Hi! New here!

Treasured · 03-31-2006, 08:20 PM

Hello everyone! My name is Deborah .. Deb to my friends ... and I just plopped in here a little while ago from cyberspace! LOL!

Like falling in a rabbit hole ... but excited to find this place. My profile is also on the OH board if any of you ever go over there, you can check me out. I'm new to this whole process and today I've just been in total "meltdown" mode and in tears most of the afternoon.

After jumping through all the hoops required for WLS through Barix Clinics of TX and submitting it all to my insurance company, I found out TODAY that the surgeon & hospital are out of network for my insurance so it will only pay 50%!

Lord, Jesus, help me! They couldn't have told me that right up front???!!! Now I have to start all over again??!! But I'm not going to dwell on that right now .. I just have to stay focused on the "other side" and keep moving forward, whatever that takes.

Oh, BTW .. I'm 54, married to the love of my life for nearly 34 years, have 8 kids .. all married except my 21-yr-old baby boy .. and just found out that we're expecting another grandbaby sometime around the holidays. So life is good!

I'm looking forward to getting acquainted with everyone here!

Hugs,
Deb

freebird · 03-31-2006, 08:27 PM

Hi Deb!
Welcome. it's good to have you here. That sucks about the insurance company. Craig has an insurance e-book that you might find very informative and useful. It's loaded with info i think it might help you in your journey. Come join us on monday morning for the 10am chat. Hope to see you there.

DocSanae · 03-31-2006, 09:31 PM

Welcome Deb.
I'm praying that everything will work out for you.

((((((HUGS)))))))

xsmith95 · 04-01-2006, 06:36 AM

Welcome Deb. Just stay positive. I kind of had the same thing happen to me. I jumped through all the hoops, had all the testing done I needed, submitted to the insurance company for them to tell me "medically necessary" or not they would not cover my surgery. I was lucky enough to have a secondary insurance and they do pay for the surgery. It only took me a month for approval after finding a new surgeon to take my secondary insurance.

Just remember you have done all that you need to and will be much easier the second time around and hopefully will be much faster too!

Good Luck.

Treasured · 04-01-2006, 08:27 AM

Thanks, you guys. I'm feeling a little more positive right now over my morning coffee. I know this is still going to happen .. it's just that I really wanted to have it done through Barix. I live just 30 minutes from the clinic, it's the ONLY thing that's done there .. they're all bariatric specialists and perform no other kind of surgery and my surgeon was one of the leaders in the field having performed over 5,000 surgeries with less than 10 deaths in 25 years. I'd already joined the support group and was developing relationships with some of the people there. I'm just so disappointed, and I guess it's partly my own fault. I called the clinic first instead of the insurance company and just took their word that they were covered by my insurance. Then it all just snowballed and it looked like this was actually going to happen within the next 30-60 days. I was so psyched .. I feel like someone just popped my balloon. But I stayed up half the night and I've found another surgeon and hospital close by who ARE in-network for me and I'll just have to call them Monday and see what their procedure is. The hospital he uses does at least have a dedicated Bariatric Floor with a specially trained staff so I guess that's a plus. I read the doc's profile and saw his picture ... he graduated from Med School in 1996! Great ... I get Doogie Howser! (She sighs and takes another sip of coffee...)

xsmith95 · 04-01-2006, 08:36 AM

Doogie Howser! how funny! Don't fret all will work out for the best. Just put it in God's hands. He has his ways of dealing with things. I learned that going through my approval process.

RobinZ · 04-01-2006, 05:33 PM

Hi Deb! Welcome, and best wishes that everything goes smoothly from here on out. Doogie Howser may not be so bad, might know all the latest and greatest techniques! The insurance issue stinks, sorry you had to go through that, the insurance companies are tricky. I had to self pay, so it ended up being an easier road to go down, although costly I'd do it again in a minute.

8 kids - WOW. How many grands? I've got 4 grands and they are all a delight!

Treasured · 04-01-2006, 08:19 PM

Hi Robin! Thanks for the welcome. I'm sure when I get on the "other side" that whatever headaches I have to go through right now will be well worth it. I'm just so ready to do it.

From our 8 kids we've got 15 grands, with #16 due sometime between Thanksgiving & Christmas ... and our first great-grandson is 8 weeks old. We've got the 2 youngest ones here with us tonight giving mom & dad a night out ... they're the ones who just found out #3 is on the way. I love being a grandma but I want to be the kind who goes out and plays football & basketball with them as well as reading them stories so that's part of my incentive to have this surgery.

Hugs for you too!

Pillows · 04-11-2006, 03:06 PM

Hey Deb, I come from a large family too. There are seven of us kids in my family. I am the youngest. I understand how you feel about the whole wanting to go to the Barix clinic for your surgery. I wanted to also, but the surgeon I went to was very good and did a great job. Everything will work out and remember the harder it is the more you will work at it and appreciate it later in life. Keep your chin up and good things are coming your way.
janae

03-31-2006, 08:20 PM	#1 (permalink)
Treasured Whipper Snapper Join Date: Mar 2006 Location: northeast of Dallas, TX Posts: 36 Please Enter Height:	Hi! New here! Hello everyone! My name is Deborah .. Deb to my friends ... and I just plopped in here a little while ago from cyberspace! LOL! Like falling in a rabbit hole ... but excited to find this place. My profile is also on the OH board if any of you ever go over there, you can check me out. I'm new to this whole process and today I've just been in total "meltdown" mode and in tears most of the afternoon. After jumping through all the hoops required for WLS through Barix Clinics of TX and submitting it all to my insurance company, I found out TODAY that the surgeon & hospital are out of network for my insurance so it will only pay 50%! Lord, Jesus, help me! They couldn't have told me that right up front???!!! Now I have to start all over again??!! But I'm not going to dwell on that right now .. I just have to stay focused on the "other side" and keep moving forward, whatever that takes. Oh, BTW .. I'm 54, married to the love of my life for nearly 34 years, have 8 kids .. all married except my 21-yr-old baby boy .. and just found out that we're expecting another grandbaby sometime around the holidays. So life is good! I'm looking forward to getting acquainted with everyone here! Hugs, Deb

03-31-2006, 08:27 PM	#2 (permalink)
freebird WLS Mentor Join Date: Feb 2006 Location: outside of Ottawa Ontario Posts: 1,187 Please Enter Height:	Hi Deb! Welcome. it's good to have you here. That sucks about the insurance company. Craig has an insurance e-book that you might find very informative and useful. It's loaded with info i think it might help you in your journey. Come join us on monday morning for the 10am chat. Hope to see you there. __________________ Don't let todays sorrows cloud tomorrows dreams (Surgery date? = still waiting)

03-31-2006, 09:31 PM	#3 (permalink)
DocSanae Super Moderator Join Date: Nov 2005 Location: Tokyo, Japan Posts: 9,865 Blog Entries: 2 5' 5" Height:	Welcome Deb. I'm praying that everything will work out for you. ((((((HUGS))))))) __________________ "In every job that must be done, there is an element of fun." Just a li'l bit 'bout myself Last edited by DocSanae; 04-01-2006 at 07:49 AM.

04-01-2006, 06:36 AM	#4 (permalink)
xsmith95 WLS Master Guru Join Date: Feb 2006 Location: Near St. Louis, MO Posts: 633 Weight Statistics June 17, 2005 Start Date: June 17, 2005 Surgery Date: 5' 2" Height: 313 lb Start Weight: 173 lb Current Weight: 140 lb Goal Weight: 140 lb Weight Loss: 33 lb Lb Left to Lose: 44.7284345048 % % Lost: don't have a set goal date, I take it day by day that way I don't get discouraged Goal Date: Body Mass Index 57.2421956296 BMI Start: 31.6386576483 BMI Current: 25.6035379813 BMI Goal: Weight Loss Method Roux en Y Gastric Bypass	Welcome Deb. Just stay positive. I kind of had the same thing happen to me. I jumped through all the hoops, had all the testing done I needed, submitted to the insurance company for them to tell me "medically necessary" or not they would not cover my surgery. I was lucky enough to have a secondary insurance and they do pay for the surgery. It only took me a month for approval after finding a new surgeon to take my secondary insurance. Just remember you have done all that you need to and will be much easier the second time around and hopefully will be much faster too! Good Luck. __________________ Shelley He who finds diamonds must grapple in mud and mire because diamonds are not found in polished stones. They are made.

04-01-2006, 08:27 AM	#5 (permalink)
Treasured Whipper Snapper Join Date: Mar 2006 Location: northeast of Dallas, TX Posts: 36 Please Enter Height:	Thanks, you guys. I'm feeling a little more positive right now over my morning coffee. I know this is still going to happen .. it's just that I really wanted to have it done through Barix. I live just 30 minutes from the clinic, it's the ONLY thing that's done there .. they're all bariatric specialists and perform no other kind of surgery and my surgeon was one of the leaders in the field having performed over 5,000 surgeries with less than 10 deaths in 25 years. I'd already joined the support group and was developing relationships with some of the people there. I'm just so disappointed, and I guess it's partly my own fault. I called the clinic first instead of the insurance company and just took their word that they were covered by my insurance. Then it all just snowballed and it looked like this was actually going to happen within the next 30-60 days. I was so psyched .. I feel like someone just popped my balloon. But I stayed up half the night and I've found another surgeon and hospital close by who ARE in-network for me and I'll just have to call them Monday and see what their procedure is. The hospital he uses does at least have a dedicated Bariatric Floor with a specially trained staff so I guess that's a plus. I read the doc's profile and saw his picture ... he graduated from Med School in 1996! Great ... I get Doogie Howser! (She sighs and takes another sip of coffee...) __________________ "Therefore God exalted Him to the highest place and gave Him the Name that is above every name." Philippians 2:9



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	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.

04-01-2006, 08:36 AM	#6 (permalink)
xsmith95 WLS Master Guru Join Date: Feb 2006 Location: Near St. Louis, MO Posts: 633 Weight Statistics June 17, 2005 Start Date: June 17, 2005 Surgery Date: 5' 2" Height: 313 lb Start Weight: 173 lb Current Weight: 140 lb Goal Weight: 140 lb Weight Loss: 33 lb Lb Left to Lose: 44.7284345048 % % Lost: don't have a set goal date, I take it day by day that way I don't get discouraged Goal Date: Body Mass Index 57.2421956296 BMI Start: 31.6386576483 BMI Current: 25.6035379813 BMI Goal: Weight Loss Method Roux en Y Gastric Bypass	Doogie Howser! how funny! Don't fret all will work out for the best. Just put it in God's hands. He has his ways of dealing with things. I learned that going through my approval process. __________________ Shelley He who finds diamonds must grapple in mud and mire because diamonds are not found in polished stones. They are made.

04-01-2006, 05:33 PM	#7 (permalink)
RobinZ Big Loser Join Date: Mar 2006 Location: Newburgh, NY Posts: 131 Please Enter Height:	Hi Deb! Welcome, and best wishes that everything goes smoothly from here on out. Doogie Howser may not be so bad, might know all the latest and greatest techniques! The insurance issue stinks, sorry you had to go through that, the insurance companies are tricky. I had to self pay, so it ended up being an easier road to go down, although costly I'd do it again in a minute. 8 kids - WOW. How many grands? I've got 4 grands and they are all a delight! __________________ Hugs - RobinZ

04-01-2006, 08:19 PM	#8 (permalink)
Treasured Whipper Snapper Join Date: Mar 2006 Location: northeast of Dallas, TX Posts: 36 Please Enter Height:	Hi Robin! Thanks for the welcome. I'm sure when I get on the "other side" that whatever headaches I have to go through right now will be well worth it. I'm just so ready to do it. From our 8 kids we've got 15 grands, with #16 due sometime between Thanksgiving & Christmas ... and our first great-grandson is 8 weeks old. We've got the 2 youngest ones here with us tonight giving mom & dad a night out ... they're the ones who just found out #3 is on the way. I love being a grandma but I want to be the kind who goes out and plays football & basketball with them as well as reading them stories so that's part of my incentive to have this surgery. Hugs for you too! __________________ "Therefore God exalted Him to the highest place and gave Him the Name that is above every name." Philippians 2:9

04-11-2006, 03:06 PM	#9 (permalink)
Pillows Seasoned Veteran Join Date: Feb 2006 Location: McGuire Air Force Base, New Jersey, USA Posts: 2,495 Please Enter Height:	Hey Deb, I come from a large family too. There are seven of us kids in my family. I am the youngest. I understand how you feel about the whole wanting to go to the Barix clinic for your surgery. I wanted to also, but the surgeon I went to was very good and did a great job. Everything will work out and remember the harder it is the more you will work at it and appreciate it later in life. Keep your chin up and good things are coming your way. janae __________________ "Being happy doesn't mean that everything is perfect...it means that you have learned to see past the imperfections. " Surgery date April 4th 2006

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