Twelve more sleeps!
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boomerkae
Posts: 217 Member
Twelve more sleeps till I'm knocked way out and have most of my stomach taken out!
After calling my insurance company every few days since I knew the paperwork was submitted, Monday they finally told me I was approved. Yes, I wanted to wait on hold while they called to inform the practice!
A couple hours later I had a phone call from the practice. I could have the surgery on 11/20, but with the surgeon I hadn't consulted with, or wait until 12/1 for mine..... Since Doc #2 did my scope and seemed fine, I opted for the earlier day.
I counted days while on the phone with them and realized that meant I started the preop shakes they require (impact) and my bariatric vitamins the next day. Since I lack comorbidities, I can't lose too much or I'll fall below BMI for approval, so I am still on a full diet, just adding those awful shakes. I've gotten used to the powdered vitamins.
With a compressed schedule, I have 3-4 hours of preop education Monday, an hour break then all the pre-op admission testing at the hospital. Two days later, it's consult/consent with the surgeon.
I'm excited. I'm scared. I actually cried when I hung up the phone.
I am so busy at work, renovating our home, and preparing for this - It's taken me this long to share the news!
After calling my insurance company every few days since I knew the paperwork was submitted, Monday they finally told me I was approved. Yes, I wanted to wait on hold while they called to inform the practice!
A couple hours later I had a phone call from the practice. I could have the surgery on 11/20, but with the surgeon I hadn't consulted with, or wait until 12/1 for mine..... Since Doc #2 did my scope and seemed fine, I opted for the earlier day.
I counted days while on the phone with them and realized that meant I started the preop shakes they require (impact) and my bariatric vitamins the next day. Since I lack comorbidities, I can't lose too much or I'll fall below BMI for approval, so I am still on a full diet, just adding those awful shakes. I've gotten used to the powdered vitamins.
With a compressed schedule, I have 3-4 hours of preop education Monday, an hour break then all the pre-op admission testing at the hospital. Two days later, it's consult/consent with the surgeon.
I'm excited. I'm scared. I actually cried when I hung up the phone.
I am so busy at work, renovating our home, and preparing for this - It's taken me this long to share the news!
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Replies
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Congratulations first off!
Now for the odd question. I had to go through a 6 month doctor supervised diet for my insurance company and one of the specific questions I asked was; "What if I get down below 35% BMI?" I was told that it made no difference since to begin with, I had to have 5 years of documented BMI of over the 35%. My entire time I was in contact with a "case worker" from United Health Care. I had to contact her after each visit to track my progress or lack thereof. They wanted to see me losing, even before the surgery.
I understand the comorbidities, but the pre-op diet is simply to shrink the liver so it would be easier to work around. This is the first time i've heard of the possibility of getting rejected because of falling below BMI during the pre op.
Either way, it's just odd how some insurances work. I'm sure this post is coming across a bit questionable, I don't mean for it to. Like I said, the pre op diet is supposed to be done for the patient's own safety. However, it is interesting reading how people's insurances and surgeons handle each case differently.
Good luck, you won't regret it.
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I have the same question as Jamezln.
I suggest calling to confirm the pre-op diet is supposed to be full food *plus* shakes. that doesn't make sense to me.
Good luck and we're all pulling for you!
Rob0 -
Thanks for the support!
Believe me, I've questioned this BMI thing a gazillion times. I've lost 30lbs since I first went to a seminar with the clinic. I like to think some is from diet change and exercise, but, during the process, I tested negative for sleep apnea, but was diagnosed with narcolepsy. The medication I'm on is basically an upper, and both the prescribing MD and pharmacist said it'd make me lose weight.
For my insurance, I had to show two years of history of high BMI. After adding the meds, I started dropping some weight. It was actually the practice nutritionist, not MD that told me to be careful, and that the qualifying BMI is at sign of consent, not when the paperwork is submitted.
I asked two reps at Aetna, and they said it wouldn't matter, that I'm approved. I asked the insurance liaison at the practice, and they again referred to consent or even day of surgery. When I received the approval letter in the mail, it noted that if anything changed in my health, the case would be reviewed and possibly not covered. So, I'm going with the play it safe and try to keep the BMI (above 40 for me). It's been hard. The surgeon has told me no gaining. that's it. I guess since' I've lost so far, I've done enough.
Yep, I'm food plus the shakes and bariatric vitamin. I am supposed to still restrict the bad carbs though. I wish I wasn't...I'd like the practice, and wouldn't mind loosing more preop. It's been hard to maintain. I have a comfort zone, but I think the doc office would prefer I stay at 41 so I don't have insurance issues. I lose 6 lbs in the next 10 days, I'm toast.0 -
Wow that's quiet the conundrum. Good luck! I'll be pulling for you.0
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Like jamezln said, we're all pulling for you to succeed!0
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Congrats on upcoming surgery! Good luck on your new journey.0
