Scooterbug

Mine is Cheese!!! I honestly hope I won't be able to eat it after I get banded...cheese is sooo (deliciously) EVIL!!

I was also wondering if it starts with the first surgeons visit as well..I heard it did, then I heard it starts with the first Nutritionist visit. Also heard that routine visits with the surgeon are counted as well during the process. The visits probably have to fall in 6 different months I assume .

My wife and I have to do the 6 month supervised diet as well with our UHC Options PPO insurance. We attend our first appointment with the surgeons office on the 18th, so we are really just starting the process. At first we were basically told the 6 month diet was not a requirement, but after calling the insurance company several times we managed it find out it was required. I am hoping that the 6 month will fly by, I have researched Lapband for almost 2 years now and we FINALLY have an insurance company that will pay 90%. After wanting the Lapband for 2 years, 6 months doesn't seem too much longer to wait (even though we are super anxious to have it done!!!).

I had the same issue with needed a letter of medical necessity from a PCP. We moved from South Carolina to Florida at the beginning of this year so neither me nor my wife had one. We told our surgeons office about that, and they said not to worry. They told us to do our first appointment with them (surgeons office) then they would get us an appointment with a PCP that they work with all the time and they would get the letter, physical, and everything else taken care of.

I know with my insurance the 3000.00 is the deductable. Once the deductable is met UHC/UMR covers everything 90%

My wife and I are about to meet with the Labband surgeon on the 18th of this month. We also have United Health Care handled by UMR, and have the UHC Options PPO plan. Our deductable is 3000. Initially my wife was told through her HR department that the requirments were just a BMI greater then 40 (35 with co-mobitities). We checked with her HR department twice once with a rep and once with a supervisor, and they both confirmed this. On Jan 3rd we called to UMR to check with them and find out the requirments. The rep at UMR stated the only requirment was to be 100lbs overweight. On the 4th our surgeons office called UMR and she was told 100lbs overweight and a 6 month supervised diet. After hearing about this from the surgeons office my wife called UMR and was told we only need to be 100lbs overweight. I dedcied to call after my wife did. I made the rep call to whatever department she had to and get the "propper" information. I was advised that the requirments were 6 Month supervised diet, 100lbs overweight and 40 BMI or higher.The rep said those were requirments straight from United Health Care. The rep also stated that when you call and talk to them, the reps only have basic information (trying to explain why we were told 100lbs overweight and not the correct info) Needless to say I was annoyed..not at the fact that we have to do the 6 month diet, but at the fact that they kept changing there stories. Personally i would call 3 or 4 times to verify exactly what you need, better yet see if you can get it in writing or have them email you a copy of the policy where it states what you need. Better to make sure then get ready for surgery THAN find out you need a 6 month diet.

It doesn't really matter what stage your on, you can get the hicups at anystage from eating too fast or too much. People are claiming they get the hicups from drinking Water too fast after being banded.

My sister had Gastric Bypass years ago and when she ate too much she would begin to hicup. For her it was usually a sign she was going to throw up. Her surgery was about 3 or 4 years ago and to this day she still gets the hicups when she eats. It"s weird because some people get the hicups and some don't. From what I ahve read some banded people say it's there body telling them they need to stop eating or that they ate too fast.

The Lapband and the hernia repair are 2 seperate procedures. Unfortunatly slapping on the lapband does not automatically repair the hernia because the area of the herniation has to be sutured. As far as coding, billers have to apply the code for the Lapband AND the hernia repair. Some procedures are "ALL IN ONE" codes..meaning there may be mulitiple procedures done that are listed as 1 code. As of yet there is no 1 code that will cover the Lapband with hernia repair, so you will see 2 seperate charges for the procedures. There are a few videos on Youtube that actually shows the repair of a hernia in the same session a doctor is doing a Lapband procedure. The videos are not for the squeemish, but will show you exactly that there are 2 seperate procedures to reapir the hernia and apply the Lapband. Was this nurse a person who actually assisted the doctor in the procedure or worked in the doctor's office??

I did a search for "Dr Richard Carter Texas reviews" and a few sites popped up..the one I found that info on was: http://www.casewatch.org You can try sites such as: vitals .com healthgrades .com obesityhelp .com

Just doing a small amount of research on this doctor, I was able to find some information on why I personally would never have chosen this guy: Richard A. Carter, D.O., who practices surgery in Arlington, Texas, has been disciplined three times by the Texas Board of Medical Examiner, twice related to surgery and once for false advertising. In 2006, the the board and Carter entered into an agreed order under which he paid an administrative penalty of $1,000 was required to complete ten hours of continuing medical education in the area of medical records and charting. The action was based on allegations that he had failed to meet the standard of care by leaving a sponge in the abdomen during an operation in which part of a patient's intestine was removed. In 2009, as shown below, the board ordered him to pay a $5,000 administrative fine and refrain from making misleading claims about himself and AmazeRx, a meal-replacement product he has been promoting. The Board action resulted from a complaint I made about infomercial and Web site advertising which claimed that the product could cause weight loss of up to a pound a day and failed to clearly state that the people who gave testimonials to that effect had undergone bariatric surgery. The order (shown below) prohibits any statements or claims that (a) he is "America's weight loss doctor," ( he is one of the most successful bariatric surgeons in the nation, and © the product will cure fatty livers and/or nutritional cirrhosis." Carter is also prohibited from making any other misleading claims about immediate results or long-term sustainability or how post-bariatric surgical patients compare to the general population. Infomercial Watch has a detailed analysis of the AmazeRx infomercial. In 2011, Carter and the board entered into an agreed order requiring him to pay a $1000 administrative fine and complete 20 hours of continuing medical education that includes 5 hours in medical record-keeping, 5 hours in risk management and 10 hours in physician/patient communication. The Board found Carter did not adequately document his rationale for the timing for removal of a patient's lap band or that he had counseled the patient. Makes me so glad that stuff like the internet exists so I was able to research the surgeon who will be doing mine and my wife's surgery.

My wife and I have our first appointment scheduled for January 18th. The woman who set up the appointment also told us it would take several hours.

Thanks for the reply and heads up. When you got your policy was it during open enrollment? I am going to school full time for Medical Billing and Coding. This semester we started on our Insurance part of the class. From what I understand (and also clarified with my instructor) during open enrollment an insurance company is not "supposed to" use the pre-existing condition against someone. If you did start your insurance during open enrollment, make sure you fight them tooth and nail. "Regulations about pre-existing condition exclusions may vary from state to state, but generally speaking the following applies: If you are enrolling in a health plan on an approriate eligibility date (such as open enrollment, taking a new job, becoming newly eligible due to marriage, etc.) pre-existing condition exclusions do not apply" My wife just signed up during open enrollment...so going by what I have read and researched, pre-exisiting condition should not be a problem. Keeping my fingers crossed.

Hey Ella, I live in Jacksonville Fl as well. My wife and I are attending a seminar with Dr Cywes on Nov 16th, and if all goes well...we are hoping to both be banded early next year (new insurance kicks in Jan 1st so we have to wait until then to get officially satrted). How was your experience with Dr Cywes so far? My wifes biggest fear is that she will not do good on her Pre-Op diet when the time comes...how long did Dr Cywes have you on it? PS: Love the New York Mets logo as your profile pic!!! Thats my favorite team!!

Sorry to hear about that..... Back in 2009 I was very excited to learn that the insurance company I had covered Lapband, so I went to a seminar and was about to set up an appointment to meet with a surgeon when I discovered my EMPLOYER (Verizon Wireless) did not cover it. Needless to say I was peeved. Now in 2011 my wife is about to get insurance through her new job. It took alot of digging and calling different people (her HR department, UHC, UMR, etc) but we did verify that both the insurance and company cover Lapband. As far as our requirments my wife was told they would be the UHC requirments, so we have someone in her HR department trying to get us the EXACT information we need. I want to have every peice of info I can get involving requirments before I attend another seminar on the 16th. In a case like yours I personally think the surgeon/doctor SHOULD refund all or at least 1/2 of what you paid them.

Thanks Melinda, My biggest peeve at the moment comes from lack of information from my wifes HR department and UMR. Her HR simply sent there employees a short email alerting them of open enrollment. My wife had search for a couple hours on there internal website and she found only a small bit of information (printed out it came to 5 pages..just saying what was covered, co-pay, coinsurance %, etc). My wife contacted her HR person and they refered my wife to call the 1-800 number for there main HR person..since she didn't have any information on the insurance. The main 1-800 told her the same thing, that they didn't have any information...and they refered my wife to call UMR. Well upon calling UMR my wife was told they couldn't help her unless she was ALREADY enrolled in the insurance plan..then they told her to call her HR department. So far from what we DID find..some type of bariactric surgery is covered. As far as the requirments we are still in the dark. Was trying to get as much information as possible before we got our hopes up.

My wife is about to sign up for her new insurace now that it is open enrollment time. We are both looking to get Lap Band and was wondering if anyone could answer a few question for us. So far she has gotten only a small amount of info regarding her options (basically a 5 page print out of information so far). On the print out it says: Gastric or Intestinal Bypass Maximum benefit per lifetime: 1 also on another page it states: Morbid Obesity Treatment 1) If it states 1 under benefits per lifetime..does that mean only 1 of us would be able to get it..or does it mean 1 per person? 2) What would Modbid Obesity Treatment cover..as in how is it differnt from Gastric/Intestinal Bypass or Lapband? 3) Would this cover Lapband? (It doesn't show Lap Band on the small amount of info she got...and I don't want to ASSUME it's covered) 4) Has anyone had any experience with the UMR/UHC plans? If so what are the BASIC requirments?

I am from Jacksonville as well. My wife just signed up for open enrollment with her new job, and we were thrilled to find out Lap Band was covered!! We are both going to attend a seminar from Dr. Cywes on the 16th.