I was denyed - and I'm depressed...

[Guest guest]

Hello other Tara,

I am not going to use Dr. R..for different reasons...I'm depressed too and

feel very selfish.

My hubby has an awful job with good insurance (they cover WLS...but usually

you have to go through one appeal I hear)...he may be getting a reallllllly

good job offer with insurance that doesn't cover the procedure. If only

Ihad kept my appointment back in December, this wouldn't be an issue. We can

only afford to COBRA the insurance for a few months...which means I have to

have surgery by July. My consultation is in May....then I got to get

approved...then schedule the surgery. I'm hoping he can hold off the job

until June...after I get approval (I'm worried once the insurance comapny

knows I am a COBRA policyholder that they will deny it trying to run down the

clock). I feel so selfish...my hubby really hates his job. What do you

all think?

Tara

[Guest guest]

Hello other Tara,

I am not going to use Dr. R..for different reasons...I'm depressed too and

feel very selfish.

My hubby has an awful job with good insurance (they cover WLS...but usually

you have to go through one appeal I hear)...he may be getting a reallllllly

good job offer with insurance that doesn't cover the procedure. If only

Ihad kept my appointment back in December, this wouldn't be an issue. We can

only afford to COBRA the insurance for a few months...which means I have to

have surgery by July. My consultation is in May....then I got to get

approved...then schedule the surgery. I'm hoping he can hold off the job

until June...after I get approval (I'm worried once the insurance comapny

knows I am a COBRA policyholder that they will deny it trying to run down the

clock). I feel so selfish...my hubby really hates his job. What do you

all think?

Tara

[Guest guest]

Well, my insurance company finally got back to me -

with a denyal on the grounds that I could have the

surgery done locally - so now what do I do??? I do

meet all of the criterior - so if I go to a local

surgeon they will pay for it. There is a local surgeon

who ONLY does WLS (open) - and he is supposed to be

wonderful. My sister-in-law had it done by him 4 years

ago and praises him like all of us praise Dr.

Rutledge. I don't understand how the insurance company

can refer to open surgery as being the same as a lap

procedure? The lap is cheaper - and there is less risk

involved - seems to me they would jump at the chance!

They are sending me a letter to go through the appeals

process - I am just so tired of waiting. Do I put this

off for another few months - or do I go ahead and

" cross to the other side " the hard way with the open

procedure??? Hmmmm.... Do you suppose Dr. Rutledge

could set up a payment plan? Ha-ha - ....... Maybe I

could put the surgery on " lay-away " ! I think I'll

go eat a chocolate bunny... just kidding -

BOOOOOOOOOOOOOO I am so discouraged!

Sorry to vent - but it had to go

somewhere... Tara Lynn

--- jfehl wrote:

>

>

> I hear you, Tara....I was 286 when my husband

> married me....219 when he

> left...we had issues...but weight was not one of

> them...now I'm 310 and

> he's showing renewed interest...hmmmm....go

> figure...

>

> Cara

>

>

------------------------------------------------------------------------

> Start a new hobby. Meet a new friend.

> http://www.ONElist.com

> ONElist: The leading provider of free e-mail list

> services!

>

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> This message is from the Mini-Gastric Bypass List at

> Onelist.com

>

_________________________________________________________

[Guest guest]

Tara--

Our policy is a COBRA policy, and it didn't seem to make any difference in

the decision making. My company is AETNA. I don't know about other

companies.

Katy

[Guest guest]

Tara--

Our policy is a COBRA policy, and it didn't seem to make any difference in

the decision making. My company is AETNA. I don't know about other

companies.

Katy

[Guest guest]

Tara Lynn!

DO NOT GIVE UP!

What's the name of the doctor locally? The one that did your sister-in-laws

surgery? I'm just curious (and nosey!). Maybe a little research about this

local doc wouldn't hurt, but don't give in until you have as much info as

possible about him/her! Okay? Okay! Let me know what's going on!

[Guest guest]

Tara,

I know that some insurances will cover surgery that's " out of network " if

the procedure can't be done " in network " . If there are not doctors doing

the bypass lap in your area, then perhaps they'd be willing to consider

payment to Rutledge. Especially since it's less expensive. Perhaps Dr. R

could submit to them the rational/benefits of the lap procedure over the

open procedure. Just some thoughts. I really feel for your dilemma. I do

know that if an open was my only option for bypass surgery, I'd take it. I

know of many, many people who have had it done open and have no regrets.

Hang in there.

Merritt

I was denyed - and I'm depressed...

>

>

>

>Well, my insurance company finally got back to me -

>with a denyal on the grounds that I could have the

>surgery done locally - so now what do I do??? I do

>meet all of the criterior - so if I go to a local

>surgeon they will pay for it. There is a local surgeon

>who ONLY does WLS (open) - and he is supposed to be

>wonderful. My sister-in-law had it done by him 4 years

>ago and praises him like all of us praise Dr.

>Rutledge. I don't understand how the insurance company

>can refer to open surgery as being the same as a lap

>procedure? The lap is cheaper - and there is less risk

>involved - seems to me they would jump at the chance!

>They are sending me a letter to go through the appeals

>process - I am just so tired of waiting. Do I put this

>off for another few months - or do I go ahead and

> " cross to the other side " the hard way with the open

>procedure??? Hmmmm.... Do you suppose Dr. Rutledge

>could set up a payment plan? Ha-ha - ....... Maybe I

>could put the surgery on " lay-away " ! I think I'll

>go eat a chocolate bunny... just kidding -

>BOOOOOOOOOOOOOO I am so discouraged!

> Sorry to vent - but it had to go

>somewhere... Tara Lynn

>

>

>

>

>

>

>

>

>--- jfehl wrote:

>>

>>

>> I hear you, Tara....I was 286 when my husband

>> married me....219 when he

>> left...we had issues...but weight was not one of

>> them...now I'm 310 and

>> he's showing renewed interest...hmmmm....go

>> figure...

>>

>> Cara

>>

>>

>------------------------------------------------------------------------

>> Start a new hobby. Meet a new friend.

>> http://www.ONElist.com

>> ONElist: The leading provider of free e-mail list

>> services!

>>

>------------------------------------------------------------------------

>> This message is from the Mini-Gastric Bypass List at

>> Onelist.com

>>

>

>_________________________________________________________

>

[Guest guest]

Tara,

Wish I knew what to tell you but I am anxious about my PPO soing the

same thing because some of their Preferred Providers (or perverted providers

as I like to call some of them) also do gastric surgery for obesity....I'll

" listen in " and see what others have to say but " good luck " in the meantime

( and at least you had some type of approval!).

Amy

I was denyed - and I'm depressed...

>

>

>

>Well, my insurance company finally got back to me -

>with a denyal on the grounds that I could have the

>surgery done locally - so now what do I do??? I do

>meet all of the criterior - so if I go to a local

>surgeon they will pay for it. There is a local surgeon

>who ONLY does WLS (open) - and he is supposed to be

>wonderful. My sister-in-law had it done by him 4 years

>ago and praises him like all of us praise Dr.

>Rutledge. I don't understand how the insurance company

>can refer to open surgery as being the same as a lap

>procedure? The lap is cheaper - and there is less risk

>involved - seems to me they would jump at the chance!

>They are sending me a letter to go through the appeals

>process - I am just so tired of waiting. Do I put this

>off for another few months - or do I go ahead and

> " cross to the other side " the hard way with the open

>procedure??? Hmmmm.... Do you suppose Dr. Rutledge

>could set up a payment plan? Ha-ha - ....... Maybe I

>could put the surgery on " lay-away " ! I think I'll

>go eat a chocolate bunny... just kidding -

>BOOOOOOOOOOOOOO I am so discouraged!

> Sorry to vent - but it had to go

>somewhere... Tara Lynn

>

>

>

>

>

>

>

>

>--- jfehl wrote:

>>

>>

>> I hear you, Tara....I was 286 when my husband

>> married me....219 when he

>> left...we had issues...but weight was not one of

>> them...now I'm 310 and

>> he's showing renewed interest...hmmmm....go

>> figure...

>>

>> Cara

>>

>>

>------------------------------------------------------------------------

>> Start a new hobby. Meet a new friend.

>> http://www.ONElist.com

>> ONElist: The leading provider of free e-mail list

>> services!

>>

>------------------------------------------------------------------------

>> This message is from the Mini-Gastric Bypass List at

>> Onelist.com

>>

>

>_________________________________________________________

>