mufasas-mom

see that's what i thought - it was the ENDING BMI that counts prior to paperwork being sent to the insurance company - not what i am now.... but True Results says that the only BMI that counts is at the beginning.... although i really like dealing with the people at True Results..I think they are feeding me a line of BS....after the 6 months they still get paid - and I'm out of luck if i go below the 40 BMI....I swear - i hate wigging out about stuff like this, I talk with my insurance nurse today and i'll double check with her - so i can have the 'correct facts per my insurance requirement' and not true results facts...

OMG - 61 pounds lost so far...that's incredible !! I have a friend how is a DIE HARD Packer fan, she goes to this one bar/restaurant every Sunday for the Packers games...Vernon's I'm so psyched about this adventure....hope all goes well w/insurance and such!!

Hello fellow Texans! I live in Princeton Texas and am just starting this journey. I am so excited - at 4'11" i currently weight 201 with a BMI of 41.1 - so for insurance purposes I qualify without any other medical issues. I have UHC Core insurance - so i have to do the 6 months and the various tests, and today i have my appointment with the bariatric nurse who works for UHC and i have TONS of questions for her!! Did any of you use True Results? I am going through TR in Richardson, they are fantastic - it's nice going somewhere knowing they have all been banded so they 'really' know what it is like. Congrats to all of you who have been banded already - i'm thrilled to be starting this journey as i've been looking for the Tool that will hold me accountable for years....and I think that the lap band is just that. I'm sure as the dates get closer, i'll be asking you guys lots of questions. good luck!

I have my phone consultation with the bariatric resources services covered by United Healthcare - Core. I have a few questions for her like the psych eval on the form i received from UHC with my checklist - it states i have to contact United Behavioral Health - so does that mean i also have to do one at True Results? I am also going to double check the requirements so i have the correct checklist and do not have to do any unnecessary testing. In Network issues and such... Can you think of any questions that i should ask the insurance nurse?? something that came up with you and you wish you would of asked ahead of time so you would not of been surprised/shocked? thanks....

thanks so much for the reply. I had knee surgery a year ago and dealt with the nurses online and such and they were terrific. I'm wigging out because I am going through True Results and they assigned me a surgeon, however that surgeon is In Network, but not the facility he performs the surgery at - so I am going to ask the nurse tomorrow my main questions about coverage and such to ensure that I'm going to the right surgeon and facility that's In Network as i've already met all my deductibles (thanks to kidney stones). Worried that True Results keeps saying they accept Out of Network and at the end I'm going to pay out the wazoo. Guess i'll find out all my answers tomorrow. when you said expect to pay an extra amount to have the report sent to the doctor - do they even give you a copy of the report? thanks again - was trying to find someone with the same insurance....

I think my question should really be - is it up to ME to make sure my surgeon does my surgery at an in network facility (hospital and such) I dont' want to be forced into using a facility that my surgeon uses that is NOT in network...how do i find out what other facilities that my surgeon can use? as I might have to use another surgeon....

So - to be sure i understand how this works, since the surgery center of Richardson where the True Results office is located and where i'm going for all the appointments and such to 'follow the rules' of my insurance (United Healthcare-Core) I have to do my 6 months of visits plus psych eval, along with dietician consult and all the necessary 5th visit requirements of EKG/PFT and bloodwork - all are covered by the healthplan. My question is - since the Dr. is IN NETWORK - but his facility is OUT OF NETWORK - i need to make sure that when my surgery is scheduled - that it is at a hospital that is IN NETWORK...correct? I'm assuming I'm going to have to just stay on top of things.... as True Results of Richardson keeps saying stuff like they accept out of network...duh...but I'd end up spending out of pocket for that... also as far as testing goes - what is PFT???

too funny - lifting up your shirt at work...I can almost picture that!! Ok - wow - 4 incisions or so.....do the stitches have to be removed by the doctor or do they dissolve?? just thinking of aftercare and such. thanks for your replies!! off topic - how in the heck do I clear off the stupid ads on this site, when i do down the page to view replies and such on other posts - there is no section to hit to view the next page....

I think they are so nice there - i'm just worried because the Dr. there is in my preferred doctors list for United Healthcare - their facility is not. I think i will still go to them for the 6 months prior to surgery so that we cross all the "T's" and such and follow United Healthcare's checklist - but I will have to use a hospital for the inpatient surgery. Does anyone know that if you use a hospital for your lapband - are you required to stay overnight? only concern is that i live alone, and maybe the first evening having a little help would be nice.....

Seriously....it's not PRE APPROVED??? ok now I'm wigging out...I could go though 6 months of visits - and testing all to find out at the very end that something changed or whatever and I'd not be covered. omg....I wanted this to all be pre-approved and done going through UHC requirements prior to the surgery.....jeez. yikes.....

great news....I think the staff there is great as well.... Did you get a letter from Aetna saying it was all approved?? I called UHC bariatric number and had an appointment today for their nurse to call me, but they didn't call - so i emailed them to make sure they had correct timezones and phone number - apparently the nurse who was to call was sick today. I received in the mail this weekend a package from United Healthcare - but no real Letter of Approval.... was wondering if we get that, as I want every piece of info in my file....I hate surprises...like someone here posted that surgery was tomorrow and now her surgery center is not part of the network...