StacyS

How much did he charge out of pocket? They told me $600 program fee...why should I pay for that when my insurance covers 100%????

I live in lancaster and the doctor here, dr. yadegar, is not covered by my insurance so I'm going to dr. quilici in burbank.

Hi All, Just wondering if anyone has experience with Dr. Philippe Quilici out of Burbank, Ca? I went to the consultation and they told me that he was one of the best doctors in California and I even spoke to patients in the waiting room waiting for a fill who said they loved him. The feeling I got from his office staff was that they were pretty busy and wouldnt start working on my paperwork until I had my psych eval.... I was just curious to see if anyone else on here has used him for their surgery?? Thanks, Stacy

OMG, I have to quit smoking too!!! I guess I'm just waiting for my approval and pre-authorization before really committing myself to quitting and dieting. I know that sounds rediculous but I'm skeptical of getting approval.

Good for you!! I'm so excited for you! I cant wait til I'm posting my approval and surgery date too! The most painful process is the waiting!! I cant stand waiting!! I want everything to happen on my time, but it doesnt work that way here, does it? Good luck to you! Keep us posted!

I'm exactly like Alygator... I had to keep my BMI at 40 and so I was eating and eating to actually gain weight. I had my consultation and first weigh in on the 5 Jan and just barely made it. Now that I'm in the process: psych eval on Monday, support group on Wed, etc, I should really be focusing on the smaller portions and such, but I have the mentality of "the last supper" too. I'm sure once I have to do the 2 wk liquid diet, I'll focus more on losing the weight but my surgeon does not require a pre-op diet except for the 2wks prior to surgery. I'm a little scared to start dieting now, but I've promised myself this is the last time I "diet" with the lapband, so this will be my last hoorah! We have to be diligent in focusing on our portion sizes and actually eating healthy!! Let the life changing experience begin!!!!! Good luck to you!!!

Every insurance company has different requirements. The best advice I can give you is to call your insurance company, find out what exactly they require and what the total amount is covered. If they absolutely do not cover bariatric surgery, then your only options are to pay for it out of pocket or switch health insurances to one who does cover it.

My surgeon's office said it was to help fund their program... what that exactly means, I have no idea. My first impression was that it's to help support the Dr's wallet. But, like I said before, I called 3 other surgeons and they all charge a fee as well. So, to me, $600 is not bad for the price of getting thin and healthy for my family.

I sure hope you're right. I wont find out until after I complete my psych eval on 17 Jan 11.... Then once the surgeon receives the results, the paperwork should be sent to BCBS. I would think 6mo of a supervised diet plan is better than nothing, but someone else has said that they are actually getting stricter rather than more lenient.....Does anyone have experience with the new year?

I am on BCBS-Fed and will be submitting my paperwork this month for approval and pre-certification. Are there any new requirements? Like 1yr supervised diet, etc? I have 6 months of documented supervised diet, but certainly not a year.... Any help would be great- in order to know what I'm up against!!!

I actually called two other surgeons and the charge more than the $600. So, you might want to ask if they have any out of pocket charges before you make your appointment....

I'm in the same boat but decided to put on the extra weight. And when they took my height i bent my knees a little bit so I was 5'2 rather than 5'3 and thank god I did cuz I was barely 40.2 BMI. I'm waiting for my psych eval, then approval/denial. Putting on the additional weight has really taken a toll on my body but I had to in order to qualify!! If I get denied I'll have to go to mexico and pay for it cuz I can't be this fat any longer!!! Good luck with your decision.

Thank you all for your replies!! I actually have been jumping thru hoops all last week with my health insurance (BCBS-Fed) and discovered that their website has a lot of incorrect info. So, in the end I found a doctor and a facility and actually have my appt with him today. They do it all at one place, meaning the psych eval, nutrition eval, blood work, etc like a one stop shop. My appt is in a few hours so I'll post how it goes. I also obtained my previous 5 year medical records....my only concern is that the highest weight it has for me is not nearly as fat as I am now. Well that matter? I sure hope not.

Hello, I am a newbie, to the fullest. I dont have a date or anything like that. In fact, I am to attend the manditory lap band seminar on 5 Jan and then will be able to schedule the consultation with the surgeon. But, I've been reading a lot of posts and had a few questions.... Do you have to lose weight before you get surgery? I've been seeing people say they've lost like 30lbs and they havent even gotten banded yet. I'm sorry, but if I have to lose weight like that before the lap band, I'm not sure I'll be able to. Do you have to go through all the pre-opt testing, like the psych eval and the nutrictionist appointments? What are the requirements before getting approval? Thanks for any advice... I'm super anxious and feel like I cant wait any long to get the procedure done!!!! Stacy P.S... how do you get those cool weight loss tracker things?

Well, I go to the seminar next Wed 5 Jan, and will see what they require. I spoke to my health insurance and will only be required to attend the psych eval, 5 year history from GP, and proof that I have attended a supervised weight lose plan for at least 1 consecutive year... So, I'm very excited!!! Thank you all for your stories!! I'll keep you posted on my progress after next week!

I have BC/BS and have just started the process. What is your BMI?? I have read the benefits packet in detail and it clearly states that if you are over 40 BMI, you qualify w/out having to have co-morbities....

Hi All, I'm considering doing the lapband and can either go with Dr. Lourie or Dr. Martin in Pasadena, Ca and would like to know if any of you have had your band done by either of them and who would you recommend? Thanks, Stacy

I actually had to switch health insurances in order to have the lapband covered. Luckily, it was open season so I was able to switch from Health Net of California to Blue Cross/Blue Sheld PPO of California. I evaluated all of the health insurance options to see what exaclty was covered, what was considered to be the qualifications, and ease of approval. I decided to go with BC/BS since their requirements were less restricted than Aetna HMO. I would advise that you pull up each policies beneifts packages and compare who/which insurances cover obesity surgery and see if you could switch insurances since it is end of the year... if not, you will need to upload Anthem's benefits packet and carefully read their policies. If it's abolutely not covered, you will probably have to pay out of pocket for the lapband.

Do you live in California? I also have BC/BS PPO for California though and was wondering if I might experience a denial as well...

Hi All, I'm considering doing the lapband and can either go with Dr. Lourie or Dr. Martin in Pasadena, Ca and would like to know if any of you have had your band done by either of them and who would you recommend? Thanks, Stacy

I agree with Jaleena. I actually had to GAIN weight in order to hit the 40 BMI since I didnt qualify at 37 BMI due to the fact that I had no co-morbidity complications (I'm a healthy fat person). So, here I am, trying to gain weight over the holidays, rather than lose, and then they're gonna tell me I need to lose 20-30lbs before surgery? That makes NO sense to me. I know every surgeon is different and I'll get all my questions answered at the seminar next week, but I dont understand..... I'm in California!!

So, you had to get all your lab work done before you even saw the doctor? How did you know what kind of labs you needed? Why would they have you go through all of that if you dont even qualify? What kind of evaluation are you having done?

I am very curious since I have GERD and a small Hiatal Hernia and am wondering if this will be an issue in getting the lap band. Please keep me posted on what you find out JustPlainTired!

I too, am a newbie and have not yet started the process. I called a few doctors which are covered by my insurance and I have to attend a manditory seminar before either Dr will set up a consultation. So, I go on 5 Jan for the seminar. The receptionist told me that I could be seen a early as the next day since they are pretty slow right now. I'm exactly like Bubbles where I'm so excited I can't wait and get frustrated if I dont get things rolling fast enough. I'm very curious to see how long from start to surgury it will take, especially since I'm ready for surgery NOW and don't want to wait til March or April for my date, but sometimes we have no other options. What is the process??? I hear we have to go through a psyche eval and nutritionist appts?? How long do those take?