good news

[Guest guest]

Sara, God is good!!!

I am so happy for you!!!

Sister Trish Lanman lol

[Guest guest]

In a message dated 7/17/2000 3:14:11 PM Eastern Daylight Time,

vaschutz@... writes:

<<

Thanks Trish!!! I wish I could meet you!

Sara

>>

Someday Sara we will!!!

[Guest guest]

Way to go Sara! I don't know the answers to your questions, but I know my

old insurance company did say that some things were over the usual and

customary fees, so they wouldn't pay them and they didn't count toward my out

of pocket max. I was also wondering if I will have to pay anything up front.

I guess I sort of assumed that they would bill my insurance, and then send

me a bill for whatever is unpaid. Anyone know about this?

I am also worried that even though I received verbal approval over the

phone Thursday, something might happen and I won't get that letter saying so.

I would be devastated at this point if I got turned down! We just have to

think positively!

Good luck, hope to see you in Durham! I will be staying at Comfort Suites

from July 30 - Aug. 4 or 5. Where are you planning to stay? Are you

bringing your kids?

Best wishes,

Deb in IL

MGB 7/31

[Guest guest]

Thanks Sara,

I sort of wanted July 31st because it is a good friend's birthday, so I

thought it would be lucky for me... I know what you mean about keeping costs

down.. We have 4 kids, and I'm already thinking I shouldn't be spending so

much on a trip right before school starts! But, whatever the cost, it will

be worth it in the long run! And, it will be a nice little vacation for us.

I am not used to leaving my kids, so even the one day I was gone to Durham

last week was lonely without them! I hope to see you there, and hope

everything works out with both of our insurance companies.

Deb in IL

[Guest guest]

Thanks Sara,

I sort of wanted July 31st because it is a good friend's birthday, so I

thought it would be lucky for me... I know what you mean about keeping costs

down.. We have 4 kids, and I'm already thinking I shouldn't be spending so

much on a trip right before school starts! But, whatever the cost, it will

be worth it in the long run! And, it will be a nice little vacation for us.

I am not used to leaving my kids, so even the one day I was gone to Durham

last week was lonely without them! I hope to see you there, and hope

everything works out with both of our insurance companies.

Deb in IL

[Guest guest]

In a message dated 7/17/00 12:10:06 PM Pacific Daylight Time,

vaschutz@... writes:

<<

Sara

BMI 43 (but not for long!)

>>

Sara,

I am genuinely thrilled for you, sweetie!

Regards,

Debbie in IL

Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45

Counting on Cigna for Debbie (BMI 40) ins letter sent 7/14

[Guest guest]

\o/ \o/ PTL, Sara!! \o/ \o/

Tricia in IL

who is hoping to hear something *positive* from the insurance company

this week,

so maybe I'll be joining you on Aug 2!!

Vaughn and Sara Schütz wrote:

>

> HOORAY!!! A big hurdle has just been crossed for me!!!! My insurance

> company

> called a little while ago and said that I have been approved to have

> this

> surgery because of medical necessity!! Yeah!!!! It's a

> miracle!!!!!!!!!!

> I am very excited, but I am trying to remain somewhat calm because we

> still

> have to find out how much of it they are going to cover. My book says

> they

> will only cover 60% of surgeries that are out of network, and we don't

> know yet

> if we can get them to cover this at in network percentages. The only

> WLS I

> know of that is done in my network is open RNY, so the comparatively

> low MGB

> costs should look good to the insurance company.

> We have called the insurance representative at my husband's workplace,

> and she

> says that the per person maximum that I should have to pay per year

> out of

> pocket is $1,250 of which $250 is my deductible, which I have already

> met this

> year. So that should mean that no matter what rate they cover the

> surgery at,

> I should still only have to pay $1000. Does that seem correct to you

> insurance

> experts out there? The rep did say that they make you pay any costs

> that they

> feel are unreasonable out of your pocket, over and above the $1000.

> For

> example, if the hospital charges $10 for an aspirin, and the insurance

> company

> only allows $5 for an aspirin, then I would have to pay the other $5

> in

> addition to the $1000.

> So all this sounds all right because I can pay as much as $1000 up

> front, and

> could pay the rest later, but what I am worried about are the

> following things:

>

> 1) Whether the hospital and/or Dr. R will require that I pay upfront

> the

> percentage that the insurance company says they won't cover. Does

> anyone know

> if they will require any upfront payment even if I can show them that

> I have a

> personal yearly maximum of $1000? Because I can't afford to pay 40%

> of this

> surgery upfront, even if I am going to be reimbursed later, because I

> just

> don't have access to that kind of money all at once.

>

> 2) I also worry (hopefully unreasonably) that they will change their

> minds and

> not cover me (or decide not to cover the MGB) because I have to wait

> for a

> letter to come from some other office in another state saying that I

> am

> approved, according to the insurance caseworker who called me.

>

> 3) I will be devastated if, after all of this, something happens and I

> can't

> have the surgery.

>

> The insurance company said they will call Dr. R's office this

> afternoon and set

> a surgery date for me, so I called Debbie and told her that they will

> be

> calling, and she said I can have surgery on August 2nd. I am so

> glad!!!

>

> If anyone can give me any advice or reassurance about the insurance

> questions

> above, I would really appreciate it. If all goes well, I will be at

> clinic on

> August 1st, and have surgery on August 2nd!!!!! Anyone else on those

> dates?

>

> Sara

> BMI 43 (but not for long!)

>

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

>

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

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

> Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to:

> MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

[Guest guest]

Thanks Trish!!! I wish I could meet you!

Sara

metrishal@... wrote:

> Sara, God is good!!!

> I am so happy for you!!!

> Sister Trish Lanman lol

>

[Guest guest]

Tricia Bardell wrote:

> \o/ \o/ PTL, Sara!! \o/ \o/

>

> Tricia in IL

> who is hoping to hear something *positive* from the insurance company

> this week,

> so maybe I'll be joining you on Aug 2!!

>

I hope so, Tricia!!!

Sara

[Guest guest]

Hi Deb,

We will probably be staying in Rocky Mount, NC with some friends. We used to

live there. It is about an hour east of Durham. We will be bringing our

children, all six of them!!! Our older children are looking forward to seeing

old friends in Rocky Mount. We have to keep expenses down as much as possible

(our oldest is starting college this fall), so it will really help us to stay

with friends who don't charge us! Although, after having all 8 of us there for

several days, they may decide to make us pay somehow! LOL

You're having your surgery on my husband's birthday. That's a good day.

Sara

Hadjab@... wrote:

> Way to go Sara! I don't know the answers to your questions, but I know my

> old insurance company did say that some things were over the usual and

> customary fees, so they wouldn't pay them and they didn't count toward my out

> of pocket max. I was also wondering if I will have to pay anything up front.

> I guess I sort of assumed that they would bill my insurance, and then send

> me a bill for whatever is unpaid. Anyone know about this?

> I am also worried that even though I received verbal approval over the

> phone Thursday, something might happen and I won't get that letter saying so.

> I would be devastated at this point if I got turned down! We just have to

> think positively!

>

> Good luck, hope to see you in Durham! I will be staying at Comfort Suites

> from July 30 - Aug. 4 or 5. Where are you planning to stay? Are you

> bringing your kids?

>

> Best wishes,

>

> Deb in IL

> MGB 7/31

>

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

> Get great brand name shoes with just the click of a mouse. Check out

> the huge selection at Zappos.com, the Web's Most Popular Store!

> http://click.egroups.com/1/6994/3/_/453517/_/963863154/

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

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

> To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

[Guest guest]

Sara,

I am sssooooooo happy for you! Today is a big day for both of us, I

also received my insurance approval today!!! Mine is a long story

but I am going to TRY to have my surgery next week...if not, maybe we

will be " littermates " !!! That would be great since we also live so

close. I am sssooooo excited but I am like you too, afraid something

will go wrong! I guess thats why I haven't posted on line yet. I am

waiting for a date.

Keep in touch.

Winstead

sburg, TN

> HOORAY!!! A big hurdle has just been crossed for me!!!! My

insurance company

> called a little while ago and said that I have been approved to

have this

> surgery because of medical necessity!! Yeah!!!! It's a

miracle!!!!!!!!!!

> I am very excited, but I am trying to remain somewhat calm because

we still

> have to find out how much of it they are going to cover. My book

says they

> will only cover 60% of surgeries that are out of network, and we

don't know yet

> if we can get them to cover this at in network percentages. The

only WLS I

> know of that is done in my network is open RNY, so the

comparatively low MGB

> costs should look good to the insurance company.

> We have called the insurance representative at my husband's

workplace, and she

> says that the per person maximum that I should have to pay per year

out of

> pocket is $1,250 of which $250 is my deductible, which I have

already met this

> year. So that should mean that no matter what rate they cover the

surgery at,

> I should still only have to pay $1000. Does that seem correct to

you insurance

> experts out there? The rep did say that they make you pay any

costs that they

> feel are unreasonable out of your pocket, over and above the

$1000. For

> example, if the hospital charges $10 for an aspirin, and the

insurance company

> only allows $5 for an aspirin, then I would have to pay the other

$5 in

> addition to the $1000.

> So all this sounds all right because I can pay as much as $1000 up

front, and

> could pay the rest later, but what I am worried about are the

following things:

>

> 1) Whether the hospital and/or Dr. R will require that I pay

upfront the

> percentage that the insurance company says they won't cover. Does

anyone know

> if they will require any upfront payment even if I can show them

that I have a

> personal yearly maximum of $1000? Because I can't afford to pay

40% of this

> surgery upfront, even if I am going to be reimbursed later, because

I just

> don't have access to that kind of money all at once.

>

> 2) I also worry (hopefully unreasonably) that they will change

their minds and

> not cover me (or decide not to cover the MGB) because I have to

wait for a

> letter to come from some other office in another state saying that

I am

> approved, according to the insurance caseworker who called me.

>

> 3) I will be devastated if, after all of this, something happens

and I can't

> have the surgery.

>

> The insurance company said they will call Dr. R's office this

afternoon and set

> a surgery date for me, so I called Debbie and told her that they

will be

> calling, and she said I can have surgery on August 2nd. I am so

glad!!!

>

> If anyone can give me any advice or reassurance about the insurance

questions

> above, I would really appreciate it. If all goes well, I will be

at clinic on

> August 1st, and have surgery on August 2nd!!!!! Anyone else on

those dates?

>

> Sara

> BMI 43 (but not for long!)

[Guest guest]

Sara,

I am sssooooooo happy for you! Today is a big day for both of us, I

also received my insurance approval today!!! Mine is a long story

but I am going to TRY to have my surgery next week...if not, maybe we

will be " littermates " !!! That would be great since we also live so

close. I am sssooooo excited but I am like you too, afraid something

will go wrong! I guess thats why I haven't posted on line yet. I am

waiting for a date.

Keep in touch.

Winstead

sburg, TN

> HOORAY!!! A big hurdle has just been crossed for me!!!! My

insurance company

> called a little while ago and said that I have been approved to

have this

> surgery because of medical necessity!! Yeah!!!! It's a

miracle!!!!!!!!!!

> I am very excited, but I am trying to remain somewhat calm because

we still

> have to find out how much of it they are going to cover. My book

says they

> will only cover 60% of surgeries that are out of network, and we

don't know yet

> if we can get them to cover this at in network percentages. The

only WLS I

> know of that is done in my network is open RNY, so the

comparatively low MGB

> costs should look good to the insurance company.

> We have called the insurance representative at my husband's

workplace, and she

> says that the per person maximum that I should have to pay per year

out of

> pocket is $1,250 of which $250 is my deductible, which I have

already met this

> year. So that should mean that no matter what rate they cover the

surgery at,

> I should still only have to pay $1000. Does that seem correct to

you insurance

> experts out there? The rep did say that they make you pay any

costs that they

> feel are unreasonable out of your pocket, over and above the

$1000. For

> example, if the hospital charges $10 for an aspirin, and the

insurance company

> only allows $5 for an aspirin, then I would have to pay the other

$5 in

> addition to the $1000.

> So all this sounds all right because I can pay as much as $1000 up

front, and

> could pay the rest later, but what I am worried about are the

following things:

>

> 1) Whether the hospital and/or Dr. R will require that I pay

upfront the

> percentage that the insurance company says they won't cover. Does

anyone know

> if they will require any upfront payment even if I can show them

that I have a

> personal yearly maximum of $1000? Because I can't afford to pay

40% of this

> surgery upfront, even if I am going to be reimbursed later, because

I just

> don't have access to that kind of money all at once.

>

> 2) I also worry (hopefully unreasonably) that they will change

their minds and

> not cover me (or decide not to cover the MGB) because I have to

wait for a

> letter to come from some other office in another state saying that

I am

> approved, according to the insurance caseworker who called me.

>

> 3) I will be devastated if, after all of this, something happens

and I can't

> have the surgery.

>

> The insurance company said they will call Dr. R's office this

afternoon and set

> a surgery date for me, so I called Debbie and told her that they

will be

> calling, and she said I can have surgery on August 2nd. I am so

glad!!!

>

> If anyone can give me any advice or reassurance about the insurance

questions

> above, I would really appreciate it. If all goes well, I will be

at clinic on

> August 1st, and have surgery on August 2nd!!!!! Anyone else on

those dates?

>

> Sara

> BMI 43 (but not for long!)

[Guest guest]

In a message dated 7/17/00 6:59:31 PM Pacific Daylight Time,

vaschutz@... writes:

<< Thank you, Debbie. Is getting excited? When do you expect to hear

about

your own approval?

Sara

>>

Hi Sara,

Thanks for asking. is still at camp in Mass. but is coming home next

Sunday (after 4 weeks). I talked to her when I got back from my trip on

Friday and she seemed to be excited (and a bit nervous). I will be glad when

I can take her in my arms and give her a hug!

As for me, I had hoped to be a lot further along but am sort of back at the

beginning since the letter from Dr R's office to Cigna was just sent out last

Friday, due to some kind of glitch. I do have all my appeal letters in

envelopes ready to go, though, and of course my dialing finger is ready to

call the nice lady in charge of appeals! LOL I guess I know the drill!

[Guest guest]

Congrats Sara! I hope to say that same thing one day soon! Maybe

before Aug 1 and I can meet you in NC.

Dinah in Alabama

> >

> > HOORAY!!! A big hurdle has just been crossed for me!!!! My

insurance

> > company

> > called a little while ago and said that I have been approved to

have

> > this

> > surgery because of medical necessity!! Yeah!!!! It's a

> > miracle!!!!!!!!!!

> > I am very excited, but I am trying to remain somewhat calm

because we

> > still

> > have to find out how much of it they are going to cover. My book

says

> > they

> > will only cover 60% of surgeries that are out of network, and we

don't

> > know yet

> > if we can get them to cover this at in network percentages. The

only

> > WLS I

> > know of that is done in my network is open RNY, so the

comparatively

> > low MGB

> > costs should look good to the insurance company.

> > We have called the insurance representative at my husband's

workplace,

> > and she

> > says that the per person maximum that I should have to pay per

year

> > out of

> > pocket is $1,250 of which $250 is my deductible, which I have

already

> > met this

> > year. So that should mean that no matter what rate they cover the

> > surgery at,

> > I should still only have to pay $1000. Does that seem correct to

you

> > insurance

> > experts out there? The rep did say that they make you pay any

costs

> > that they

> > feel are unreasonable out of your pocket, over and above the

$1000.

> > For

> > example, if the hospital charges $10 for an aspirin, and the

insurance

> > company

> > only allows $5 for an aspirin, then I would have to pay the other

$5

> > in

> > addition to the $1000.

> > So all this sounds all right because I can pay as much as $1000 up

> > front, and

> > could pay the rest later, but what I am worried about are the

> > following things:

> >

> > 1) Whether the hospital and/or Dr. R will require that I pay

upfront

> > the

> > percentage that the insurance company says they won't cover. Does

> > anyone know

> > if they will require any upfront payment even if I can show them

that

> > I have a

> > personal yearly maximum of $1000? Because I can't afford to pay

40%

> > of this

> > surgery upfront, even if I am going to be reimbursed later,

because I

> > just

> > don't have access to that kind of money all at once.

> >

> > 2) I also worry (hopefully unreasonably) that they will change

their

> > minds and

> > not cover me (or decide not to cover the MGB) because I have to

wait

> > for a

> > letter to come from some other office in another state saying

that I

> > am

> > approved, according to the insurance caseworker who called me.

> >

> > 3) I will be devastated if, after all of this, something happens

and I

> > can't

> > have the surgery.

> >

> > The insurance company said they will call Dr. R's office this

> > afternoon and set

> > a surgery date for me, so I called Debbie and told her that they

will

> > be

> > calling, and she said I can have surgery on August 2nd. I am so

> > glad!!!

> >

> > If anyone can give me any advice or reassurance about the

insurance

> > questions

> > above, I would really appreciate it. If all goes well, I will be

at

> > clinic on

> > August 1st, and have surgery on August 2nd!!!!! Anyone else on

those

> > dates?

> >

> > Sara

> > BMI 43 (but not for long!)

> >

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

----

> >

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

----

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

> > Onelist.com

> > Please visit our web site at http://clos.net

> > Get the Patient Manual at http://clos.net/get_patient_manual.htm

> >

> > To Unsubscribe Send and Email to:

> > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

[Guest guest]

Thank you, Dinah! Good luck to you!

Sara

dinah@... wrote:

> Congrats Sara! I hope to say that same thing one day soon! Maybe

> before Aug 1 and I can meet you in NC.

>

> Dinah in Alabama

[Guest guest]

Thank you, Debbie. Is getting excited? When do you expect to hear about

your own approval?

Sara

DebLaMan@... wrote:

> In a message dated 7/17/00 12:10:06 PM Pacific Daylight Time,

> vaschutz@... writes:

>

> <<

> Sara

> BMI 43 (but not for long!)

>

> >>

> Sara,

> I am genuinely thrilled for you, sweetie!

>

> Regards,

> Debbie in IL

> Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45

> Counting on Cigna for Debbie (BMI 40) ins letter sent 7/14

>

[Guest guest]

Hi ,

Congratulations!! I hope you can have your surgery next week like you want,

but if not, it would be great if we could be littermates.

Sara

W wrote:

> Sara,

>

> I am sssooooooo happy for you! Today is a big day for both of us, I

> also received my insurance approval today!!! Mine is a long story

> but I am going to TRY to have my surgery next week...if not, maybe we

> will be " littermates " !!! That would be great since we also live so

> close. I am sssooooo excited but I am like you too, afraid something

> will go wrong! I guess thats why I haven't posted on line yet. I am

> waiting for a date.

>

> Keep in touch.

>

> Winstead

> sburg, TN

>

[Guest guest]

In a message dated 8/26/01 11:37:37 AM Pacific Daylight Time,

Beauby1022050943@... writes:

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

>

Woo hoo!! I'm sure that is a great feeling!! I hope I get there !!!

~~* AJ *~~

Age 37 5'8''

Post op 7/24/01 Open BPD/DS

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 415.1

08/06/01 BMI 59 390.2 -24.9 lbs! -10.75 inches

08/16/01 BMI 58 387.0 -27.9 lbs! -11.25 inches

08/24/01 BMI 58 386.5 -28.7 lbs! -15.5 inches

My personal website: www.WLS4AJ@...

Check out the Bellingham Support Group at WWW.WLSBellingham.homestead.com

[Guest guest]

In a message dated 08/26/2001 1:37:57 PM Central Daylight Time,

Beauby1022050943@... writes:

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

Yahhooo! Isn't this surgery a wonder!!!

Dawn----South suburban chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting!

[Guest guest]

In a message dated 08/26/2001 1:37:57 PM Central Daylight Time,

Beauby1022050943@... writes:

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

Yahhooo! Isn't this surgery a wonder!!!

Dawn----South suburban chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting!

[Guest guest]

Good News

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

> I fit into 14 jeans too, easily and 12's in Wal Mart shorts what have

elastic waist whoooooooohoooooooo!

Judie

[Guest guest]

Good News

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

> I fit into 14 jeans too, easily and 12's in Wal Mart shorts what have

elastic waist whoooooooohoooooooo!

Judie

[Guest guest]

I'm sure that is a great feeling!! I hope I get there !!!

~~* AJ *~~

You dont " Hope " to get there, Aj.....you WILL get there!!! <g>

Right now it seems to take forever but trust me......time has a way of going

pretty fast now! Just keep busy and keep in touch here and before you know

it, you will be a 14 too! Hey.....tell ya what.......Ill save my size 14

jeans for you when you reach that size....just tell me when you are an 18 so

you can have something to look forward to.... ok??

Judie

[Guest guest]

Yay!!!! I can't tell you what *year* it was the last time I fit into a size

14 jeans. )

alyssa

Good News

> I fit into a size 14 jeans. I am a happy person.Ellen(Pam

>

[Guest guest]

Yahhooo! Isn't this surgery a wonder!!!>>>>

You bet it is, Dawn! Remember my concern that you got into size 10 at 165

and I couldnt do it? Well, now I can get into size 12 shorts with elastic

waist! Im not far behind the 10 now and Im 162! Maybe when I hit 155 I

will get into the 10? Ill get there!!

Hugs, Judie