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03-23-2010, 07:35 PM
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#1 (permalink)
| | WLS Guru
Join Date: Nov 2009 Location: Janesville, WI
Posts: 455
Weight Statistics 11/2009 for the last time! Start Date:
04/28/2010 Surgery Date:
5' 8"
Height:
412 lb Start Weight:
261 lb Current Weight:
171 lb Goal Weight:
151 lb Weight Loss:
90 lb Lb Left to Lose:
36.6504854369 % % Lost:
Body Mass Index62.6375432526 BMI Start:
39.6805795848 BMI Current:
25.9976211073 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
 |  Insurance Woes...
I am needing some good vibes from everyone. I have insurance which does cover RNY, but they are playing games and wearing on my patience.
The information was submitted 2/12 and they stated that the case was closed on 2/19 due to lack of information from the doctor's office. However, the information they wanted was right in the file.
I got my HR person involved and then received a call from the insurance company stated they had already called my dr's office and would be working with them.
That was 2 weeks ago and I keep in close contact with my dr's office hoping for a date soon. The earliest date now would be in May and thus I think I'd make it after Mother's Day just in case something went wrong.
It's been a long journey and I so want to be on the other side! I'll post more when I have a date - I'm getting so close and anxious!
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|  |  | Weight Loss Surgery Insurance | | | |
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03-23-2010, 10:52 PM
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#2 (permalink)
| | Seasoned Veteran
Join Date: May 2008 Location: Just north of Iowa, not far from I-35. 2nd star on the right and straight on 'til morning!
Posts: 8,641
Weight Statistics December 13, 2007 (pre-op liquid diet started) Start Date:
December 27, 2007 Surgery Date:
5' 9"
Height:
280 lb Start Weight:
172 lb Current Weight:
184 lb Goal Weight:
108 lb Weight Loss:
-12 lb Lb Left to Lose:
38.5714285714 % % Lost:
Originally - 12/08. Actually - 8/08. Goal Date:
Body Mass Index41.3442554085 BMI Start:
25.3971854652 BMI Current:
27.1690821256 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Just keep on them. You are the one with the highest interest level in them doing their job. They get paid no matter what. Just keep that fire burning and remember, the squeaky wheel gets the grease. If the lower level paper shufflers can't make it happen, move up the line, courteously and firmly, taking no crap from anyone.
Awhile back we had a lady tell us that her strategy was to send the insurance gal a bunch of flowers with a nice note thanking her for all her help. She got noticed, and got the help she needed. Something about the relative merits of different baits when catching flies ... 
CT
__________________ da perfesser
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Dare to live your dream!!
If you want to be healthy for life, do for life the things that get you healthy!! Living healthy takes work. Dying fat is easy!! "That which we persist in doing becomes easier, not that the nature of the task has changed, but that our capacity to do has increased." - HJ Grant
"Do, or do not. There is no try!" - Yoda
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03-24-2010, 08:36 AM
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#3 (permalink)
| | Guru In Training
Join Date: Feb 2010 Location: New England
Posts: 300
Weight Statistics January 12 Start Date:
Feb. 23, 2010 Surgery Date:
5' 6"
Height:
284 lb Start Weight:
147 lb Current Weight:
170 lb Goal Weight:
137 lb Weight Loss:
-23 lb Lb Left to Lose:
48.2394366197 % % Lost:
Body Mass Index45.8337924702 BMI Start:
23.7238292011 BMI Current:
27.4357208448 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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My insurance company has a time limit for how long they allow a case to be open and if the doctor didn't respond within a certain amount of time they closed the case. I had to continually hound my doc and all the people who sent referrals to get everything together . Once the entire package was given to the insurance company they made a decision in 3 days! Good luck and Hang in there.
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03-24-2010, 11:14 AM
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#4 (permalink)
| | Whipper Snapper
Join Date: Feb 2010 Location: Minneapolis
Posts: 23
Weight Statistics January 19th 2010 Start Date:
6/16/10 Surgery Date:
5' 9"
Height:
403 lb Start Weight:
213 lb Current Weight:
199 lb Goal Weight:
190 lb Weight Loss:
14 lb Lb Left to Lose:
47.1464019851 % % Lost:
2012 Goal Date:
Body Mass Index59.5061961773 BMI Start:
31.4511657215 BMI Current:
29.3839529511 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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How do you know where it is at with the insurance company? Do you call them direct or your surgeons office?
I am just finishing up my last psych appt today and I know that will be a few weeks to get the final report to the Surgeon and then I think they submitt for final apporoval??
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03-24-2010, 12:55 PM
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#5 (permalink)
| | Cub Reporter
Join Date: Dec 2009 Location: Washington, DC
Posts: 91
Weight Statistics April 20,2010 Surgery Date:
5' 10"
Height:
424 lb Start Weight:
175 lb Current Weight:
199 lb Goal Weight:
249 lb Weight Loss:
-24 lb Lb Left to Lose:
58.7264150943 % % Lost:
Sometime 2011 Goal Date:
Body Mass Index60.8310204082 BMI Start:
25.1071428571 BMI Current:
28.5504081633 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Stay on them, keep notes, write down names and dates when you speak to people and know that one day you will look back on all of this and smile. | |
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03-26-2010, 07:41 PM
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#6 (permalink)
| | WLS Guru
Join Date: Nov 2009 Location: Janesville, WI
Posts: 455
Weight Statistics 11/2009 for the last time! Start Date:
04/28/2010 Surgery Date:
5' 8"
Height:
412 lb Start Weight:
261 lb Current Weight:
171 lb Goal Weight:
151 lb Weight Loss:
90 lb Lb Left to Lose:
36.6504854369 % % Lost:
Body Mass Index62.6375432526 BMI Start:
39.6805795848 BMI Current:
25.9976211073 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Thanks everyone! I called again on Wednesday and the woman stated it was approved and tried to tell me it was done quickly since they had received everything on Monday. 
I proceeded to tell her that they'd had everything for over 5 weeks and she became very quiet. 
I then asked her to fax the letter of approval to me - which I still haven't received! My goodness they are pokey.
Any who, I have been working closely with the clinic and have been pursuing the insurance company at least weekly. I'm waiting for my mailed copy of the letter and then can go ahead with scheduling.
I'm just so close!!!
Thanks for everyone's good vibes!!
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03-26-2010, 07:50 PM
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#7 (permalink)
| | Guru In Training
Join Date: Feb 2010 Location: Indiana
Posts: 291
Weight Statistics 1/11/2010 Start Date:
1/28/2010 Surgery Date:
5' 5"
Height:
258 lb Start Weight:
202 lb Current Weight:
150 lb Goal Weight:
56 lb Weight Loss:
52 lb Lb Left to Lose:
21.7054263566 % % Lost:
Body Mass Index42.9287573964 BMI Start:
33.610887574 BMI Current:
24.9585798817 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Cue the BeeGees...
I'm pickin' up good vibrations, their givin' you the excitations.
I'm pickin' up good vibrations, their givin' you the excitations.
Good, good, good, good vibrations, their givin' you the approval.
Good, good, good, good vibrations, their givin' you the approval.
(( ))
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03-26-2010, 09:15 PM
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#8 (permalink)
| | Super Moderator
Join Date: Nov 2005 Location: Tokyo, Japan
Posts: 24,791
5' 5"
Height:
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Congratulations on the approval!!
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03-26-2010, 10:03 PM
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#9 (permalink)
| | Seasoned Veteran
Join Date: May 2008 Location: Just north of Iowa, not far from I-35. 2nd star on the right and straight on 'til morning!
Posts: 8,641
Weight Statistics December 13, 2007 (pre-op liquid diet started) Start Date:
December 27, 2007 Surgery Date:
5' 9"
Height:
280 lb Start Weight:
172 lb Current Weight:
184 lb Goal Weight:
108 lb Weight Loss:
-12 lb Lb Left to Lose:
38.5714285714 % % Lost:
Originally - 12/08. Actually - 8/08. Goal Date:
Body Mass Index41.3442554085 BMI Start:
25.3971854652 BMI Current:
27.1690821256 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Quote:
Originally Posted by Betsy  Cue the BeeGees...
I'm pickin' up good vibrations, their givin' you the excitations. | Pardon me, but back in the '60s I think I remember that being the Beach Boys... Good Vibrations Lyrics, Beach Boys Good Vibrations Lyrics - LyricsFreak.com
CT
__________________ da perfesser
*******************
Dare to live your dream!!
If you want to be healthy for life, do for life the things that get you healthy!! Living healthy takes work. Dying fat is easy!! "That which we persist in doing becomes easier, not that the nature of the task has changed, but that our capacity to do has increased." - HJ Grant
"Do, or do not. There is no try!" - Yoda
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03-27-2010, 06:03 AM
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#10 (permalink)
| | Guru In Training
Join Date: Feb 2010 Location: Indiana
Posts: 291
Weight Statistics 1/11/2010 Start Date:
1/28/2010 Surgery Date:
5' 5"
Height:
258 lb Start Weight:
202 lb Current Weight:
150 lb Goal Weight:
56 lb Weight Loss:
52 lb Lb Left to Lose:
21.7054263566 % % Lost:
Body Mass Index42.9287573964 BMI Start:
33.610887574 BMI Current:
24.9585798817 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Perfesser you are right, my bad. I was in a hurry.
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