Re: Denied

[Guest guest]

Ahhhh Sharon....shit.

Wrapping my heart around you while you cry. Lets have a good cry,

get it out of the system so you can make room for the anger to fight

the mean nasty stupid insurance company.

Christ this is the year 2003 not the 1800's...what woman needs or

wants an apron or saddle bags? Especially ones made of skin....geez

Hugging you tight

Jo

[Guest guest]

Oh Sharon, my heart goes out to you. Have a very good cry (if you haven't

already) and then get MAD and FIGHT BACK! Hugs and blessings, Ann

[Guest guest]

Hi Sharon,

I am so sorry about the denial for surgery. Those rashes you get

are so painful, I get them also. I used to feel ugly with my apron I

have had one for 26 years. However everyone who has ever seen it who

loved me said I was beautiful even with that (body flaw as I called

it) and that I was too hard on my self. I look forward to a day

without mine but if I am stuck with it I will be very sad too.

Are you able to have that surgery if you have a hernia repair? I

am not saying go out and get a hernia but I do hear alot of people

talking about that.

I wish I could give you a hug.... I don't feel like an email could

comfort you as well. I have seen miracles happen for people who get

denied a procedure and I hope for that for you. I also hope that you

will take pictures of these rashes you get and perservere. OH and by

the way you are a beautiful person with or without an apron.... I am

sure that your husband loves you every night he sees you.

My best wishes and prayers to you,

Kinsey

[Guest guest]

In a message dated 4/30/2003 8:32:59 PM Central Daylight Time,

roseofsharon_ps121@... writes:

> So I have to get mad...

> thanks for being a good friend,

> Shaton in Onyx

> who- shit, shit, shit, cant get these water works to stop....

>

Sharon,

As one who cried in Walmart last week when she looked in the full

mirror, I can understand....Seems the more I lose the worse it looks to me.

Shit, by the time I lose a hundred pounds I will be so vain noone will stand

me....LOL.

Get mad and fight them. I understand it is considered reconstructive

if you lose more than 100 lbs, so find out how others did it. And why the

hell is dr. K and the other docs word not good enough?? I mean, who are they

to tell you who should treat your rashes....LOL??? Get mad and Get even

Girl!!

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

04/25- 315 (minus 62.5 lbs)

[Guest guest]

> Sharon, I hate insurance companies! You let a stranger look at

naked pics of you and then get told it is cosmetic. Kee-ripes. Hey,

start documenting. You can get I will be documenting after reading

what you wrote. Marta

>

I know, I cant even believe after what he saw, that he could

actually sit there and say it was cosmetic....like I was having my

nose redone or something.. I wish he could for just one day carry

around these things on my legs, try to walk fast, or sleep on his

side...just one day. I am in total amazement. I do have

documentation about my rashes. My gyno, and Dr. K before surgery.

But they want it from my pcp, who I havent gone back to since he

told me I was to weak of mind to diet.

heavy sigh. I am going to appeal.

Sharon in Onyx

who is getting her dander up, just thinking about someone looking at

those pics laughing and saying she lost all that weight just to look

like this...

[Guest guest]

In a message dated 4/30/2003 9:41:45 PM Central Daylight Time,

roseofsharon_ps121@... writes:

> The first thing that went thru my mind was he isnt to bright

> insulting a woman that is 3 times his size, heck I was thinking I

> could take him out in a heartbeat, but then I wouldnt have got my

> referal to Dr K. So I behaved, and he still lives.

> hugs back,

> Sharon in Onyx

>

OMG Sharon, A woman after my own heart!!

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

04/25- 315 (minus 62.5 lbs)

[Guest guest]

> Ahhhh Sharon....shit.

>

>

> Wrapping my heart around you while you cry. Lets have a good cry,

> get it out of the system so you can make room for the anger to

fight

> the mean nasty stupid insurance company.

>

> Christ this is the year 2003 not the 1800's...what woman needs or

> wants an apron or saddle bags? Especially ones made of

skin....geez

>

> Hugging you tight

> Jo

The only place for saddle bags is on a horse. And my Nona wore an

apron, but a pretty one...

thanks for the hug...I have to stop crying now as my DH will be home

soon and it hurts him when I cry. So I have to get mad...

thanks for being a good friend,

Shaton in Onyx

who- shit, shit, shit, cant get these water works to stop....

[Guest guest]

> Ok Sharon

>

> First of all..you do not look obscene!

::I will send you pics to prove it. lol no, it would ruin your

youth, cnat do that.

You are absolutely gorgeous and any flaws are always hidden by your

beautiful personality and smile. (Believe me - Aussies dont say

nice things if we dont mean it!)

I am sorry this has happened but I beleive you will get the surgery

when the time is right..keep fighting.

>

> You are a lovely person and we all care about you deeply..please

dont be too upset. Call on us for support whenever you need to!

>

> Love

> Kristy

Thanks for being a good friend, Kristy, I will keep smiling as soon

as I can get these water works to stop. I care about you too, go to

the Dr. Did you get your card?

I will fight them sob's you better believe it!

thanks for the encouragement...

love you too,

Sharon in Onyx

who knows that aussies dont sugar coat anything! Just tell iti like

they see it.

[Guest guest]

> Are you able to have that surgery if you have a hernia repair?

::I do not have a hernia, if I did the cost for the panni and

sadllebags would be minimal and I could self pay. I am 16 months

out and probably wont get a hernia now if I did try.

I wish I could give you a hug.... I don't feel like an email could

> comfort you as well. I have seen miracles happen for people who get

> denied a procedure and I hope for that for you. I also hope that

you will take pictures of these rashes you get and perservere.

:: My DH will be taking pics tonite. And email comfort is good

enough for me. thank you for the hugs and encouragement. I will

fight this, and not give in so easily.

My best wishes and prayers to you,

> Kinsey

thank you for the prayers, I know the evil one is messing with me,

as I am working a Christian retreat starting tomorrow, and as my DH

reminded me, I always get attacked just before these weekends...so

It isnt over yet.

thanks again,

sharon in onyx

who isnt crying anymore...

[Guest guest]

First of all! Regardless of what YOU think, your hubby thinks you're

beautiful and so do we! You may see big thighs and an overhanging

panni, but we see this woman with a gorgeous smile, sparkling eyes

and someone that we're really glad to know! As for your insurance

company..I've heard that it's pretty standard for insurance companies

to deny PS on the first request, so definitely APPEAL. Do you have a

direct contact or can you get a direct contact in your insurance

companies medical management/pre-authorization department so you can

fax the information directly to them and you're not just an anonymous

statistic ?

*hugs*

Anita in Denver

> Hi all

> Well I just got off the phone with and UHC denied my

> reconstructive surgery. He said it was cosmetic. lol ....He saw

> my pictures with my apron hanging and these saddle bags hanging and

> said it was cosmetic, can you believe it. I am trying not to cry...

> said I needed Dr. proof that these rashes I get wont go

> away with antibiotics etc, extensive Dr. reports. Well I never

went

> to a dr. for these rashes, I have always just dealt with them. My

> immobility due to these things on my legs, well what could a dr do

> other than suggest they be removed, which is why I went to Dr. Bae

> after Dr. K suggested it.

> Well at least one good thing came out of it. I found that I am

more

> scared to live with these abnormalities, then of having the

> surgery. Before I was just scared of the surgery.

> I am totally heart sick, and sick to my stomach...I cant believe it

> wont happen on may 23rd....I just cant believe it.

> I look obscene, and now it seems like I will be forever disfigured.

> YUCH!!! And my poor hubby gets to see this every nite before he

goes

> to bed, all I can think of is the nightmares it must cause. Great

> foreplay, huh?

> sigh...

> Sharon in Onyx

> ok, who is now crying, for heaven sake...this is ridiculous!

[Guest guest]

Rocky,

You need a new PCP since you can't give your current one a swift boot

to the head! I'm sure you can find a better one!

*hugs*

Anita in Denver

My gyno, and Dr. K before surgery.

> But they want it from my pcp, who I havent gone back to since he

> told me I was to weak of mind to diet.

> heavy sigh. I am going to appeal.

> Sharon in Onyx

> who is getting her dander up, just thinking about someone looking

at

> those pics laughing and saying she lost all that weight just to

look

> like this...

[Guest guest]

> First of all! Regardless of what YOU think, your hubby thinks

you're beautiful and so do we! You may see big thighs and an

overhanging panni, but we see this woman with a gorgeous smile,

sparkling eyes and someone that we're really glad to know! As for

your insurance company..I've heard that it's pretty standard for

insurance companies to deny PS on the first request, so definitely

APPEAL. Do you have a direct contact or can you get a direct

contact in your insurance companies medical management/pre-

authorization department so you can fax the information directly to

them and you're not just an anonymous statistic ?

>

> *hugs*

> Anita in Denver

>

I am so thankful for friends like you. I know my honey loves me,

heck he loved me at 347lbs, and my heart knows this, but sometimes

my head says it isnt so.... I have had a little time to calm down

and as Jo put it , get mad! and will definately appeal. My DH has

contacted someone in his company to find a contact to appeal

through. There not finished seeing me yet. And if the appeals has

a problem well, I will email them these Obscene pictures and they

can loose their lunch...it would serve them right. lol

thanks Anita, for being here and a friend...I dont know what I would

do with out you all.

Hugs back,

Sharon in Onyx

[Guest guest]

> Rocky,

>

> You need a new PCP since you can't give your current one a swift

boot

> to the head! I'm sure you can find a better one!

>

> *hugs*

> Anita in Denver

Yea, I know, but in a remote area like mine you have to take what is

within 50 miles from you and he is it. The humerous thing about it

is, he is a very small man, and when he told me this I weighed 335

lbs. The first thing that went thru my mind was he isnt to bright

insulting a woman that is 3 times his size, heck I was thinking I

could take him out in a heartbeat, but then I wouldnt have got my

referal to Dr K. So I behaved, and he still lives.

hugs back,

Sharon in Onyx

[Guest guest]

> Sharon, you should fire your PCP and get a new PCP. I can't

believe it! PCP's are a dime a dozen, find a nice one like me!

Marta

Oh, Marta,

If I only could, you would definately be my choice, Hands down.

S in O

[Guest guest]

Sharon...besides taking pics of rashes and getting into your PCP to

document them (and even if he prescribes antibiotics, fill the

prescription but you don't have to use them then keep going back

complaining the rash isn't going away) Plus...could you get a

specialist to exam you and write it up that because of the apron and

saddle bags it changes your gait/stride/walk and is doing damage to

your back? At the very least start complaining of back pain and the

tripping when you walk. Make sure your pcp documents your

complaints.....Anything that can be related to the apron and

saddlebags causing problems...complain, complain, complain.

Jo

[Guest guest]

Sharon..APPEAL APPEAL APPEAL!!! Most insurance companies turn down

requests automatically, hopeful that the patient doesn't know their

rights and will quietly fad into the sunset. There is ALWAYS someone

over the person that denied you...keep going!!!!!

[Guest guest]

> Sharon..APPEAL APPEAL APPEAL!!! Most insurance companies turn down

> requests automatically, hopeful that the patient doesn't know

their

> rights and will quietly fad into the sunset. There is ALWAYS

someone

> over the person that denied you...keep going!!!!!

Hi

Good to see you back. Hows Katz?

I am going to appeal. Can I keep appealing if I self pay so I dont

loose my date? I will be appealing before this natrually, just that

I know they arent in a big hurry to answer.

I hate to loose this date as it will be months before I can get

another.

Delano Reg & Dr K are in my plan book, I know they saw the pics, I

just dont understand their reasoning. But now thye are in for a

fight!

Sharon in Onyx

who is now pi**ed

[Guest guest]

> Yea, I know, but in a remote area like mine you have to take what

is

> within 50 miles from you and he is it. The humerous thing about it

> is, he is a very small man, and when he told me this I weighed 335

> lbs. The first thing that went thru my mind was he isnt to bright

> insulting a woman that is 3 times his size, heck I was thinking I

> could take him out in a heartbeat, but then I wouldnt have got my

> referal to Dr K. So I behaved, and he still lives.

> hugs back,

> Sharon in Onyx

~~~~~~~~~~~~~~~```

Sharon,

My heart breaks for you. But remember this at your retreat this

weekend.You are with a lot of women praying and prayer is a

powerful thing so good things can come thru with this retreat.

Yes, get mad and fight,some of these people are so dumb,dumb,

dumb. Things will work out...Just remember all good things

happen in Gods time, not ours...darn,darn...lol

God bless,

Pat

[Guest guest]

Does anyone know how hard it is to get skin fixed with medicare or am I going

to have to fight them to get it done? Or wait forever until Tom finishes

school(2 yrs) and gets a job and the waiting time is up??

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

04/25- 315 (minus 62.5 lbs)

[Guest guest]

Sharon,

I'm collecting information for the day when I may need surgery for

the extra skin.

The web site shown below might help you in identifying the items you

need to document. You may also want to include this article in your

appeal. It shows the Recommended Criteria for Third-Party Payer

Coverage for Treatment of Skin Redundancy Following Massive Weight

Loss

http://www.plasticsurgery.org/medical_professionals/publications/Treat

ment-of-Skin-Redundancy-Following-Massive-Weight-Loss.cfm

Beverly in Antioch

-DS on 3/10/2002

> roseofsharon_ps121 <roseofsharon_ps121@y...> wrote:--- I do have

> documentation about my rashes. My gyno, and Dr. K before surgery.

> But they want it from my pcp, who I havent gone back to since he

> told me I was to weak of mind to diet.

> heavy sigh.

> >

[Guest guest]

In a message dated 5/2/2003 12:51:27 PM Central Daylight Time,

p_welborn13@... writes:

> 62.5 lbs.....Way to go girl!!!!

> Pat in Taft

>

See todays sig line....LOL<grinning big>

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

05/02- 311 (minus 66.5 lbs)

[Guest guest]

In a message dated 5/2/2003 4:34:29 PM Central Daylight Time,

ambert@... writes:

> congrats on the scales moving

> Amber In Hawaii

>

Thanks Amber, I have had a good month so far haven't I?...LOL

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

05/02- 311 (minus 66.5 lbs)

[Guest guest]

> Does anyone know how hard it is to get skin fixed with medicare or

am I going

> to have to fight them to get it done? Or wait forever until Tom

finishes

> school(2 yrs) and gets a job and the waiting time is up??

>

> in Bama

>

>

http://hometown.aol.com/mdl1031/myhomepage/profile.html

> Surgery- RNY to DS revision on12/6 -377.5

> 12/17 - 346.5 ( minus 31lbs)

> 01/15- 338.1 (minus 39.1lbs)

> 02/12-330.0 (minus 47.5 lbs)

> 04/06- 324.3 (minus 53.2 lbs)

> 04/25- 315 (minus 62.5 lbs)

> ~~~~~~~~~~~~~~~~~~`

Mel,

I am not sure how hard it is as you know I had a hernia repair

with my tt,but I have Medi/Medi=Medical/Medicare and they always

bill Medicare first and they paid on my tt.

62.5 lbs.....Way to go girl!!!!

Pat in Taft

>

>

[Guest guest]

In a message dated 5/2/2003 5:10:12 PM Central Daylight Time,

ambert@... writes:

> yes you have lets hope this is a new trend for you

> Amber In Hawaii

>

If I lost this much every 6 months I'd be happy with the end result.I just

hope it doesn't slow down too much!

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

05/02- 311 (minus 66.5 lbs)

[Guest guest]

congrats on the scales moving

Amber In Hawaii

gastric stapling 1989 lost 40#

D.S. July 8th 2002

starting wt 287 size 26

wt at 9 months 172 size 14

starting BMI 48 NOW 29

Re: Re: Denied

In a message dated 5/2/2003 12:51:27 PM Central Daylight Time,

p_welborn13@... writes:

> 62.5 lbs.....Way to go girl!!!!

> Pat in Taft

>

See todays sig line....LOL<grinning big>

in Bama

http://hometown.aol.com/mdl1031/myhomepage/profile.html

Surgery- RNY to DS revision on12/6 -377.5

12/17 - 346.5 ( minus 31lbs)

01/15- 338.1 (minus 39.1lbs)

02/12-330.0 (minus 47.5 lbs)

04/06- 324.3 (minus 53.2 lbs)

05/02- 311 (minus 66.5 lbs)