Guest guest Posted October 24, 2001 Report Share Posted October 24, 2001 Hey Roxanne! Good to hear from another southern " redneck " ! I am from , LA. is between Baton Rouge & Hammond. Small town of about 5000 people. Yes, I do intend to use Dr. Booth's office for surgery IF I can obtain approval. I really felt very comfortable with him and his staff. My husband had some serious doubts and fears about surgery. However, after going to see Dr. Booth with me and sitting in on all the consult information, he is all far it. I have been waiting since Feb. because at first my pre-approval claim got " lost " because the lady who was working it left the company.....then, they have never denied or approved the surgery. You can't appeal something that has not been denied! They just say that if I meet the criteria it will be covered. The criteria is crazy! Like requiring 3 out of the last 5 years to have been spent dieting under doctor supervision and then 6 months out of the last year to have been making WEEKLY doctor visits for diet and nutrition counseling. NO ONE who has been morbidly obese for over 20 years is still playing that yo-yo game! So, of course, I don't have that criteria met. You have to have been morbidly obese for no less than 5 years and 200% over your ideal weight...since I am now super morbidly obese...I've got all those covered! Since we first sent the LOMN in Feb., the self-insured company that my husband has our insurance through has changed where you submit claims and pre-approvals...so we had to start over and re-submit everything. I sent a 7 page letter with an inch thick " book " of attachments to document everything I could find. I even found my weight and height on a couple of old report cards from 4 and 5 grade and got a parish growth chart and proved that I was bigger than 90 out of 100 kids in the same age group. Proved I was obese that far back! I copied pages of my dead mom's journals where we went to " health salons " . So, the waiting begins again. Keep me posted on your progress! What kind of sugery did you have originally? I am kinda afraid that if they approve...then I'll have to start the out of network battle. There is a new doctor in Baton Rouge who is doing the RNY and I want the DS. According to Dr. Booth, a super morbidly obese person has better lasting results from DS surgery. But I'll cross that bridge when it happens! " Still " fluffy, Hugs, Jerry, Southern Gal from Louisiana waiting on approval. > >Reply-To: duodenalswitch >To: duodenalswitch >Subject: Hello Jerry Cook >Date: Wed, 24 Oct 2001 12:55:02 -0000 > >Hi Jerry I noticed from your post that you are from Louisiana. I am >also a Southern Gal from LA. I live in Abbeville. What part of LA are >you from? BTW who is your insurance? What is the hold up on your >approval/denial? Feb. is a long time to still be waiting. Also, are >you going to Mississippi for your surgery? I'm planning on seeing Dr. >Booth/Kim for my revision. Any other Louisiana's out here?????? >Have a Good Day, Roxanne > > >---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2001 Report Share Posted October 24, 2001 Hi Betsy, How far off are you from qualifying? Do you have any co-morbid problems? Keep fighting. Roxanne Quote Link to comment Share on other sites More sharing options...
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