Everything posted by Scooterbug
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Anyone With Uhc
That's the same information my wife and I got on 4 or 5 different occasions when we called. When our surgeon's office called to get the requirements they said it was BMI over 35, 5 years weight history, 6 month PSD (Physician Supervised Diet), and a few other things. Even our booklet says the only requirement is 35 BMI +. Guess the doctor's office has certain people they talk to that give them the CORRECT info
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Walden Farms Products
Excellent! I am hoping the Chocolate syrup is good...I usually do chocolate protein shakes for breakfast with some unsweetened almond milk. They taste OK, but are kind of bland, I am hoping to try the Chocolate syrup to add some flavor and not have to worry about using any extra carbs.
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Walden Farms Products
While looking for a low carb syrup to help take some blandness out of my Protein shakes, I came across a company called Walden Farms. They say there products have "no calories, fat, carbs, gluten or sugars of any kind! Has anyone tried these products? If so how did they taste? And are they worth paying $3.75 a bottle for them?
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Starting The Waiting Game
Called UMR today and they didn't have anything in there system yet. They said it takes up to 48 hours for info to get into there system, so I guess I will try back on Monday. I also called the surgeons office to make sure they did in fact send the info in yesterday, but I had to leave a message and nobody called me back yet.
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Starting The Waiting Game
Mailed in??? Geez...in this day and age what doc's office would not fax the information??
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Starting The Waiting Game
My wife and I had our group meeting with the Lap Band surgeon yesterday, basically so he could explain the mental part of making the Lap Band effective (changing your thinking about food, etc). After the meeting the we were told that our information should be filed with insurance today (UHC Options PPO plan through UMR)!! I know all insurance companies are different, but if anyone has experience with UHC or UMR, what is about the average wait time to see if your approved?? The woman who collected our information at the surgeons office told us that insurance companies are slow for some reason recently, so she predicts we will be waiting 30 days
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Anyone With Uhc
My wife and I have a UHC Options PPO plan...we were required to do a 6 month diet.
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United Healthcare
My wife and I have the UHC Options PPO plan...and we had to do the 6 month supervised diet. We just finished that the begining of June, and meet with the surgeon again on July 18th for out final visit before we sinmit the info to insurance.
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Will My Doctor Refer Me For Lap-Band?
My suggestion is... if you haven't already, attend a seminar of the Lap band doctor your choice. After the seminar they usually have the insurance coordinator there and a few other staff members to answer question. Explain to them you would like the name of a PCP who they deal with on a regular basis concerning Lap Band. They should be able to hook you up with at least a few PCP docs who you can see. If the Lap Band surgeon's office deals with these PCP docs, they should have no problem recommending you for Lap Band.
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Lap Band Plication Or Lap Band?
I think the big difference is that with the Plication you lose quicker at first, almost like losing with a gastric bypass (people lose weight quickly right out of the gate). The difference is you also have the band to help maintain and still lose. Almost like having the best of both world (gastric bypass and lap band) except there not rearranging your insides as bad as gastric bypass). There is a chance of necrosis, but according to my doc and a few people I have talked to that had the plication, the chances are pretty low. Also the plication is reversible. My biggest worry about the band was slippage, which I heard the chance of is kind of low, but from what I am told the plication actually reduces the chance of slippage even more.
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Lap Band Plication Or Lap Band?
This is a good basic animation video on the Plication. They add the band on top of the plication procedure. From my information it makes for faster initial weight loss, they are still measuring the long term results to see if it is MORE or LESS then just having the Lap Band itself.
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Insurance Can Be Tricky
If you have to call 3, 4 or 5 times to get the right answers you should do it. It seemed, at least for me anyway, I had to call the insurance company 4 times before I got a correct answer...and that's for even general questions I had for them.
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Will My Doctor Refer Me For Lap-Band?
All doctor's are different honestly. When I lived in South Carolina a couple years ago, I inquired about Lap Band with my PCP (who I had seen since 1999), she was against it and there was no way she was going to recommend me for the surgery. She sometimes had a very old school approach to things, basically saying I could lose all the weight on my own. I moved to Florida just over a year ago, and started my lap Band process this past December. This time I got the name of a PCP that they deal with all the time from my Lap Band surgeon. Getting her to write the letter of necessity was pretty easy once I was checked out and got Cardio clearance, Anesthesia clearance, and did a sleep study. Basically long story short, it all depends if your doc is an advocate of Lap Band or if they have the attitude that you can lose your weight on your own. List of Co-Morbidity for Lap Band: Cardiometabolic syndrome Type 2 diabetes Hypertension Dyslipidemia Coronary heart disease Osteoarthritis Stroke Gall bladder disease Obstructive sleep apnea Gastroesophageal reflux disease (GERD) Some cancers (endometrial, breast, and colon)
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6 Month Supervised Diet - Frustrated And Annoyed!
Thank you! No change in medications..in fact I am only on 2 meds, one is for Uric Acid, the other is for slightly elevated blood pressure. The BP meds also have a diuretic in them, so I am in the bathroom ever 30 minutes (rules out any type of bloating making me weigh more). I decided to give this Counselor 1 more shot, so I emailed and she sent over a 5 step plan for me to try until my next weigh in. Basically Clear liquids for 2 days, full liquids for 2 days, then after day 5 solid foods (basically eating the same stuff I am now). So we will see how this works.
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6 Month Supervised Diet - Frustrated And Annoyed!
For exercise we walk when we can. I have 4 months of schooling left before I take my test to get certified for Medical Billing and Coding. My wife works 7am to 3:30pm, I am always studying during the day, and when she gets home around 4pm I have to hurry off to class (Mon, Tues, Thursday and I have a part time internship on Wednesday), by the time I get home at 10pm it's time for bed, so she can get up early. I met the surgeon and he is real nice. The "hassling" is coming from there Weight Loss Counselor. I have not changed my eating habits at all since we started, and certainly not in the last 5 days to make me gain 7 pounds. Protein shake in the morning, light lunch which consists of a small amount of cheese, ham, or turkey, and for dinner chicken, Fish, or meat with a veggy. No bread, Pasta, rice, etc....been extremly great about checking items for carbs since we started.
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6 Month Supervised Diet - Frustrated And Annoyed!
When we went to the Surgeons office the first time we met with, I guess it was a coordinator, who was going over what our insurance required from us. She explained the 6 month supervised diet and she said "not to look at it as a diet", they just needed to get our weight 6 months prior to submitting our paper work to show the insurance company. Another thing the Weight Loss Counselor kept saying yesterday is that if we don't lose enough weight our liver won't shrink for the surgery. As far as I understand that is why we are supposed to do a week or 2 (or 3 or 4) of liquid diet before the surgery. To me it almost sounds like she is trying to use a scare tactics...not sure why. (Lose weight or no surgery!, Shrink your liver now or no surgery!) or maybe I am reading too much into it. Personally I WOULD normally look for a new Surgeons office to go to, BUT my wife and I are going to be getting the Banded-Plication, and this surgeon is the only one around who does it. Actually I had turned in my letter of necessity from my PCP to them yesterday and it was in the file the Weight Loss Counselor had with her. It actually stated in the letter I had lost 11 pounds since January, mainly to show the insurance company I was attempting to lose weight..so she had it at her disposal. Again the letter was written on and dated April 25th, after I was weighed at the PCP's office (I had to wait an extra 30 minutes at the visit for the doc to write the letter), 5 days prior to our visit to the counselor yesterday.
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6 Month Supervised Diet - Frustrated And Annoyed!
My wife and I are going through the process of both getting Lapband and we started our supervised diets with our surgeons Weight Loss Counselor back in January. We just had our 4th visit yesterday. Since then we have both been on a NO CARB diet, we were told to eat Proteins and given a list full of food we CAN and CANNOT have. Last month our weight loss counselor had us start the process of starting the Protein shakes so we can get used to them. On Wednesday I had a visit with my PCP for some blood work and to pick up my letter of medical necessity. She gave me an awesome letter, and praised me for losing 11 pounds since January. I was feeling pretty good at this point. My wife was there a week prior and she was showing a 10 pound loss just in the last month.. Yesterday we went in for our monthly weigh in with the weight loss counselor, and after the weigh in she told me I had only lost 4 pounds since we started with her in January, and she told my wife she had only lost 6!! I have lost 11 pounds since January (according to my PCP) ... so what confuses me is that the weight loss counselor is telling us something different!! So we were basically told that if we didn't show more weight loss by the 18th of May (our next visit) she would have to MAKE us see the Lapband surgeon for "drastic" measures..whatever that means. It almost felt like we were kids being threatened! Today I feel extremely stressed out because I KNOW for a fact my wife and have been following the weight loss counselor's instructions to a T, and according to her we are not losing (but according to our PCP we are). I myself in the past have only lost weight doing really low calorie diets (300 to 600 calories a day), so I am not sure if should just do the very low cal diet until surgery or keep following what the weight loss counselor says, and have a chance of not losing before the 18th.
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UMR/UHC Options PPO Question
That's exactly what my wife's plan requires of us as well. My physician required Cardiac, Anesthesia , and sleep consults as well.
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UMR/UHC Options PPO Question
My wife and I have already started the process (about 3 months ago), so we are moving right along. My question is: What is that "Two years with the company" thing all about??? I never heard anything about this at all.
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Medical Coding
Yes..the code for Lapband is 43770. It is whats known as a CPT code. When checking to see if Lapband is covered by an insurance company, that is the code you can use to check and see if they cover the procedure. Code 43644 (in the above post) is for a Roux-en-Y gastric bypass, Code 43771 is used only for a Lapband "adjustment" (adding or removing saline). Try not to let other posts confuse you. Someone mentioned "HCPCS" codes..HCPCS codes are supply codes for example codes for crutches, wheelchairs, etc (any kind of billable equipment), HCPCS also list dental codes as well. Also someone mentioned ICD-9 codes. ICD-9 codes are "diagnosis" codes. Such as if you go to the doctor complaining of a sore throat, they would code the reason for your visit "sore throat" (462 Acute, 472.1 chronic), if that makes sense. So if I was reading this post right, you were wanting to know what the code was for LapBand to see if its covered by insurance... which you were correct using 43770. Remember: CPT = Procedure codes ICD-9 = Diagnosis codes HCPCS = Supply codes
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Has Anyone Had An At Home Sleep Study?
I had a sleep study done last Saturday at a sleep center. The tech said I could lay anyway I want as long as I was comfortable, he didn't mention anything about laying on my back. I only slept for 2 hours if I was lucky and they got all the info they needed by the time the study was done. I usually go to the bathroom a couple times a night as well. I have never seen the home study machines, but in the center the tech came in and unplugged the box with all the wires from another box, and I had to carry one of the boxes with me. When I was done he just hooped the boxes back together..was not too much of a hassle. Getting comfortable.....that's a different story...
- My Vegan Story
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Failing Home Sleep Study
I got a call from the Sleep doc's office today. Apparently they were able to get the info they needed from the 2 hours or less of sleep I actually got. Now they scheduled me for another sleep study at 9pm on Friday night, this time with the mask. I take it they will still have all the crazy electrodes hooked to me, I am just praying they don't have the one hooked to my nose this time because that was the worst part. Think I will take some stronger sleep meds this time before I go..maybe I will actually fall asleep this time.
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My Vegan Story
You can also try the meat substitute (soy) products from companies like Morning Star Farms, Boca, Smart-Life, and Quorn (just to name a few). I became a Pescatarian about 5 years ago, and haven't eaten meat since. I could never be a full vegan because I love cheese and shrimp too much (cheese is my downfall). The soy products are not too bad, some of them just take a little getting used to. I asked my Nutritionist about the soy products and she said they should not present a problem, even my surgeon agreed that as long as it's chewed extremly well (like any food) it should have no problem with the band.
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Failing Home Sleep Study
I did a sleep study last night and it was absolutely horrible!! I took some sleep aid before I went. When I arrived at 7:30pm I could feel the sleep aid kicking in. I was literally falling asleep while the tech was attaching the endless amount of wires to me. By 9:00pm I had the lights out and was attempting to get comfortable, which was kind of hard especially with the stuff hooked up to my nose. I laid there for awhile and couldn't get to sleep. The tech came in around 10:15 because when I turned from one side to the other, one of the electrodes on my leg came off...so he has to come in, turn on the light and fix it. I took this time to run to the bathroom. Around 10:30pm I FINALLY fell asleep. When I woke up I was hoping it was close to the end of the study.. unfortunately it was only 12:30am From that point on I would doze off a few minutes wake up, doze off and wake up again. This happened most of the night. Of course every time I even adjusted in bed an electrode would fall off and the tech would have to come in, turn on the light and fix it. Not to mention that every time I moved slightly I would hear the tech over the intercom asking "Are you alright"??? Finally at 5:20am after feeling I was awake all night, constant electrodes falling off, and the Tech asking every few minutes if i was "alright" I was at my wits end and just sat on the edge of the bed until 5:30am when the study was over. I certainly hope they got enough data, because I don't know if I could take another round of all that garbage hooked up to me,