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Old 12-11-2007, 06:46 PM   #1 (permalink)
mlg78
Big Loser
 
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Join Date: Aug 2007
Location: North Royalton, Ohio
Posts: 177

Weight Statistics

June 4, 2008
Surgery Date:
5' 1"
Height:
214 lb
Start Weight:
190 lb
Current Weight:
125 lb
Goal Weight:
24 lb
Weight Loss:
65 lb
Lb Left to Lose:
11.214953271 %
% Lost:

Body Mass Index
40.4305294276
BMI Start:
35.896264445
BMI Current:
23.6159634507
BMI Goal:
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Default 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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Alt Weight Loss Surgery Insurance
Yes, you can often get insurance cover for your Weight Loss Surgery.
Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.

   
Old 12-11-2007, 06:49 PM   #2 (permalink)
Trulykath
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Join Date: Jun 2007
Location: North Texas
Posts: 3,459
Blog Entries: 1

Weight Statistics

I've lost/gained my whole life!!!
Start Date:
Aug 1, 2007
Surgery Date:
5' 8"
Height:
280 lb
Start Weight:
142 lb
Current Weight:
150 lb
Goal Weight:
138 lb
Weight Loss:
-8 lb
Lb Left to Lose:
49.2857142857 %
% Lost:
Summer 2008
Goal Date:

Body Mass Index
42.5692041522
BMI Start:
21.5886678201
BMI Current:
22.8049307958
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Default

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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Old 12-11-2007, 06:49 PM   #3 (permalink)
Kenyar
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Join Date: Apr 2007
Location: Mount Vernon, NY
Posts: 7,498

Weight Statistics

4/1/07
Start Date:
4/19/07
Surgery Date:
5' 9"
Height:
258 lb
Start Weight:
151 lb
Current Weight:
165 lb
Goal Weight:
107 lb
Weight Loss:
-14 lb
Lb Left to Lose:
41.4728682171 %
% Lost:
04/19/2008
Goal Date:

Body Mass Index
38.0957781979
BMI Start:
22.2963663096
BMI Current:
24.36357908
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Default

dont cry. stay strong. it's not over yet you are in my thoughts and prayers. please keep us posted.
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Old 12-11-2007, 07:36 PM   #4 (permalink)
TamTamW
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Join Date: Oct 2007
Location: Minnesota
Posts: 1,241
Blog Entries: 1

Weight Statistics

On and off my whole life...
Start Date:
November 20, 2007
Surgery Date:
5' 9"
Height:
287 lb
Start Weight:
212 lb
Current Weight:
150 lb
Goal Weight:
75 lb
Weight Loss:
62 lb
Lb Left to Lose:
26.1324041812 %
% Lost:
August 2009
Goal Date:

Body Mass Index
42.3778617937
BMI Start:
31.3035076665
BMI Current:
22.1487082546
BMI Goal:

Weight Loss Method
Roux 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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Old 12-11-2007, 07:55 PM   #5 (permalink)
DocSanae
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Location: Tokyo, Japan
Posts: 9,321
Blog Entries: 2

5' 5"
Height:
Default

((((((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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Just a li'l bit 'bout myself
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Old 12-11-2007, 07:55 PM   #6 (permalink)
beckamarie
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Join Date: Jan 2007
Location: Hawaii
Posts: 3,791
Blog Entries: 9

Weight Statistics

07/23/2007
Start Date:
July 23, 2007
Surgery Date:
5' 2"
Height:
230 lb
Start Weight:
120 lb
Current Weight:
125 lb
Goal Weight:
110 lb
Weight Loss:
-5 lb
Lb Left to Lose:
47.8260869565 %
% Lost:
June 23 2008
Goal Date:

Body Mass Index
42.0629552549
BMI Start:
21.9458896982
BMI Current:
22.860301769
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Big Hugs Sweety hang in there and keep fighting them
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Old 12-11-2007, 07:59 PM   #7 (permalink)
traciflud
WLS Mentor
 
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Join Date: Sep 2007
Location: coarsegold california
Posts: 1,380

Weight Statistics

8/23/07
Start Date:
8/22/07
Surgery Date:
5' 7"
Height:
315 lb
Start Weight:
198 lb
Current Weight:
170 lb
Goal Weight:
117 lb
Weight Loss:
28 lb
Lb Left to Lose:
37.1428571429 %
% Lost:
I have no idea
Goal Date:

Body Mass Index
49.3305858766
BMI Start:
31.0077968367
BMI Current:
26.6228558699
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

Hang in there, wait and see what happens, keep us posted also!
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Old 12-11-2007, 09:20 PM   #8 (permalink)
qt82699
Seasoned Veteran
 
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Join Date: May 2007
Location: minnesota
Posts: 4,108

Weight Statistics

july 21, 2007
Start Date:
august 17, 2007
Surgery Date:
5' 6"
Height:
339 lb
Start Weight:
179 lb
Current Weight:
160 lb
Goal Weight:
160 lb
Weight Loss:
19 lb
Lb Left to Lose:
47.197640118 %
% Lost:

Body Mass Index
54.7100550964
BMI Start:
28.8882001837
BMI Current:
25.8218549128
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

you are in my prayers...think good thoughts
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Old 12-12-2007, 06:21 AM   #9 (permalink)
MsVickie
Seasoned Veteran
 
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Join Date: Mar 2007
Location: Floyd County Virginia
Posts: 3,608
Blog Entries: 1

Weight Statistics

September 19th 2007
Start Date:
September 19th 2007
Surgery Date:
5' 10"
Height:
363 lb
Start Weight:
211 lb
Current Weight:
165 lb
Goal Weight:
152 lb
Weight Loss:
46 lb
Lb Left to Lose:
41.8732782369 %
% Lost:
12/31/09
Goal Date:

Body Mass Index
52.0793877551
BMI Start:
30.2720408163
BMI Current:
23.6724489796
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

Honey use the reason they denied you to fight them on it. Never ever give up.
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Tough times never last
Tough people do.

This ribbon is for our Lady Lisa and all the beautiful women that fight this ugly disease.

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Old 12-12-2007, 09:29 AM   #10 (permalink)
Lch
WLS Guru
 
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Join Date: Jan 2007
Location: Modesto, CA
Posts: 470
Blog Entries: 11

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 Method
Roux en Y Gastric Bypass
Default

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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