mufasas-mom

Happy birthday - congrats on your successful weight loss...

well I am 4'11" and weigh in at 201 (bmi 41.1) so don't sweat it - you stick to the program, listen to the doctors and I'm sure all will be ok. I've not been banded yet, so i'm not speaking from experience, just from what i've read on these posts. You'll be great!

what scares me is that it is not an actual hospital - and that it's not in network -so i will not have the procedure done there - I just hope the true results team allows me to change doctors without starting all over again....i do feel that they are pushing dr. benevides services upon me, so i will have to be a little forceful and such to ensure I have a surgery center that is not only a center of excellence recognized by MY insurance company - but that it is in network. I know that the surgery center of richardson is a center of excellence, however my insurance company does not recognize it.

with my insurance - i have to make sure that it is IN Network and the surgery center of richardson is NOT....therefore, i'm going to ask them to change surgeons for me so my procedure may be done at a local hospital in network. I've read my insurance documents very closely - I have hit my deductible already - so it's just the 20% - of which i have no idea how much the surgery costs nor surgeon fees and such. can anyone give me a ballpark price on how much the lapband costs through true results?

what? i have United Healthcare Choice Plus - covered through PepsiCo and PepsiCo added the bariatric surgery option to their plan - maybe your company did not pick up that? sorry to hear that you have to pay so much...I'll find out my co-pay on my next visit March 27th - in network and out of network. i really don't want to use the richardson surgery facility....it scares me - want to do it in the hospital, just in case.....

they were assigning me dr. benavides - however, although the surgeon is in network for my insurance their facility Surgery Center of Richardson is NOT in my network or even anywhere - my insurance rep for United Healthcare couldn't find them in the system - so I want to change doctors so that i can have the surgery in Carrollton at a hospital... yes they say they will work with my insurance and such - but if it's not IN NETWORK it will cost me more - of course they'd accept it, they still get paid - but I refuse to pay anymore than I have to... what insurance do you have??

i'm using true results of richardson. the staff is great- but i feel like they are pushing me towards a certain physician and i want a different one so that i can have the surgery performed at a local hospital and not an 'out patient' facility. I live alone, so i would prefer to stay the night after surgery before going home. like i said, the staff overall is fantastic....

you will probably need to complete the 6 months of nutrition/dietician visits prior to getting approved. have you phone the insurance company on the back of your insurance card? and ask for the bariatric person to assist you with your questions? each insurance is so different pending on location/company that it's always best to call and have your questions written down so you don't miss anything. good luck..

question - so after the band is put into place, do they not fill it a little bit at that time? or is it empty till you go back for your fills???

My cubicle at the office is completely trashed....but I'm so glad that they didn't go the 'over the hill- black decorations' route - as i am pretty sure my kids will take care of that.... and for my birthday gift to myself this year ----- LAPBAND. i hope to be banded by August this year....already started the visits (have to do 6 months - 4 to go) and of course the other testing - which will be in June or July.... and by next year.....watch out - this hot grandma will be back riding her motorcycle and living life!!!! have a great weekend everyone! Diane

thanks to all the happy birthday wishes... I cannot wait till August to get banded!!! thanks again....

Not sure if 50 is the new 21 - but for me it still feels like 40.....thanks for all the well wishes everyone. I'm looking forward to this journey and having you guys here makes it that much easier.... Diane

I'm so excited about the band - it's going to be a great tool to hold me accountable for my poor eating habits.

congrats.....that's great news!!

soccer-mom - the insane 6 month wait is just a stipulation of my insurance - UHC through PepsiCo. It's ok - i really only have 4 more months to wait...should be banded by August...which is good - as i hope to be used to the band and such in time for all the christmas food madness.... wow you must have great insurance to not have any wait...that's awesome!! I'm still trying to figure out the insurance side of things so i stay In Network - the surgeon's office says i can use their location - but my insurance person says i need to stay in network for me not to run into unnecessary spending on my part... i am so freaking confused - waiting for my insurance rep to email me back....

me too.... although it's so freaking confusing. the surgeons office emailed me and said this: first email to my question about in network facility: Ms. Petty, Dr. Benavides is contracted with UHC and performs surgeries at contracted facilities(Baylor Medical Center at Trophy Club and The Surgery Centre at Craig Ranch in McKinney). You should have been made aware that the facilities that are not contracted(Surgery Center of Richardson & the Hospital at Craig Ranch) accept contracted rates. This means you are held to the contracted deductibles and co-insurance, not the out of network allowables. then i asked another question stating that my UHC Nurse specifically said i must use an In Network provided and facility so I don't have to pay any additional fees...her reply: You do not have to worry about the additional charges if the procedure is performed at Surgery Center of Richardson. They are non-contracted, but act as and accept contracted rates so it would be exactly like going to a contracted facility. this seems like alot of baloney to me....waiting on my nurse to reply back..... Diane

I keep reading here about pre-op diets.... who is requiring this? ins company or surgeon?? also- what if you started out with a BMI of 41.1 and then lost 10pds or so and went below the 40 BMI (which is a requirement of my health insurance since i have no other medical issues....yet) - would all that waiting for 6 months be useless??? and can the insurance company THEN deny you because you lost weight during the 6 month time???

good deal soccer mom.... i have that dreaded 6 month wait...actually this month is the 2nd visit on the 27th - so i really only have 4 months left....yippee!!!

just got to thinking about the incisions and wondered if it was all done through the belly button area? and if the port leaves a scar?? thanks

hoping to find someone here who works for PepsiCo (or spouse) and has gone through this process already.....

Just spoke with my bariatric nurse assigned to me from United Healthcare - she answered all my questions and I'm so glad i found this site, as it helped me ask the right questions. I was worried about my BMI which is currently at 41.1 and what would happen after the 6 months if it went under the 40 - nurse said that they use the starting BMI not the BMI prior to approval (which is after the 6 month dreaded wait). so I'm good there. now i just have to make sure that true results in richardson, tx assigns me to a different surgeon so that he and the hospital/surgery center is approved as IN NETWORK. I phoned TR before i got my call from the nurse, and asked about other surgeons they use - they gave me 2 other names and both of them and the hospital/surgery centers they use to perform the procedure are IN NETWORK....so I'm good to go on this journey. I kept seeing posts here about being denied and such and was so concerned - but i have my checklist and a clear understanding of which surgeons to use - so I truly hope that I don't have any nightmares 5 more months down the road....August is when I should have my surgery...seems so far away..but i know it will be here before I know it. I recognize that this journey and all the insurance hoops I have to jump through are solely MY responsibility - and I'll make sure I keep a log of everything. looking forward to future success....

this is great to hear - I am going through True Results in Richardson (staff is terrific) and i just need to make sure they change my surgeon from Dr. Benavides to Dr. Marsden to ensure we follow my health care benefits with United Healthcare. I'm so excited!! I believe that my surgery will be at the Carrollton Baylor facility. thanks for the good words about this surgeon - I feel so much better.

ok - just got off the phone with my bariatric nurse who works for United Healthcare - luckily they use the initial BMI taken at the first visit - so that's ok. Second about the surgeon - she said he was in network but the surgery center needs to be in network as well. the surgery center the surgeon is affiliated with is NOT part of the network - so i have to reinforce with True Results of matching me with a surgeon who is in network and who's is affiliated with an in network surgery center/hospital. this is 'my' surgery - and it's up to ME to make sure I have completed all the legwork and requirements of my insurance - the dr,s' office certainly won't.... time to print out acceptable surgeons and such to have with me for the 2nd visit at true results. thanks again everyone...

I agree - i'll ask the nurse when she phones in about 5 minutes....great question to ask - which BMI to they (insurance company) use. I find that you always need to do your due diligence on things like this....which is why i don't like surprises...want all the facts first. I'll let you guys know which BMI route my insurance takes...as well as surgeon and surgery center as i can't find the surgeon and his facility (the surgeon that true results assigned me) on our UHC website anywhere - and i'm logged into the UHC website under my plan w/pepsico. crossing my fingers....

so were you below the 40 bmi mark at your final weigh in before surgery??? just phone true results again - i swear i am going to drive them insane...- and they keep telling me that my dr. is IN NETWORK and so is his facility....will comfirm with the ins company this morning - this is frustrating and i'm just starting...