Insurance Approval for BPD/DS needed for BMI under 50 how???

[JackieOnLine]

I'm sorry it's going so badly, Spiky Bugger. I hope Tuesday brings complete relief.

 

[Spiky Bugger]

I’m sorry. Did you whap your hubby for his comment???

I have permission, right?

 

[Spiky Bugger]

I'm sorry it's going so badly, Spiky Bugger. I hope Tuesday brings complete relief.

Thank you.

 

[southernlady]

I have permission, right?

Yes!

 

[Whit]

Hi there,
I had TriCare as my secondary coverage. They automatically covered revision to DS if my Primary covered it. That was 5 years ago so it may have changed. Is it possible for you to to purchase another insurance plan? If you can TriCare will automatically be your secondary insurance and maybe pick up the difference.

 

[mcnee]

I have no idea why you have decided to start sharing what you know about bariatric surgery (and insurance) (and marriage, for that matter), but I sure wish you'd master some facts first...because it would be good if you knew a lot more.

yes, I'm confident. But yes, I also realize I don't know everything and am more than willing and open to continue learning if what I believe to be correct turns out not to be so.

I don't need an apology, but I also don't need snide comments. If you feel something I share is incorrect, fine. All I would ask is you respectfully point it out and let me know the correct information.

And I never claimed to know anything about marriage... I believe all I did do was provide some info based on a study. I didn't embellish or spin anything.

 

[Spiky Bugger]

See, here's the deal:

You wandered on to a bariatric surgery support site, did not bother to introduce yourself and immediately participated...in a rather inane way...in two threads.

To begin, why anyone would go from site to site seeking info on post-op divorce rates is a wonder. There are so many variables that would need to be controlled for that embarking on that venture in this way seems quite ill-conceived. Clearly, the 85% rate is bullshit. The author of THAT drivel needs to defend those numbers. And no "truth" will be found on support groups.

Far worse than that, though, is the way in which you attempt...here and at other sites...to establish your bona fides in the field of health. You are a HEALTH COACH? Based on a certificate from this place: https://www.credentialwatch.org/reports/iin.shtml ?

You obviously have an interest in the topic...but the credential offered from "mills" like the one you mention are available to anyone who can come up with the money...and few legitimate colleges even accept transfer credits from such places. Given that background, and the fact that you allude to "a doctor I work with," which might imply a medical expertise on your part when, in fact, you might "work with" a doctor on picking out his office furniture has the potential to be very misleading.

You posts parrot misinformation on the topic of insurance and on the duodenal switch.

Again, mastering facts might be beneficial. Or not volunteering incorrect info might work.

But, since I'm a 71-year old asshole with an extremely limited tolerance for bullshit and a PhD in Snide, you might want to just block me. I can handle the rejection.

 

[mcnee]

You mention mastering facts... by searching various sites about divorce rates after surgery.. and finally finding some scientific studies on the subject... wasn't I doing just that? yea, I know the 80-85% was BS. That's why I was looking for something that would provide some actual information. And yes, before anyone else points it out, I know there are lots of factors behind it. The what and the why are two very different conversations.

As for volunteering incorrect info... um..until it was oh-so politely pointed out to me, I didn't realize the inaccuracies (tho I did know about the issues around self-insurance and hadn't taken that into account when I first posted).

I have no need to defend myself. I'm confident enough in what I know/do to want to continue to share and try to help others. And I'm humble enough to admit when I'm wrong and try to keep learning along the way.

But that's just me.

 

[galaxygrrl]

To the OP. I went to MX. I could have gone through the appeal process and dragged this out and perhaps I would have won. Or, I could have just popped down to MX and be done in a few weeks. I was lucky and had the money. It was 11k for a vigin DS. I figured it would be one more year of my life where I was skinny. That was worth the money to me.

 

[Spiky Bugger]

You mention mastering facts... by searching various sites about divorce rates after surgery.. and finally finding some scientific studies on the subject... wasn't I doing just that? yea, I know the 80-85% was BS. That's why I was looking for something that would provide some actual information. And yes, before anyone else points it out, I know there are lots of factors behind it. The what and the why are two very different conversations.

As for volunteering incorrect info... um..until it was oh-so politely pointed out to me, I didn't realize the inaccuracies (tho I did know about the issues around self-insurance and hadn't taken that into account when I first posted).

I have no need to defend myself. I'm confident enough in what I know/do to want to continue to share and try to help others. And I'm humble enough to admit when I'm wrong and try to keep learning along the way.

But that's just me.

So, this blurb... http://www.obesityppm.com/rob-portinga where you "mention" your experience as a bariatric surgery patient, on the board of Obesity Action Coalition, training as a "holistic health coach," should be ignored because even nine years into the journey, you are just "learning along the way?"

THIS IS NOT ONLY CONFUSING TO PEOPLE WHO NEED HELP, IT'S POTENTIALLY VERY HARMFUL!

If, nine years post-op and very active in the bariatric surgery community, you are posting the nonsense you shared regarding the DS, you need to stop writing anything beyond "Sorry, I don't know anything about the DS, but please go to BariatricFacts.org and ask there."

(While you're at it, have you written about the risk of Bariatric BeriBeri post RnY? Today, I had to remind a nurse, an RnY patient, to get her labs done and to include B1. She's a nurse. Poorly informed about her surgery and had never heard of mine.)

 

[Mikapooh82]

I have 1199 SEIU insurance. Back In 2013, they had that stupid 50 BMI requirement for DS approval. My BMI was only 44 but I took the chance & applied anyway. Of course I initially got denied but I didn’t give up! U have to try to fight for the surgery u want. Don’t just settle for what your insurance allows u to have.

Diana & Larra graciously guided me through the multiple appeals and I finally got approved!

My insurance no longer has a specific BMI requirement for DS approval. They probably got tired of people challenging them or maybe they finally saw that the rule is useless.