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Hello! Had RNY (gastric bypass) in 02....Let's just say it was never quite right. I didn't lose enough even though I ate well and have always exercised. I can't eat most foods and feel like at some point I will need to eat baby food! I have the whole gerd thing going....Anyway, Anthem BC/BS just declined my surgery with Dr. K. I'm waiting for the official letter from insurance. Neither his office nor I have received it yet. I was told BMI was too low and gerd wasn't enough. I look forward to your thoughts on moving forward in this process. Failure (not having the surgery) is not an option.

BTW, I am 55, married, no kids, lots of dogs and work in the entertainment business in Hollyweird.
 
Hello McQueenB

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Hi McQueenB and welcome!

When you get that denial letter, let me and esp let DianaCox know. We can't promise that we can help you but we can at least review the denial as well as your EOC (Evidence of Coverage) and see what's what.
So while you're waiting for that letter to arrive, get your EOC - the whole thing, which is many pages. You are entitled to have this, either from your insurer or from your employer. This will help us to sort out the nature of your coverage, whether or not an exclusion is the problem, etc. There is no way to know where you stand as far as any available appeals goes without this document.
 
Hi Everyone! I've been lurking around here for a while now, and I must say...this is the most educated group people I've found regarding WLS! I feel like most of the posters here really know what they are talking about, and it's so refreshing. I can't spend too much time of some of the bigger forums because it seems like everyone things they know everything and really they are clueless half the time!

I know that the vast majority of members here are DSers (is that how I'd say it?), but I will be VSG, so I hope you will still accept me. It seems the VSG board doesn't get used often. My surgery is scheduled for 8/5/14.

The personal stuff...I'm 37, married, and have a 6 year old son and a 2 year old daughter. I just received my degree in Health Education (Community/Worksite), but I'm currently just doing part time office work at my university. Well, I will be after surgery. I've been off the past two months because I don't work in the summer. I can't wait to go out and get a different job now that I've finally graduated, because secretarial work is not my strength.

My Highest weight (last summer) was 284. The day of my surgical consult I was 276 (July 14th), and I'm now down to 266, which is shocking because I have the most unrestrictive liver-shrinking pre-op diet I've seen. It's 3 meals, 2 snacks, with at least one high protein item in every meal. It includes combinations of protein shakes, fruit, veggies, lean protein, and .5 cup portions of starches, such as potatoes, rice, bread, and pasta. I choose any combination 2-3 of these in a meal and 1 (or 2) of these for a snack. I hope the weight loss means my liver is actually shrinking! It's been steady since I finally got on track around a week ago. And I live in Idaho.

HELLO!!!!!
 
Thank you everyone! I'll probably mostly be hanging out quietly in the background, but like I said, I'm really impressed with this forum!
 
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