Annie

Each time I called, I got a different answer. Eventually though, I was approved and had the surgery in June. I have UHC Choice. Each employers plan is written differently...but if you meet the National Institute of Healths guidelines, you should qualify. My BMI wasn't over 40, never has been, It has been over 35 though, and if it's over 35 and have a comorbidity you should qualify. I did sumbit my last 5 yrs worth of weights that was charted each time I'd go to the dr for a visit. Hope this helps. I know UHC can be frustrating, but have the surgeons office submitt the info to care coordination, and see how it goes.

There was an earlier question about having a sore throat...I too have had a sore throat this past week, and it isn't the normal sore throat feeling...it's more an irritation. It doesn't get any worse, or any better. Can someone explain what that may have to do with the earlier question in regard to dilation. Thanks!

Kathy, Yes, I called the number on the back, then asked for care coordination....

I have UHC, and was approved and banded earlier this month. I too was worried about what extra's they would need to approve. My BMI was 37 and I have high blood pressure, and a family hx of diabetes and heart disease. I got a copy of my weight history from my regular doctor, from all my previous visits for things....(they always weigh you, and take your bp when you go in) Anyway, by weight fluctuated from 200-235 throughout my history. (which was since 1998) My surgeons office submitted the paper work on a Tuesday, and told me it would probably be a few weeks till we heard anything, so I called UHC that Friday to see if they had recieved everything they needed and to check the status. They told me then I was approved, and had sent my approval letter that day. It was quick all in all. I didn't think it would be that easy, I was expecting a denial. Hope this helps anyone in waiting. Good luck to you all.

Anyone banded have any statistics, or experience with knowing whether or not where the surgeon places the port has anything to do with the port twisting? I'm curious to know if there is any benifit to having it placed in one place or the other? (near stomach, or lower and to the side?) Thanks for any advice.

I have a port question....do any of you find that there is a difference as to whether the port is placed nearly parallel with the stomach, or off to the side and lower? I wonder if there are more problems if it's placed in one place more so than the other??

Wash U's program is just starting a group for bandsters, most of them are bypass patients. I spoke with the surgeon (Dr Eagon) that is doing my surgery (insurance approving), and he said there are about 12-15 people that are starting to get the group together. I don't have the specifics on date and times yet, but I will let you know. Perhaps, if we can get enough interest, we all could meet out somewhere, and talk about our experiences.

Hi MSmom, I was hoping you could tell me more about your experience with UHC. I have UHC Choice plus, its a federal employees plan. I have started all the preop requirements, and have my consults next week. Then the surgeons office will submit to insurance. I worry they will find some reason to deny it. I too havent had a 5 yr hx of BMI over 40. It's been over 35 and I've had HBP too. So reading your thread has gotten me a little nervous. I'd like to hear how your experience was, and what all happened. thanks!

oops...I meant "WON'T object to my lower BMI." I will let you know. I haven't read many posts about them, mostly been New Start Patients. I actually almost went with them, but had already started the process with Wash U. I hope I'm making the right choice.

Hi Shawna. I'm just starting. I have all the pretesting like labs, and barium swallow done. I am meeting with the Surgeon, the nutritionist, and the physical therapy on Monday and Tuesday. I guess it's after that appointment that they will submit to insurance. I'm still a little worried that someone will deny me. My BMI is 37 and I have HBP and a fam hx of diabetes, and heart disease...so I'm hoping the insurance or the surgeon will object to my lower BMI.

I'm nearby. I haven't been banded yet, have my consults at the end of the month with Wash U's program. How are you doing so far?

I swear, you get a different answer every time you call UHC. I've called several times to make sure I have done everything I can to get this approved, and each time I've called, I get different answers. One time this representative I spoke to actually came out and said "I can't help you".....how can she not answer a simple question??!!! I have my consults with the psych, the nutrionist, and the surgeon at the end of the month, then they will be submitting to insurance for approval. I hope all goes well, but it's hard to keep from getting discouraged when you keep getting different answers.

I've started the program at Wash U. I have my consult/appointments with them on the 30th of April, and on the 1st of May. I've already submitted my pretesting results to them, and filled out some questionaires from them. I'll keep you posted on how it goes.

You're right Travel girl...I tend to always think the worst! I'll try to think positively about the ins approval! Thanks everyone for your posts!

Good luck! Keep me posted, as we have similar situations, and I'd like to hear how it goes for you! Anne

Great! You give me hope! I too have UHC, and was told by them that is what I need as well....at least on one of the 5 calls I've made to them....each time I've called I've gotten a slightly different answer. I also did WW and just got to the 25 wk mark, then no more entries....I wrote one in for the 26 week, just for good measure! LOL! Hope it's ok....I still did the program for a few more weeks, but i didn't pay for anymore of the meetings. Plus my doc can attest to my attempts as well, so I'm hoping I won't have problems getting approved....I have a BMI of 37, but HBP, and family history of diabetes, heart disease and cancer. I just started my pre-op testing today. As for 'fudgin'' the numbers, I'd say go for it, but I'd be nervous about doing it for too many weeks.....but who am I to call the kettle black...I did it with one week. My

Well, I DID IT! I had my appointment with my doc today and she approved of it! I was all worried for nothing. I was so nervous when I got there, I had a speech all planned, and I didn't have to sell it! LOL! She walked in the room after reading my chart, and said "so you're really going to do this?!" We had a really great talk about it, and I got my labs and EKG done....as I left, she said, just let me know what all you need from me, and I'll be happy to help. WOW! I'm so excited! Next step...insurance approval. I'm keeping my fingers crossed! WHOOHOO!!! I can't wait!

Thanks everyone for your input! You all have good points, and I appreciate the fact you took time to answer! It's nice to have everyone here to bounce things off of... My appointment is Thursday, I'll keep you posted!

Hey Jane, I too plan to have my WLS done at Barnes by Dr. Halpin or Dr. Eagon. I've just started the process, and am getting all of my pre-op appointments taken care of. Please let me know how you like them, and how your experience has gone/goes. How long did it take from your meeting with the surgeon, till you got a date? Thanks!! Good luck to you!!!

I have talked with her in the past, nothing too specific, just briefly touched on it, and judging from her reaction she seemed against it. I am hoping to have enough info for her, if she has questions, and hopefully she will sign off without much of an argument. Who knows, I could be wrong, perhaps she'll be ok with it. I just would like some good advice on how to get my point across to her if she seems unwilling.

I need some advice on how to approach this with my pcp. I was hoping to avoid getting her involved, as I think it will be hard to get her to "sign off' on this surgery for me. I have an appointment with her at the end of the week, anyone have some suggestions as to what I could say to her sway her decision? She's seen my attempts, and all the failures, I am just mentally tired of fighting this battle...I am not looking forward to talking with her about it again...I hope it goes well.

Spectacularone, Well, I just spoke to the surgeons office, have my evaluation appointments set up for 24 Apr. Wish it was yesterday! LOL! I am really impatient, and I'm ready to do this now! Anyway, i told her of my concerns with all the different answers I have gotten from UHC, and she told me to call them back and ask to speak to a supervisor, that I should as them if there are any exclusions, and if I have to be on a supervised diet for any length of time before they approve it. Hopefully not, cause I don't want to have to wait 3-6-or 12 months to get this done. I'll keep you posted.

Spectatularone! I too have gotten a different answer each time I've called UHC....The first call seemed very promising, that's why I really started tp persue this. I've called them 3 more times, and each time I get a slightly different answer, each one sounding less likely it would happen. The last call, the lady was soooo rude, she actually said "I can't help you". She stated that it's all up to care coordination....that she couldn't tell me anything that could help this process along. I couldn't believe that she said it that way. Isn't their job to explain these types of things to us??? Hopefully my surgeons office will have better luck than me. Is your insurance plan for federal employees? I hear they are usually easier to get approved for some reason. Also, I'm hoping with my high blood pressure it will be enough. I have a strong family history of diabetes and heart disease also, so I hope that helps them deem it medically necessary.

Well, good luck to you! I'll say some prayers for ya! You'll have to keep me posted on how it goes. :mad:

Pamla, I wonder if that is normal, them taking that much time to review....