Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 In a message dated 1/23/00 3:03:47 PM Central Standard Time, MiniGastricBypassonelist writes: << From: BettyVeasy@... Subject: Re: Insurance Appeal I am fairly new in the appeal's process, I have insurance with an HMO. My original request was for a physician which was recommended to me by another person who had the surgery performed in Monterey, Mexico. She has been extremely successful with her surgery. I was denied on the basis that it was an " out of network provider. " I then sent a modified appeal I found on the Internet and they have denied one surgeon to perform the procedure, and has referred it to another " network provider. " When I reviewed the letter, I never paid attention to the type of surgery they were trying to get approved. It was Roux-en-Y procedure. I sent a letter requesting the request to reflect " Laparoscopic " procedure. I still have a long way to go and probably more appeals to file also. If any one has any more sources for additional appeals, please e-mail me so I can download them. Thanks a lot !!! One day trying to stay alive and get help from our insurance companies won't be so hard. In the field of work I'm in, it's sad to say, but all laws are written in blood, which means someone has to die or something drastic has to happen before a law is written or action is taken. I wish the best of luck to all who are struggling for approval and help with their problems. _________________________________________ >> Betty, Have you utilized the services of Walt Lindstrom,esq. RN/Cincy Ohio Area Pending Insurance approval Lap bypass hopeful BMI 46.1 I f you need to know how to contact him I will get that info for you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 In a message dated 1/23/00 3:03:47 PM Central Standard Time, MiniGastricBypassonelist writes: << From: BettyVeasy@... Subject: Re: Insurance Appeal I am fairly new in the appeal's process, I have insurance with an HMO. My original request was for a physician which was recommended to me by another person who had the surgery performed in Monterey, Mexico. She has been extremely successful with her surgery. I was denied on the basis that it was an " out of network provider. " I then sent a modified appeal I found on the Internet and they have denied one surgeon to perform the procedure, and has referred it to another " network provider. " When I reviewed the letter, I never paid attention to the type of surgery they were trying to get approved. It was Roux-en-Y procedure. I sent a letter requesting the request to reflect " Laparoscopic " procedure. I still have a long way to go and probably more appeals to file also. If any one has any more sources for additional appeals, please e-mail me so I can download them. Thanks a lot !!! One day trying to stay alive and get help from our insurance companies won't be so hard. In the field of work I'm in, it's sad to say, but all laws are written in blood, which means someone has to die or something drastic has to happen before a law is written or action is taken. I wish the best of luck to all who are struggling for approval and help with their problems. _________________________________________ >> Betty, Have you utilized the services of Walt Lindstrom,esq. RN/Cincy Ohio Area Pending Insurance approval Lap bypass hopeful BMI 46.1 I f you need to know how to contact him I will get that info for you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 In a message dated 1/23/00 3:03:47 PM Central Standard Time, MiniGastricBypassonelist writes: << From: BettyVeasy@... Subject: Re: Insurance Appeal I am fairly new in the appeal's process, I have insurance with an HMO. My original request was for a physician which was recommended to me by another person who had the surgery performed in Monterey, Mexico. She has been extremely successful with her surgery. I was denied on the basis that it was an " out of network provider. " I then sent a modified appeal I found on the Internet and they have denied one surgeon to perform the procedure, and has referred it to another " network provider. " When I reviewed the letter, I never paid attention to the type of surgery they were trying to get approved. It was Roux-en-Y procedure. I sent a letter requesting the request to reflect " Laparoscopic " procedure. I still have a long way to go and probably more appeals to file also. If any one has any more sources for additional appeals, please e-mail me so I can download them. Thanks a lot !!! One day trying to stay alive and get help from our insurance companies won't be so hard. In the field of work I'm in, it's sad to say, but all laws are written in blood, which means someone has to die or something drastic has to happen before a law is written or action is taken. I wish the best of luck to all who are struggling for approval and help with their problems. _________________________________________ >> Betty, Have you utilized the services of Walt Lindstrom,esq. RN/Cincy Ohio Area Pending Insurance approval Lap bypass hopeful BMI 46.1 I f you need to know how to contact him I will get that info for you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 Hello all,out of touch for awhile but back now,,glad to see everyone is doing good. The weight losses are terrific,are we a bunch of happy people or what? My update,Sept 14th surgery,as of Friday I'm down 75 big ones,,I can't even begin to tell you the changes taking place,,energy,dancing again,clothes that actually hang,,the list goes on and on! I can't imagine feeling better than this but I know I will,,it's so good!!!! It seems like a lot of my old cronies are either gone or are really busy with their new lives,,,would love to know how everyone's doing. Thank you Dr. R.,,this would not have been possible without you and your wonderful skills. Dee in Fla. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 Hello all,out of touch for awhile but back now,,glad to see everyone is doing good. The weight losses are terrific,are we a bunch of happy people or what? My update,Sept 14th surgery,as of Friday I'm down 75 big ones,,I can't even begin to tell you the changes taking place,,energy,dancing again,clothes that actually hang,,the list goes on and on! I can't imagine feeling better than this but I know I will,,it's so good!!!! It seems like a lot of my old cronies are either gone or are really busy with their new lives,,,would love to know how everyone's doing. Thank you Dr. R.,,this would not have been possible without you and your wonderful skills. Dee in Fla. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2000 Report Share Posted January 23, 2000 Hello all,out of touch for awhile but back now,,glad to see everyone is doing good. The weight losses are terrific,are we a bunch of happy people or what? My update,Sept 14th surgery,as of Friday I'm down 75 big ones,,I can't even begin to tell you the changes taking place,,energy,dancing again,clothes that actually hang,,the list goes on and on! I can't imagine feeling better than this but I know I will,,it's so good!!!! It seems like a lot of my old cronies are either gone or are really busy with their new lives,,,would love to know how everyone's doing. Thank you Dr. R.,,this would not have been possible without you and your wonderful skills. Dee in Fla. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2000 Report Share Posted January 24, 2000 Can you tell me what the process has been like so far. . .I'm just getting started. - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 No I don't have a Patienst Education Manual. . .how d I get one? - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 No I don't have a Patienst Education Manual. . .how d I get one? - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 down load it off the web site. www.clos.net. that is where you can the manual Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 << I don't have a Patients Education Manual. . .how d I get one? >> , call Debbie or at Doctor R's office and request one. The telephone number is listed on www.clos.net. There's also a Patient Manual that you can download right into your computer on that website. It's 50 to 60 pages long, though, so make sure that your 'puter can deal with it. Keep in mind that Debbie usually tries to take Thursday off to be there for us on Saturdays. Dee in MI. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 FYI, there is 18-20 inches of snow in the Durham area so for you out of towners, trust me when I say the place is SHUT DOWN. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 FYI, there is 18-20 inches of snow in the Durham area so for you out of towners, trust me when I say the place is SHUT DOWN. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 We haven't had a snow like this in 100 years, you should be in good shape by the weekend. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 And I thought that I was going to get rid of the snow by leaving Iceland on Friday. Bummer ! Is it supposed to be for long like this ? Regards, Re: Digest Number 646 From: NValmassoi@... FYI, there is 18-20 inches of snow in the Durham area so for you out of towners, trust me when I say the place is SHUT DOWN. --------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2000 Report Share Posted January 25, 2000 SKC and all, you can call Debbie or you can get it off of the internet and download it and print it if you need to. It is 59 pages from the download! Hope this helps you. I am NOW working on page 6 things myself and I wanted to tell all in the group here. I am excited and scared all at the same time. My dad wrote a family letter for him and my mom. My husband will write a family support letter also. I have my patient letter done and hope it is good enough anyone care to proof it for me?? I have talked to 10 previous patients whether they be Dr. R's or people that had open RNY. My insurance approval will hopefully be an easy one. I am asking my ob/gyn who wanted me to have open RNY to refer me to Dr. R. so he was going to check out all of his schooling etc and if he felt comfortable he was going to write a referral at the same time! I am hopeful and I look forward to getting things rolling on my insurance approval. I have a phsyc eval appt. Scheduled for 2/21/00 so I am hoping with an appointment in order I can at least get a date from Debbie. I called to see and tell her I am working on page 6 things and they were out of the office! POOO My name is Christi but I go by Chris.. I wish all you other pre- ops luck with everything and for the post - ops keep all the good info and support coming. I have learned alot just by reading posts on this list. Awaiting a date for surgery! Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 << Dad had me all the way to school before we figured out there was no one else on the road! LOL Paige >> Isn't it a scream to see how different parts of the country deal with unusual weather? My husband said that he'd be surprised if there were any city or county snowplows in the entire state of North Carolina since snow that sticks around is not an every year occurrence. Is the National Guard digging you out? The Weather Channel is focusing on another area of the country today and there aren't many pictures lately of NC. Dee in MI. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 << Dad had me all the way to school before we figured out there was no one else on the road! LOL Paige >> Isn't it a scream to see how different parts of the country deal with unusual weather? My husband said that he'd be surprised if there were any city or county snowplows in the entire state of North Carolina since snow that sticks around is not an every year occurrence. Is the National Guard digging you out? The Weather Channel is focusing on another area of the country today and there aren't many pictures lately of NC. Dee in MI. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 Dee, I am back in ND, for Love, you know!LOL I am married and my hubby is some one I dated before I moved to NC. I think they have plow in the western part of the state, but a pic of sville Beach (where I used to live in NC)was in yeasterdays ND paper! Surfers walking over the dunes in their wetsuits and surf boards, it was kind of strage to see it in the snow! LOL Paige >From: Yarnmama@... >Reply-To: MiniGastricBypassonelist >To: MiniGastricBypassonelist >Subject: Re: RE: Digest Number 646 >Date: Thu, 27 Jan 2000 08:08:42 EST > > > > ><< Dad had me all the way to school before we >figured out there was no one else on the road! LOL Paige >> > >Isn't it a scream to see how different parts of the country deal with >unusual >weather? My husband said that he'd be surprised if there were any city or >county snowplows in the entire state of North Carolina since snow that >sticks >around is not an every year occurrence. Is the National Guard digging you >out? The Weather Channel is focusing on another area of the country today >and there aren't many pictures lately of NC. Dee in MI. ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 << Surfers walking over the dunes in their wetsuits and surf boards, it was kind of strage to see it in the snow! LOL Paige >> Long live the indomitable human spirit! Surfing through ice and snow drifts...those surfers are definitely persistent! I can't wait to be that wild and crazy again as I get to be a more normal size; I'm gonna throw myself around like the tomboy that I used to be! Thanks for the " picture, " PAige! Dee in MI. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 Dee, I just cannot wait to start rollerblading!!!!! My hubby got me some and they did not fit my lower calves due to water weight, I ended up giving them to my sister in law~! I LOVE to skate!!! that is as wild and wooley as I get:) Paige >From: Yarnmama@... >Reply-To: MiniGastricBypassonelist >To: MiniGastricBypassonelist >Subject: Re: RE: Digest Number 646 >Date: Thu, 27 Jan 2000 19:35:05 EST > > > > ><< Surfers walking over the dunes in their >wetsuits and surf boards, it was kind of strage to see it in the snow! LOL >Paige >> > >Long live the indomitable human spirit! Surfing through ice and snow >drifts...those surfers are definitely persistent! I can't wait to be that >wild and crazy again as I get to be a more normal size; I'm gonna throw >myself around like the tomboy that I used to be! Thanks for the " picture, " >PAige! Dee in MI. ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2000 Report Share Posted January 27, 2000 Dee, I just cannot wait to start rollerblading!!!!! My hubby got me some and they did not fit my lower calves due to water weight, I ended up giving them to my sister in law~! I LOVE to skate!!! that is as wild and wooley as I get:) Paige >From: Yarnmama@... >Reply-To: MiniGastricBypassonelist >To: MiniGastricBypassonelist >Subject: Re: RE: Digest Number 646 >Date: Thu, 27 Jan 2000 19:35:05 EST > > > > ><< Surfers walking over the dunes in their >wetsuits and surf boards, it was kind of strage to see it in the snow! LOL >Paige >> > >Long live the indomitable human spirit! Surfing through ice and snow >drifts...those surfers are definitely persistent! I can't wait to be that >wild and crazy again as I get to be a more normal size; I'm gonna throw >myself around like the tomboy that I used to be! Thanks for the " picture, " >PAige! Dee in MI. ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2000 Report Share Posted October 17, 2000 Hi all. My name is Deborah, and I had open RNY on Oct 11, 1999, so it's just over a year now. I was 308 and am down to 220, so it's a total of 88 lbs. I basically am at a standstill since June (2 or 3 lbs in each direction then back to 220). One of the problems is that I can eat almost anything, no dumping from sugars/fats etc... I realize this surgery is just a tool, but I am really struggling right now. I hope to gain insight and support from this group. Have any of your experiences been similar? How do you shake things up? Any advice would be appreciated. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2000 Report Share Posted October 20, 2000 Deb, Welcome to the List and Happy Re-Birthday to YOU! You are right in recognizing the surgery is only a tool for the weight loss and it sounds like you are now not going to be able to rely on it to keep you away from high fat or sugar. It is, however, still within your control to continue the weight loss. If you are not taking in enough calories, your metabolism will lower to hold onto what you have thinking it is " starving. " However, if this isn't the problem, then I suggest you go back to the basics of the eating habits/portion control you were establishing way back in the beginning after your surgery. Eat protein first, then fruits and veggies; avoid high carbs and high fats and NO sugar. Add a protein supplement if you are not currently using one and be sure you drink your water. Building muscle thru weight lifting/aerobic exercise (I did water aerobics) will raise your metabolism also. Pls let me know if this helps you break that plateau! Your " window of opportunity " for weight loss is still open.......it is up to you to make the right choices to allow it to happen......and high fat and sugar is NOT on the list!! :-) There are soooooo many sugar free things on the market that will allow you to have something sweet. I just tried Stover sugar free peanut butter cups. Hmmmmm.....good stuff Maynard!! LOL TCBY has a sugar free frozen yogurt. I consider even the sugar free things " treats " now and don't have them very often. Dawn BTC/ Dr. Batay-Csorba 4/16/99 Open RNY BEFORE WLS: 257 lbs. 5'5 " sz 3x/24 AFTER: 125 lbs. 5'6 " (yes, I grew up LOL) sz 4 Abdominoplasty and mastoplexy 6/1/00 TBP <teeny but perky!> hernia and earlobe repair also! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2000 Report Share Posted October 20, 2000 Deb, Welcome to the List and Happy Re-Birthday to YOU! You are right in recognizing the surgery is only a tool for the weight loss and it sounds like you are now not going to be able to rely on it to keep you away from high fat or sugar. It is, however, still within your control to continue the weight loss. If you are not taking in enough calories, your metabolism will lower to hold onto what you have thinking it is " starving. " However, if this isn't the problem, then I suggest you go back to the basics of the eating habits/portion control you were establishing way back in the beginning after your surgery. Eat protein first, then fruits and veggies; avoid high carbs and high fats and NO sugar. Add a protein supplement if you are not currently using one and be sure you drink your water. Building muscle thru weight lifting/aerobic exercise (I did water aerobics) will raise your metabolism also. Pls let me know if this helps you break that plateau! Your " window of opportunity " for weight loss is still open.......it is up to you to make the right choices to allow it to happen......and high fat and sugar is NOT on the list!! :-) There are soooooo many sugar free things on the market that will allow you to have something sweet. I just tried Stover sugar free peanut butter cups. Hmmmmm.....good stuff Maynard!! LOL TCBY has a sugar free frozen yogurt. I consider even the sugar free things " treats " now and don't have them very often. Dawn BTC/ Dr. Batay-Csorba 4/16/99 Open RNY BEFORE WLS: 257 lbs. 5'5 " sz 3x/24 AFTER: 125 lbs. 5'6 " (yes, I grew up LOL) sz 4 Abdominoplasty and mastoplexy 6/1/00 TBP <teeny but perky!> hernia and earlobe repair also! Quote Link to comment Share on other sites More sharing options...
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