Guest guest Posted August 29, 2001 Report Share Posted August 29, 2001 In a message dated 08/29/2001 11:51:49 PM Central Daylight Time, donna_lee777@... writes: > am I just being selfish because mine > approved only the RNY and not the DS? I don't think so. Unless there is an exclusion, most insurance companies it seems approve the RNY pretty routinely as long as medical necessity is shown. Dawn----South suburban chicago area Dr. Hess, Bowling Green, OH BPD/DS 4/27/00 www.duodenalswitch.com 267 to 165 5' 4 " size 22 to size 10 have made size goal no more high blood pressure, sore feet, or dieting! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2001 Report Share Posted August 29, 2001 In a message dated 08/29/2001 11:51:49 PM Central Daylight Time, donna_lee777@... writes: > it would be so > painful to have to chew so much due to the > triggerpoints You need to get them to write that this is a medical necessity for the DS over the RNY. Dawn----South suburban chicago area Dr. Hess, Bowling Green, OH BPD/DS 4/27/00 www.duodenalswitch.com 267 to 165 5' 4 " size 22 to size 10 have made size goal no more high blood pressure, sore feet, or dieting! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Dee- I agree completely with Chris. Its not God's will it is the insurance company's will. It all comes down to the all mighty dollar. If you decide to fight for the DS and at some point down the road you find you can;t win, then at least the RNY is an alternative (I don't think its a great alternative) but it is still an option. Don't defeat yourself before you even try. It may be a long battle to get DS but I truly feel it is a battle worth fighting for. In the end it will have to be your choice, but please don't put the responsibily of an insurance denial squarely on God's shoulders, let the insurance company take the blame for the denials. When all is said and done, insurance companies are in the business of making money and typically employ people who have no knowledge on medical issues. Fight your own battle armed with knowledge and determination. You never know if you will get denied until you try. My thoughts are with you and I will keep my fingers crossed. Take care, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Dee, the hardest part of getting insurance approval is for them to adknowledge necessity. That means they concede that yes, you need WLS. You've won the hardest part of the battle. Now, you fight for the surgery you want. BTW, they're counting on you to give up and take the RNY. It would be cheaper for them. Tell them you will accept nothing less than the DS. Then,when they throw excuses your way, you can use Hull's letter to sway them. best of luck, and keep the faith!!, Meli (who had to fight like HELL to get approval for DS) -- In duodenalswitch@y..., Dee <donna_lee777@y...> wrote: > After reading so many posts about insurance companies > denying coverage, am I just being selfish because mine > approved only the RNY and not the DS? Should I be > grateful that at least I'm being given that option? > > Tomorrow I see my PCP and I'm starting to wonder if I > should just consider this God's Will to have the RNY. > I do NOT want the side effects and it would be so > painful to have to chew so much due to the > triggerpoints on my head but maybe it won't be so bad. > I've been looking at some websites of people who have > had the RNY and they're so HAPPY. > > I was so positive yesterday that the DS was the *only* > way to go but now I'm starting to wonder. ACK! > > ===== > Dee > Waiting for Ins. Co. Approval > 313/Want to be 165 > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Don't be forced into anyone's mold Dee. You deserve what is best for you. You should control what happens to you, and not an insorance complany whose bottom line is thier only concern. Fat people have been shoved around enuf--God has given you the intelligence and abiltiy to fight for what is right for you. Pammi Having Doubts After reading so many posts about insurance companies denying coverage, am I just being selfish because mine approved only the RNY and not the DS? Should I be grateful that at least I'm being given that option? Tomorrow I see my PCP and I'm starting to wonder if I should just consider this God's Will to have the RNY. I do NOT want the side effects and it would be so painful to have to chew so much due to the triggerpoints on my head but maybe it won't be so bad. I've been looking at some websites of people who have had the RNY and they're so HAPPY. I was so positive yesterday that the DS was the *only* way to go but now I'm starting to wonder. ACK! ===== Dee Waiting for Ins. Co. Approval 313/Want to be 165 __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 At 21:50 -0700 8/29/01, Dee sat down at the keyboard and wrote: >Tomorrow I see my PCP and I'm starting to wonder if I >should just consider this God's Will to have the RNY. Why in the world would you consider anything which is man's doing " God's Will " ??? A better motto would be " God helps those who helps themselves, " which is why I'm fighting tooth and nail for the procedure I know is best for me. --stella Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 At 21:50 -0700 8/29/01, Dee sat down at the keyboard and wrote: >Tomorrow I see my PCP and I'm starting to wonder if I >should just consider this God's Will to have the RNY. --------------------------------------------------------------------------------\ ------------------------------------------------ Dee, Hi ! I can really empathize with you, not because I've been there yet, but because it may be a decision I will have to make also. I am pre-op, with my consult not until mid-October. I have Cigna, and I know I am going to have to battle ... first of all just for the 'right' to have WLS of any type. I know that all insurance carriers do try to push the RNY because it is less expensive and there is a much greater likelihood there is a surgeon performing this in your network than someone performing the DS. So .... I have spent considerable time arguing with myself the pros and cons of DS .... or ... nothing (if the RNY is my ONLY option). I plan on fighting tooth and nail to get the DS (when I get that far). There is a plethora of information on this site that can aid us in that fight, and I plan to use each and every bit of it. I can't honestly say when or if I will give up the fight for the DS and choose the RNY over nothing. I plan on battling my case with legal assistance, if necessary, and have already made contact with Walter/ to let them know I may be coming their way. I think that each of us has to exhaust ALL possibilities (and 'when all possibilities are exhausted' is a very individual thing based on desire, fortitude, finances, etc.) before choosing to select an alternate procedure, whatever that may be. Although I am definitely an advocate of the DS surgery, and want nothing less, I cannot say with certainty that I would select 'nothing' over an RNY. I do know, tho, that from what I've seen from the people on this site, you will be supported no matter which way you go. The best of luck to you, Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Hi Dee, I certainly understand your problem as my story with the insurance company is the same. Everyday I wonder which is the right surgery for me. I am so drawn to the DS because there doesn't seem to be the slight weight regain in 2 years like many people experience with the RNY. But, I am not convinced that the RNY is an evil operation. MANY people do quite well and eat pretty much what they want, just in smaller portions. The stomach stretches overtime allowing for more than the initial 2 or 3 teaspoons of food. A typical meal can consist of a small chicken breast, a little rice and maybe some salad. I do think the RNY is going to require more exercise to maintain weight loss. Again, I don't know if that's a bad thing. One of the reasons surgery appeals to me is because I'm ready to learn new habits, both food and exercise. I worry about the long term effects of both surgeries. And remember, God's will is really your will amplified. I mean, that as you search yourself over which is the right choice for you, God will help you listen. Don't use your head, sit, be quite, still and ask for guidance. I always look for a feeling or a knowing. It usually is the one that is peaceful and it may not be the one your head is telling you to do. I wish you lots of success and peaceful moment as you continue down this road! Dawn C Having Doubts > After reading so many posts about insurance companies > denying coverage, am I just being selfish because mine > approved only the RNY and not the DS? Should I be > grateful that at least I'm being given that option? > > Tomorrow I see my PCP and I'm starting to wonder if I > should just consider this God's Will to have the RNY. > I do NOT want the side effects and it would be so > painful to have to chew so much due to the > triggerpoints on my head but maybe it won't be so bad. > I've been looking at some websites of people who have > had the RNY and they're so HAPPY. > > I was so positive yesterday that the DS was the *only* > way to go but now I'm starting to wonder. ACK! > > ===== > Dee > Waiting for Ins. Co. Approval > 313/Want to be 165 > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
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