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Monday, January 24, 2011

another appeal submitted

So this morning my bariatric office let me come in and get my height remeasured.  I think they were sick of me calling and pestering the PA.  When I arrived the lady at the front desk said, "Name?"

"Lee Ann [Lastname]."

"Oh yes, we were just talking about you...."

Hmmmm.  Well....er.  Oh shit that's probably not a good thing, all the phone calls I've made...they are sick of me.

I was about to ask why when the office ladies started fawning over my 8 month old who was smiling and cooing from his stroller.  He's a little charmer.

Then we sat down and waited.

When they called me back I was relieved to see the cool Nut. Guy (as opposed to the Ice Queen Nut. who I referred to as something way rude in a previous post).

He walked me back to a room and there stood a nurse standing next to the height measuring thing, waiting for me.

My Nut Guy says, "We need a second witness."  He said it with an apologetic, "I'm really sorry Lee Ann," kind of tone like, "it's not my doing...."

I'm thinking, "What THE frick?  They are treating me like a criminal."

And then I prayed that whomever mounted that height thingy-ma-bobber cared about accuracy as much as I did.

I stood under it, trying to slouch.

The nurse barked, "Stand up straight."

So I did...held my breath....and prayed.

They looked at each other.  When my Nut Guy grinned a big goofy smile, I knew it would be okay.  With surprise he said, "She is 62 inches!"

Whew!  I'm relieved.  So I'm not a liar after all.  Even standing up straight!!

Actually, I am a liar, because all of my driver's licenses say I'm 5 ft 4.

Anywho.  They are going to resubmit my case to the insurance company.  So I currently have two appeals that the insurance company is dealing with at the moment.  At the very least, I hope they see I'm not letting this go.  I'm fighting this denial until I exhaust the appeals process, which ends after 3 rounds of my own appeals (not counting the doctors' appeals).  The last round, if it goes that far, will be me facing a panel of doctors and making my case in person as to why I need and deserve this surgery.


  1. Oh, this is wonderful! I have good feelings on this! Hopefully they will see that you have doctors on your side that are saying you need this and qualify for this, and that will hopefully mean something to them! Hang in there girl. I'm so glad you are just letting it go and accepting it as is!

  2. Good Luck! All this and validation!

  3. Fight, fight, fight!!!! Thanks for the comment on my post. I actually LOVE MAD MEN and that was one that I downloaded on iTunes for the first 2 seasons. I could never get into Breaking Bad. The other show I am going to try - it sounds SyFy and my husband loves that so many we could watch together.

  4. I am so thrilled you were able to get remeasured! Way to go being assertive and taking charge! Don't give up!! We're all behind you!

  5. Keeping my fingers crossed for you, hun!!!! I know you can carry on this fight :)

  6. LOVE, so glad they finally got around to doing their jobs!! :) I hope it goes through this time!

  7. So glad! Finger crossed for approval!

  8. You go Lee Ann!! They don't know who they're up against!!


  9. Keep it up! I am praying that it goes through!

  10. Gosh I hope you get this...I'm praying for you!

  11. Hang in there! Don't give up! I was denied TWICE...now banded and only paid $150 deductible.

  12. I can't believe how different the process is where I live in Australia. Well my starting BMI was 43 so there was never any doubt I would 'qualify', but other people I know with 35 even 33 have had this surgery.

    Here you just get a referral from your GP doctor - if you have private health insurance they cover a large portion of the cost and then you book in. I am learning so much about how blessed I am not to have to jump through those hoops. It must be truly exhausting.

    My fingers are crossed for you X

  13. Congratulations on getting re-measured! Good luck with the appeals.

  14. Keep on, keep on trying. You never know. And you gave me a laugh about the height on your drivers license. Me-I've shrunk almost an inch over the years. Good luck on the appeals.