TXEd.Dhelper
Member
New year and new step! I have to complete a simple psychological evaluation by phone. I am now 2 steps from my life changing goal of revision to bypass due to GERD and other health issues.
Step 3 of 5!
- Thread starter TXEd.Dhelper
- Start date
dianeseattle
Member
Glad to know you're moving along so quickly now to the best decision you'll ever make! keep us posted.
TXEd.Dhelper
Member
Can't sleep do to reflux due to pain. I have another doc's appointment this week. I am believing that my latest sergeant will give me a firm date for this procedure. And, yes I would do it all again! I am healthier in 2023 versus 2014 (-75).
Littlebirdiesmom
Member
I hope you will get your surgery date! (I’ve heard others call it “your second birthday”. I didn’t get that until I went through it. I had pretty bad acid reflux and this surgery (so far) has helped immensely. Good luck!
TXEd.Dhelper
Member
Yep, after reviewing all the data my current doctor recommends "bypass." He is willing to push the insurance company as much as possible. Additionally, I am willing to go to court if necessary! The next step "getting the approval and surgery date." I am believing for the best outcome! I'll never stop fighting for my best health %!
I really hope you receive a surgery date soon. My PCP advocated for three years, and it was the surgeon's office that worked with insurance company to meet their requirements, including attending the dietician meetings and the psychologist's assessment. I did not need to contact the insurance company at all, the surgeon's admin staff coordinated with them. I hope it is as streamlined for you as it was for me.
dianeseattle
Member
My surgeon also wrote the necessary letter to Medicare. He actually had a form letter he just plugged different patient's names into. Insurance doesn't want to deny the surgery. But the rule of thumb used to be that you had to be 100 pounds overweight to qualify, and if that was the case, adding in a doctor's letter and a surgeon's letter sealed the deal.
They just want to have the documents to prove that the payout (up to $20k) is justified.
Congratulations, Tex.
They just want to have the documents to prove that the payout (up to $20k) is justified.
Congratulations, Tex.
TXEd.Dhelper
Member
Thanks everyone! I will never give up. I have had the same insurance since a year after my sleeve. They don't want to cover my new procedure due to blaming my previous wls. However, that procedure was done in a different state and employer. I work and pay for my coverage. I really don't understand why everything has to be a fight! I just want to be my healthiest self!
TXEd.Dhelper
Member
In a few hours I have meeting. I should have an idea of a date/plan for my procedure. There is a part of me that after this 4 year fight I just want to run. However, considering after taking a handful of antacids, anti-anxiety meds, pain pills and a shot of tequila? I still can't sleep. My throat is burning!
Healthier Me
Member
You got this. This is what you’ve been working toward.
TXEd.Dhelper
Member
The consensus is the sugery is "medically necessary." Now, let see how long it takes to coordinate services? I need some relief. I feel completely drained physically and emotionally.
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dianeseattle
Member
If you don't mind a little advice, try NOT doing instead of DOING. In other words, instead of taking any action or hamster-wheeling your fears, sit quietly, breathe in through the nose and out through the mouth. It doesn't have to be consistent or even meditative. It just has to have a calming effect, and it will.
TXEd.Dhelper
Member
I get it. I don't have a clue how not to fight. I never had anything given to me. In this world, people often see me as a strong woman. I am a wife, a person with a disability, Director, and a Doctorial Candidate. I live my life to create maps so others will not to weather as many storms. However, this process is exhausting. I want to make easier for those who will come behide me!