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1 week until surgery, still not approved. Kidney stones too

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Old 04-08-2013, 11:15 PM   #1
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Unhappy 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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Old 04-09-2013, 09:26 AM   #2
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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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Old 04-09-2013, 11:10 AM   #3
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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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Old 04-09-2013, 01:57 PM   #4
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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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Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 04-09-2013, 02:07 PM   #5
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Quote:
Originally Posted by jiffypop View Post
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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Originally Posted by jiffypop View Post
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.
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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Old 04-09-2013, 04:06 PM   #6
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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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Old 04-09-2013, 04:19 PM   #7
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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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Old 04-10-2013, 02:51 AM   #8
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How horrible!! Hope the appeal works!
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Old 04-10-2013, 05:15 AM   #9
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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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Old 04-10-2013, 11:13 AM   #10
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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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Old 04-11-2013, 12:07 PM   #11
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Guess what......

I'm approved!!!!
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Old 04-11-2013, 12:14 PM   #12
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Quote:
Originally Posted by Disneygirl52 View Post
Guess what......

I'm approved!!!!
So happy for you!!! I was following this thread hoping you got your good news soon!! Good luck!!!
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Old 04-11-2013, 01:10 PM   #13
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Quote:
Originally Posted by Disneygirl52 View Post
Guess what......

I'm approved!!!!
Whoo-hoo!!!!! So happy for you! What a relief!
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Old 04-11-2013, 02:31 PM   #14
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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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Old 04-11-2013, 04:41 PM   #15
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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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Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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