She didn't figure this out in advance, but...

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True...but she seems bright enough to challenge the claim that something CLEARLY not cosmetic in nature is being denied on those grounds.
 
Oops...she lives in Texas...a state where people vote for folks who are PRO-business to the point of being ANTI-people, so she may be right that she is screwed.

But it is clearly not cosmetic.
 
I guess my frustration is with the fact that she went into a 180 pound weight loss without a realistic expectation of what to expect...it sounds as if she was SURPRISED by hanging skin. I guess we are all somewhat surprised, but I suppose she sounds more surprised than I want people to be!
 
it is amazing but sometimes people don't know the most basic stuff.

I can't even imagine if I had not been on the internet reading and asking questions - just had my MD tell me what surgery to get and the NUT he sent me to what to do post op. I'd have been lost, I tell you, LOST! :eek:
 
it is amazing but sometimes people don't know the most basic stuff.

I can't even imagine if I had not been on the internet reading and asking questions - just had my MD tell me what surgery to get and the NUT he sent me to what to do post op. I'd have been lost, I tell you, LOST! :eek:
Lost? You could be dead, which is slightly more bad than lost. I'm having to re-adjust my vitamin regimen based on results from my last lab draw. I've got an order in to our dear Vitalady. Yep, I've learned a lot myself without any help from a Center of Excellence NUT.
 
It is scary that she didn't have an inkling that she was going to have excess skin. I wonder too if she has even had a consult with a PS or is just assuming it is considered cosmetic. Most PCP's and definitely PS's would know that this would be medically necessary if it is causing sores and rashes.
And the thing is, a PS will get paid far less for a medical procedure covered by insurance than he would for a similar procedure paid for in cash.
 
Lost? You could be dead, which is slightly more bad than lost. I'm having to re-adjust my vitamin regimen based on results from my last lab draw. I've got an order in to our dear Vitalady. Yep, I've learned a lot myself without any help from a Center of Excellence NUT.
@k9ophile , I echo you on the COE rant. I was initially one of the COE tagged patients who was given questionnaires to complete every step of the way through my WLS journey. Early out, however, I was mysteriously dropped from the program. I suspect it was because of my complaint about being lumped in with all RNY and sleeves in my post-op meetings. I also refused to follow the COE guidelines for vitamin supplementation and purchase their Celebrate products.

COE doesn't mean much.
 
Despite Houston's shenanigans of late, that stupid COE clause saved me from Husted. If Lake Cumberland had earned that prestigious* designation, I probably would have ended up there. Earlier this year, I got a letter telling me how important it was for them to keep their COE designation and I hadn't followed up in a while. Like I'm going to drive 150 miles (round trip), spend <5 minutes with Houston to tell him all is well, AND a co-pay so they can keep their COE.


*sarcasm font
 
The first time I lost 150lbs, I wasn't prepared for the amount and appearance of the excess skin.. and being in my early-mid 20's and single it was tough to deal with. I eventually regained, so it wasn't an issue..

I never did get sores, and still don't though my skin issues are bigger than the ones she's pictured, so my hanging arm/belly/thigh and back skin is considered cosmetic, despite the discomfort even when flipping over in bed. Hopefully some surgeon has reached out to her by now and directed her on how to document her issues and get this covered.
 
Despite Houston's shenanigans of late, that stupid COE clause saved me from Husted. If Lake Cumberland had earned that prestigious* designation, I probably would have ended up there. Earlier this year, I got a letter telling me how important it was for them to keep their COE designation and I hadn't followed up in a while. Like I'm going to drive 150 miles (round trip), spend <5 minutes with Houston to tell him all is well, AND a co-pay so they can keep their COE.


*sarcasm font
Yes, I too received a letter like yours from my surgeons' practice. I drove 3.5 hours when I went there. And after they completely dropped the ball when my Ferritin dipped to 9 and they didn't refer me for iron infusions, I left.

This post reminds me of when Kate Gosselin had her tummy tuck, after the birth of her septuplets. I believe she got hers paid for or donated. I bet this babe ends up getting the same thing.
 
I am pretty sure she had septuplets one baby did not survive. She wrote an article about it. She initially did not talk about the 7th baby because she was concerned about how the others would react.


MsVee
 

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