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04-08-2013, 11:15 PM
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#1
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Junior Member
Thread Starter
Join Date: Jan 2013
Location: Quantico VA
Posts: 21
S/C/G: 243/190/150
Height: 4'11
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1 week until surgery, still not approved. Kidney stones too
I'm just so frustrated. I'm scheduled to have gastric bypass next Tuesday. I've been denied, I've been sent for every test under the sun. My surgeron finally resubmitted everything to tricare last Thursday and now I can do is wait and pray. Then yesterday out of no where I start having severe pains in my back, I went to the Er and found out I have multiple kidney stones, fantastic. I hope this wont effect the surgery. I'm thinking of not even telling my surgeon, although he is in the same network as the Er so I'm sure he'll find out. I haven't even started my diet as I have no idea if the surgery is even gonna happen. Why tourture myself?
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04-09-2013, 09:26 AM
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#2
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Old Cackler
Join Date: Apr 2000
Location: northern New Jersey
Posts: 7,525
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you HAVE TO tell the surgeon. he needs ALL the information - yes, even the stuff you don't want to admit - so that he can take proper care of you. And he'll be able to tell you if it's safe for you to have surgery so soon after the kidney stones [yikes!!!!]
and i'm soooo sorry you're hitting so many roadblocks and challenges. but please take care of yourself while you're jumping over them and banging into them.
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04-09-2013, 11:10 AM
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#3
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Junior Member
Thread Starter
Join Date: Jan 2013
Location: Quantico VA
Posts: 21
S/C/G: 243/190/150
Height: 4'11
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Just got the call that surgery isn't happening. My dr office resubmitted my package with the additional test results tricare requested ( cardiologist, blood work, pulmonary dr, & chest X-ray ), they are now saying I need to appeal that denial.
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04-09-2013, 01:57 PM
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#4
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Old Cackler
Join Date: Apr 2000
Location: northern New Jersey
Posts: 7,525
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good grief. please hang in there - take a deep breath - and get ready for a long heart to heart with your doc and perhaps with your insurance company about exactly why they denied the surgery. it could be any number of reasons - including administrative stuff that have nothing to do with your health.
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04-09-2013, 02:07 PM
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#5
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I got this
Join Date: Jan 2011
Location: Near St. Louis
Posts: 2,823
S/C/G: 206/162/135
Height: a little over 5'2
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Quote:
Originally Posted by jiffypop
you HAVE TO tell the surgeon. he needs ALL the information - yes, even the stuff you don't want to admit - so that he can take proper care of you. And he'll be able to tell you if it's safe for you to have surgery so soon after the kidney stones [yikes!!!!]
and i'm soooo sorry you're hitting so many roadblocks and challenges. but please take care of yourself while you're jumping over them and banging into them.
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Quote:
Originally Posted by jiffypop
good grief. please hang in there - take a deep breath - and get ready for a long heart to heart with your doc and perhaps with your insurance company about exactly why they denied the surgery. it could be any number of reasons - including administrative stuff that have nothing to do with your health.
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I doubly second what jiffy said! I'm so sorry this happened and just keep hanging in there! I will be praying that you get approved ASAP!
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04-09-2013, 04:06 PM
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#6
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Junior Member
Thread Starter
Join Date: Jan 2013
Location: Quantico VA
Posts: 21
S/C/G: 243/190/150
Height: 4'11
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Thanks ladies. It really helps to have this site, it's been the first place I turn.
I just got back from my surgeons office, I had to sign a paper giving them permission to do an expedited appeal on my behalf. I should know something by Friday, surgery is Tuesday. At least there is hope.
Has anyone ever done an appeal like mine?
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04-09-2013, 04:19 PM
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#7
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Senior Member
Join Date: Feb 2012
Posts: 745
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I haven't had (and hopefully wont! ) an experience like yours so I can't give much advice, but I'm just popping in to wish you luck! Stick to it, I really hope it works out for you <3
Last edited by thinkfit; 04-09-2013 at 04:20 PM.
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04-10-2013, 02:51 AM
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#8
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Member
Join Date: Aug 2012
Location: South Florida
Posts: 98
S/C/G: 318.5/301/180
Height: 5'6
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How horrible!! Hope the appeal works!
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04-10-2013, 05:15 AM
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#9
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Releasing the inner hiker
Join Date: Jul 2006
Location: New England
Posts: 715
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I was initially denied due to some missing paperwork from my PCP. If I'm not mistaken, I think my surgeon's group also had to submit appeal paperwork. Once they received all the missing forms, the appeal approval happened fairly quickly (within 2 days if I recall). Good luck!
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04-10-2013, 11:13 AM
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#10
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Junior Member
Thread Starter
Join Date: Jan 2013
Location: Quantico VA
Posts: 21
S/C/G: 243/190/150
Height: 4'11
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Zeitgeist- that's good to hear! This waiting game is killing me! I really hope it's approved. I have been waiting so long. My parents, sister and husband all took vacation to be here for me. I've schedule my sons 1st birthday party around the surgery. I wish I could just crawl in a hole until I get an answer.
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04-11-2013, 12:07 PM
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#11
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Junior Member
Thread Starter
Join Date: Jan 2013
Location: Quantico VA
Posts: 21
S/C/G: 243/190/150
Height: 4'11
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Guess what......
I'm approved!!!!
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04-11-2013, 12:14 PM
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#12
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Senior Member
Join Date: Sep 2012
Location: Canada
Posts: 3,689
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04-11-2013, 01:10 PM
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#13
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I got this
Join Date: Jan 2011
Location: Near St. Louis
Posts: 2,823
S/C/G: 206/162/135
Height: a little over 5'2
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Quote:
Originally Posted by Disneygirl52
Guess what......
I'm approved!!!!
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Whoo-hoo!!!!! So happy for you! What a relief!
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04-11-2013, 02:31 PM
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#14
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Senior Member
Join Date: Feb 2012
Posts: 745
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YAY!!!!! omg! I had my fingers crossed for you, so glad you didn't have to have this drawn out any longer!
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04-11-2013, 04:41 PM
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#15
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Old Cackler
Join Date: Apr 2000
Location: northern New Jersey
Posts: 7,525
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good heavens!!! what changed??? ?congratulations! ya know - i've heard of some companies that'll turn people down for <fill in the blank here> just because they don't think the person will appeal the denial and they won't have to pay. and then when the appeal is filed, they approve it quickly.
wow. i'm so happy for you!!!!
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