Yordis
I began my journey in Nov. 2005. I went to the siminar at Cedars Sinai and in Jan 2006 I had my first consult with the Dr. He said I was a good candidate for Lap. RNY.
I had my stress test and one of two Endoscospy in March. Met with the NUT and Social Worker.
After these were done Cedars called and said the papers were faxed to my Insurance.
I was denied because my insuranse does not cover WLS.
In April I wrote a letter to the HR department requesting that they revise the policy and allow WLS. In a couple of days I had a email back from them and they said that my letter had some good points to it and that they were going to add a Rider to the policy. They said it would be June. Well here it is July 7 and I am still waiting. I was assured by HR on June 26 that it was taking longer than expected and they were aiming for July 1. I am being very paitient do to the fact that this is costing them alot of money. I just hope that in the near future I will get the call from my insurance that the policy rider is in place so I can have surgery.
Aug 5. I received word from HR that the policy is just about in place. They sent me a copy of the rider. It looks like I will have to do a weight loss program. I am waiting for the insurance to put the policy into place and review my information form the surgeon. They will tell me what I need to do. I was hoping that I wouldn't have to do the wl program because time limitation for the testing I had done is running out and I will have to re-test. But I will do anything to get to a new me.
I am thinking of switching from Cedars in LA and finding a DR. here in Ventura Co.
I am so tired of being fat and ready to start my journey to a new me.
I forgot to mention that my PCP and the Medical Clinic they belong to is changing to Kaiser Insurance. This is a big issue for my area since it will mean a majority of the patients will have to find a new PCP. I need to find a new PCP by the first of the year. I sure hate having to start over with a new DR. It never fails when you get used to one, your insurance changes or they move.
Oct. 4th 2006. The rider is in place for WLS. I talked to HR. My company's HQ is in GA, I am in CA. The Hospital that would handle the preoperaitive medical consulaton and approval is located in GA. Since we do not have a program here in CA. The hospital in GA will be contacting me to determine what programs I need or have met.
HR is very understanding and knows that I want to get things moving asap. She is doing what she can to push this.
Dec. 1st. HR told me that they are waiving the 6 months diet. HR is having the insurance put in my file the waiver. I was told by HR that I need to get a surgery date so that my insurance will approve me. The insurance will not put the waiver in my file until I have a date. Well the problem with that is when the DR. office calls the insurance it says I need to do the 6 months diet. Since UHC will not put the waiver in my file I am in a catch 22 situation. I have been going back and forth with the HR and insurance on this matter.
Feb. I was told that the waiver is being put in my file now and to get a surgery date. The DR. called UHC and they still said that the waive was not in place. I called HR and told them the details. The are very upset with UHC and can not understand what is taking the so long. The Head of HR is now involved and told UHC to get this taken care of NOW. UHC said they would call the DR office and give the approval.
March 1. I called UHC to see if they had contacted the DR. I was told that they didn't see any records indicating that had called. I then called the DR office and asked if they had received a call from UHC. She said she had not and hadn't received any letters either. I then contacted HR and she demanded UHC to call my DR.
March 2. I got email from the rep. from UHC that handles our company and she said she left a couple of messages at the DR. This was around 1 pm. 4:45 pm I got a call from the Dr. office asking me if I wanted surgery on the 19th. I asked if I could do it a week later March 26th.
Finally..... after 11 months of working with HR and insurance I get approved.
3/16/17 Went for my pre surgery Dr. visit today. Met Dr. Khalili. Everything is scheduled and ready to go. He was nice and to the point. Answered all my questions. He did my sons surgery 2 1/2 yrs ago so I feel confidient with him. So far I am impressed with Cedars Sinai Medical Center. They seemed to go an extra step with you, and very friendly.
April 24 2007, went for my 1 month check up. My heart rate was up and the Dr. sent me to a specialist. Found out I have Atrial Fibrillation. I was put into the hospital for 3 days. I am doing better now. My heart rate is normal and the irregular heart rate is now normal. The only thing now is I can not do anything to get my heart rate up. So doing heavy excersing is out. I am walking about a mile at least 3 to 4 times a week.
June 2, 2007. I am 2 months post op and down 40 lbs - 4" all around and 2 sizes. I am getting in all my protein and water. I went through my closet this morning and got rid of half my clothes. Thank goodness I do have some smaller sizes to get into.
Sept. 9, 2007. Ok time to up date here. I have been on a stall for the last month. I am starting to see my weight starting to go down again. I am now down 80lbs. Going from a 4X - 5X down to a 1X in tops. Not too sure about my pant size. I do know I was in a 30 womans and I have been wearing a 24 womans. I might be able to get into a 22 but want to wait a bit longer to see if I drop more weight.
Some days I am bored with the food I eat. I am realizing that I feel better when I eat several small meals. Especially breakfast. I do better with a protien drink in the morning.
I am walking 2 to 2 1/2 miles on the weekends and almost a mile druing the week. I know I should do more but I just can't get motivated.
I did my labs on Thursday and I go to the surgeon on the 21st hope everything is OK.
Insurer Info:
United Healthcare, ppo
