
230 lb Start Weight:
130 lb Current Weight:
125 lb Goal Weight:
100 lb Weight Loss:
5 lb Lb Left to Lose:
43.4782608696 % % Lost:
June 23 2008 Goal Date:
Body Mass Index42.0629552549 BMI Start:
23.7747138398 BMI Current:
22.860301769 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Big Hugs Sweety hang in there and keep fighting them
__________________ 
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12-11-2007, 07:59 PM
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#7 (permalink)
| | Seasoned Veteran
Join Date: Sep 2007 Location: coarsegold california
Posts: 1,541
Weight Statistics 8/23/07 Start Date:
8/22/07 Surgery Date:
5' 7"
Height:
315 lb Start Weight:
192 lb Current Weight:
170 lb Goal Weight:
123 lb Weight Loss:
22 lb Lb Left to Lose:
39.0476190476 % % Lost:
I have no idea Goal Date:
Body Mass Index49.3305858766 BMI Start:
30.0681666295 BMI Current:
26.6228558699 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Hang in there, wait and see what happens, keep us posted also!
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12-11-2007, 09:20 PM
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#8 (permalink)
| | Seasoned Veteran
Join Date: May 2007 Location: minnesota
Posts: 5,595
Weight Statistics july 21, 2007 Start Date:
august 17, 2007 Surgery Date:
5' 6"
Height:
339 lb Start Weight:
177 lb Current Weight:
160 lb Goal Weight:
162 lb Weight Loss:
17 lb Lb Left to Lose:
47.7876106195 % % Lost:
Body Mass Index54.7100550964 BMI Start:
28.5654269972 BMI Current:
25.8218549128 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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you are in my prayers...think good thoughts
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12-12-2007, 06:21 AM
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#9 (permalink)
| | Seasoned Veteran
Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 9,445
Weight Statistics September 19th 2007 Start Date:
September 19th 2007 June 18,2012 Surgery Date:
5' 10"
Height:
363 lb Start Weight:
226 lb Current Weight:
170 lb Goal Weight:
137 lb Weight Loss:
56 lb Lb Left to Lose:
37.741046832 % % Lost:
When I get there again Goal Date:
Body Mass Index52.0793877551 BMI Start:
32.4240816327 BMI Current:
24.3897959184 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Honey use the reason they denied you to fight them on it. Never ever give up.
__________________ Remember Tough times never last Tough people do... This Ribbon is for our Lady Lisa and all the women that fight this ugly disease. RIP Jerry my friend
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12-12-2007, 09:29 AM
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#10 (permalink)
| | WLS Guru
Join Date: Jan 2007 Location: Modesto, CA
Posts: 470
Weight Statistics 12/13/06 Start Date:
December 13, 2006 Surgery Date:
Height:
220 lb Start Weight:
150 lb Current Weight:
145 lb Goal Weight:
70 lb Weight Loss:
5 lb Lb Left to Lose:
31.8181818182 % % Lost:
Dec 2007 Goal Date:
Weight Loss MethodRoux en Y Gastric Bypass
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I Was Denied Twice Also, Then Approved On The Third One, Hopefully The Third Time Will Be The Charm For You Too, Just Keep At It, Is All I Can Say, I Had Many Nights Of Tears And Fears That They Wouldn't Let Me Have The Surgery, But I Never Gave Up. Hang In There And We Will All Be Here For You.
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