Re: Re: Hi friends!~ I'm back!

[Guest guest]

In a message dated 07/15/2000 1:49:50 AM Eastern Daylight Time,

lindat@... writes:

<<

When you could have the MGB and be up and going the next day, feeling

fine, no big scar, 35 minutes on the operating table, 1 day in the

hospital?

>>

,

I have loved reading all of your thought provoking, sometimes heart wrenching

and then at other times funny posts. I would like to speak up for those of us

that do not get the privilege of having Dr. R. do our surgery. I have fought

with my insurance since Nov. to get approval for the MGB. I was denied the

first time then after a lot of help from this site and 3 appeal letters (one

from me, my PCP and Dr. R's office) I was approved. Now the part that stinks

even after extensive conversations with the appeals director my insurance

company will only send me to an " in network " doctor. (I pretty much told them

how stupid it was to send me to a doctor that was more expensive and

invasive, to no avail) He only does the open RNY. I went to my appt. with

him ready not to like him or the surgery he performs. But in all fairness I

have to say he is a very professional, caring person and made me feel that he

would be there for me in whatever way I needed. We even talked about Dr. R.

He was not familiar with his surgery so therefore would not make any comments

on him. He was very thorough. Needless to say I like him and even though it

is not my surgery of choice I think he will do a fine job.

I guess what I am getting at is: that there are those of us that still want

to be part of this family and don't want to feel the " us " and " them " that we

have known all of our lives. I hope we are still one big happy family, and

those of us that don't get the MGB for whatever reason be it choice, or

insurance necessity are still welcome here with open and eager arms and not

made to feel like we made a wrong choice. (stepping off my soapbox)

Thanks and I love all of you guys!

Sharon In KY

[Guest guest]

Hi Sharon!

I'm not trying to turn it into and " us " v. " them " thing, it's just that

when you are on this list, it makes it obvious that you know about the

MGB so when someone publicly announces (without further explanation)

that they are having some other procedure, you have to admit it raises

eyebrows.

As for your insurance issue, the insurance company can't " send " you

anywhere. It is your choice to go where you want. Now they may only

pay the " out of network " rates (usually 70/30) if you go " out of

network, " but that is when you should find out what your " stop loss "

amount is. Even if they only say they will pay the " out of network "

amount, you should not have to pay anything more than your " stop loss "

amount, which is usually about $1,000 - $1500. Insurance companies

don't tell you this.

Thus, it could very well be possible to have the MGB, but don't count on

your insurance company to clue you in. That's what I was getting at.

Best wishes for a wonderful outcome whatever you do!

Hugs & kind regards,

nonesuch98@... wrote:

>

> In a message dated 07/15/2000 1:49:50 AM Eastern Daylight Time,

> lindat@... writes:

>

> <<

> When you could have the MGB and be up and going the next day, feeling

> fine, no big scar, 35 minutes on the operating table, 1 day in the

> hospital?

> >>

>

> ,

> I have loved reading all of your thought provoking, sometimes heart

> wrenching

> and then at other times funny posts. I would like to speak up for

> those of us

> that do not get the privilege of having Dr. R. do our surgery. I have

> fought

> with my insurance since Nov. to get approval for the MGB. I was denied

> the

> first time then after a lot of help from this site and 3 appeal

> letters (one

> from me, my PCP and Dr. R's office) I was approved. Now the part that

> stinks

> even after extensive conversations with the appeals director my

> insurance

> company will only send me to an " in network " doctor. (I pretty much

> told them

> how stupid it was to send me to a doctor that was more expensive and

> invasive, to no avail) He only does the open RNY. I went to my appt.

> with

> him ready not to like him or the surgery he performs. But in all

> fairness I

> have to say he is a very professional, caring person and made me feel

> that he

> would be there for me in whatever way I needed. We even talked about

> Dr. R.

> He was not familiar with his surgery so therefore would not make any

> comments

> on him. He was very thorough. Needless to say I like him and even

> though it

> is not my surgery of choice I think he will do a fine job.

> I guess what I am getting at is: that there are those of us that still

> want

> to be part of this family and don't want to feel the " us " and " them "

> that we

> have known all of our lives. I hope we are still one big happy family,

> and

> those of us that don't get the MGB for whatever reason be it choice,

> or

> insurance necessity are still welcome here with open and eager arms

> and not

> made to feel like we made a wrong choice. (stepping off my soapbox)

> Thanks and I love all of you guys!

> Sharon In KY

[Guest guest]

, I thought that someone would ask these questions!!! I give

information on both surgeries RNY and MGB aand they picked apporoval for RNY

they said that the MGB was experimental and that they didn't have enough

history on the out come later down the road, I'm very comfortablr with this

and have checked out many different surgeries and I'm just happy that they

are paying!!! As for the scarring I rally don't care I already haave a

C-section scar from my last child 9 years ago,I guess money is not an object

for Hallmark Cards it is a very wealthly company.I have had other surgeries

and it doesn't really bother me NO I don't like pain but knives and shots

don't really bother me I'll be asleep I know that people think I " m nut's I

feel very greatful to be having the surgery. Also the time I'm off work is

all paid and I will be taking 12 weeks off and hopfully the last couple will

be a much needed vacation I plan to spend time with my two boys ages 14 and

9 and enjoy every minute of my paid time off for my recovery. Thanks for the

wish of Good Luck!!!! Friend Suzi Remley

Re: Hi friends!~ I'm back!

>>

>> >In a message dated 7/14/2000 10:46:59 AM Eastern Daylight Time,

>> >DebLaMan@... writes:

>> >

>> >>

>> >> A big CONGRATS to all who were approved! Deb in IL and Holly in

>> IL

>> stand

>> >> out

>> >> in my mind. It's good to see all the IL peeps. Holly, where are

>> you

>> >from?

>> >>

>> >> I'm in Naperville. Everyone else who was approved--I'm so happy

>> for

>> you.

>> >>

>> >Hi Debbie! I am in Decatur. How many people do we have from

>> Illinois

>> here?

>> >Me, you and the other Deb..anyone else? I am still a wannabe but

>> getting

>> >closer everyday! Where is the other Deb from in Illinois?

>> >

>> >Holly

>> >

>> >------------------------------------------------------------------------

>> >To email plain text is conventional, to add graphics is divine.

>> >We'll show you how at www.supersig.com.

>> >http://click.egroups.com/1/6808/3/_/453517/_/963603242/

>

>

>------------------------------------------------------------------------

>Get a NextCard Visa, in 30 seconds!

>1. Fill in the brief application

>2. Receive approval decision within 30 seconds

>3. Get rates as low as 2.9% Intro or 9.9% Fixed APR

>http://click.egroups.com/1/6630/3/_/453517/_/963637570/

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>

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>Please visit our web site at http://clos.net

>Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

>

[Guest guest]

, I don't know about everyone else but I 'm on the list for not only

for THIS SURGERY, but for the continuing support that I feel I have no

matter what surgery I'm actually having and the friendship I feel though all

of you caring people, I will not stop supporting my friends on this list

either!!!!! You are all good people with great hearts. Thanks again Suzi

Remley

Re: Re: Hi friends!~ I'm back!

>Hi Sharon!

>

>I'm not trying to turn it into and " us " v. " them " thing, it's just that

>when you are on this list, it makes it obvious that you know about the

>MGB so when someone publicly announces (without further explanation)

>that they are having some other procedure, you have to admit it raises

>eyebrows.

>

>As for your insurance issue, the insurance company can't " send " you

>anywhere. It is your choice to go where you want. Now they may only

>pay the " out of network " rates (usually 70/30) if you go " out of

>network, " but that is when you should find out what your " stop loss "

>amount is. Even if they only say they will pay the " out of network "

>amount, you should not have to pay anything more than your " stop loss "

>amount, which is usually about $1,000 - $1500. Insurance companies

>don't tell you this.

>

>Thus, it could very well be possible to have the MGB, but don't count on

>your insurance company to clue you in. That's what I was getting at.

>

>Best wishes for a wonderful outcome whatever you do!

>

>Hugs & kind regards,

>

>

>

>

>nonesuch98@... wrote:

>>

>> In a message dated 07/15/2000 1:49:50 AM Eastern Daylight Time,

>> lindat@... writes:

>>

>> <<

>> When you could have the MGB and be up and going the next day, feeling

>> fine, no big scar, 35 minutes on the operating table, 1 day in the

>> hospital?

>> >>

>>

>> ,

>> I have loved reading all of your thought provoking, sometimes heart

>> wrenching

>> and then at other times funny posts. I would like to speak up for

>> those of us

>> that do not get the privilege of having Dr. R. do our surgery. I have

>> fought

>> with my insurance since Nov. to get approval for the MGB. I was denied

>> the

>> first time then after a lot of help from this site and 3 appeal

>> letters (one

>> from me, my PCP and Dr. R's office) I was approved. Now the part that

>> stinks

>> even after extensive conversations with the appeals director my

>> insurance

>> company will only send me to an " in network " doctor. (I pretty much

>> told them

>> how stupid it was to send me to a doctor that was more expensive and

>> invasive, to no avail) He only does the open RNY. I went to my appt.

>> with

>> him ready not to like him or the surgery he performs. But in all

>> fairness I

>> have to say he is a very professional, caring person and made me feel

>> that he

>> would be there for me in whatever way I needed. We even talked about

>> Dr. R.

>> He was not familiar with his surgery so therefore would not make any

>> comments

>> on him. He was very thorough. Needless to say I like him and even

>> though it

>> is not my surgery of choice I think he will do a fine job.

>> I guess what I am getting at is: that there are those of us that still

>> want

>> to be part of this family and don't want to feel the " us " and " them "

>> that we

>> have known all of our lives. I hope we are still one big happy family,

>> and

>> those of us that don't get the MGB for whatever reason be it choice,

>> or

>> insurance necessity are still welcome here with open and eager arms

>> and not

>> made to feel like we made a wrong choice. (stepping off my soapbox)

>> Thanks and I love all of you guys!

>> Sharon In KY

>

>

>

>------------------------------------------------------------------------

>Life's too short to send boring email. Let SuperSig come to the rescue.

>http://click.egroups.com/1/6809/3/_/453517/_/963688522/

>------------------------------------------------------------------------

>

>This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

>Please visit our web site at http://clos.net

>Get the Patient Manual at http://clos.net/get_patient_manual.htm

>

>

[Guest guest]

Hi !

Nobody's questioning that -- don't start an " us " v. " them " thing,

sheesh. Glad you're here.

Kind regards,

Remley wrote:

>

> , I don't know about everyone else but I 'm on the list for not

> only

> for THIS SURGERY, but for the continuing support that I feel I have no

> matter what surgery I'm actually having and the friendship I feel

> though all

> of you caring people, I will not stop supporting my friends on this

> list

> either!!!!! You are all good people with great hearts. Thanks again

> Suzi

> Remley

> Re: Re: Hi friends!~ I'm back!

>

> >Hi Sharon!

> >

> >I'm not trying to turn it into and " us " v. " them " thing, it's just

> that

> >when you are on this list, it makes it obvious that you know about

> the

> >MGB so when someone publicly announces (without further explanation)

> >that they are having some other procedure, you have to admit it

> raises

> >eyebrows.

> >

> >As for your insurance issue, the insurance company can't " send " you

> >anywhere. It is your choice to go where you want. Now they may only

> >pay the " out of network " rates (usually 70/30) if you go " out of

> >network, " but that is when you should find out what your " stop loss "

> >amount is. Even if they only say they will pay the " out of network "

> >amount, you should not have to pay anything more than your " stop

> loss "

> >amount, which is usually about $1,000 - $1500. Insurance companies

> >don't tell you this.

> >

> >Thus, it could very well be possible to have the MGB, but don't count

> on

> >your insurance company to clue you in. That's what I was getting at.

> >

> >Best wishes for a wonderful outcome whatever you do!

> >

> >Hugs & kind regards,

> >

> >

> >

> >

> >nonesuch98@... wrote:

> >>

> >> In a message dated 07/15/2000 1:49:50 AM Eastern Daylight Time,

> >> lindat@... writes:

> >>

> >> <<

> >> When you could have the MGB and be up and going the next day,

> feeling

> >> fine, no big scar, 35 minutes on the operating table, 1 day in the

> >> hospital?

> >> >>

> >>

> >> ,

> >> I have loved reading all of your thought provoking, sometimes heart

> >> wrenching

> >> and then at other times funny posts. I would like to speak up for

> >> those of us

> >> that do not get the privilege of having Dr. R. do our surgery. I

> have

> >> fought

> >> with my insurance since Nov. to get approval for the MGB. I was

> denied

> >> the

> >> first time then after a lot of help from this site and 3 appeal

> >> letters (one

> >> from me, my PCP and Dr. R's office) I was approved. Now the part

> that

> >> stinks

> >> even after extensive conversations with the appeals director my

> >> insurance

> >> company will only send me to an " in network " doctor. (I pretty much

> >> told them

> >> how stupid it was to send me to a doctor that was more expensive

> and

> >> invasive, to no avail) He only does the open RNY. I went to my

> appt.

> >> with

> >> him ready not to like him or the surgery he performs. But in all

> >> fairness I

> >> have to say he is a very professional, caring person and made me

> feel

> >> that he

> >> would be there for me in whatever way I needed. We even talked

> about

> >> Dr. R.

> >> He was not familiar with his surgery so therefore would not make

> any

> >> comments

> >> on him. He was very thorough. Needless to say I like him and even

> >> though it

> >> is not my surgery of choice I think he will do a fine job.

> >> I guess what I am getting at is: that there are those of us that

> still

> >> want

> >> to be part of this family and don't want to feel the " us " and

> " them "

> >> that we

> >> have known all of our lives. I hope we are still one big happy

> family,

> >> and

> >> those of us that don't get the MGB for whatever reason be it

> choice,

> >> or

> >> insurance necessity are still welcome here with open and eager arms

> >> and not

> >> made to feel like we made a wrong choice. (stepping off my soapbox)

> >> Thanks and I love all of you guys!

> >> Sharon In KY

> >