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oklafarmgal

LAP-BAND Patients
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Posts posted by oklafarmgal


  1. Yes. I emailed the girl that sets up appts and asked her to let me know if there is a cancellation. I sure hope there is. I just really have a feeling I will be into March before I can have surgery. That is really going to stink. I dont know how I can fit surgery into that month. The seminar is very informative. You will hopefully enjoy it. Plan on a long office wait on Wednesday. Dont be surprised if you have an hour wait to see him. But it's worth it. Good luck.


  2. It's going. Lol.....I sent to the pulmomologist and psych eval this week. I go to the cardiologist tomorrow. But, then I don't have another appointment for almost 3 weeks. They should have my sleep study scheduled by friday. I have a second dietician appt, then the surgeon on Feb 8th. I hate having that much lull in my appts. I think that is alot of time to waste. I would like to know how long after the surgeon appt do they have surgery scheduled. How is it going with you? What appointments have you had so far? Good luck Mollie!! Oh, btw, I changed my screen name to oklafarmgal, but it's still me. lol.......


  3. I started my seminars in october. The 6 month diet is a requirement of your insurance if there is one, not the dr. Its not a fast process. You have to see the dietician twice. You see exercise and behavioral, pft, chext xray, ekg. You also have to go to a support group meeting. Then its to the psychologist, pulmonologist, cardiologist, on top of that you meet with dr kirk or his np every month. After all that, then you see the surgeon. Then, its submitted go insurance and wait for them. If you're lucky you will be approved and not denied and have to appeal. I started om October and wont finish all my appts until February. It is NOT a fast process. I dont want to bust your bubble but i see no way you will have surgery in February. If you are lucky, April or May. It's a bummer. I know! !


  4. Oh yea, I think we have had this discussion before. Pookeyism is right. If they are smart enough to take your money and do your surgery, you would think they would be smart enough to get it past the insurance. I know that I am not going to fight with them too long before I go to Cancun. It's just so much cheaper and a whole lot less headache. And, I know that is exactly what UHC wants you to do. Know what I mean????? No cost to them.....


  5. I spoke with my insurance coordinator in my surgeons office and was told that my insurance would accept a bmi of 35 and over for the morbid obesity requirement for 5 years. I called my primary care doctor and luckily I have that. It's funny how I want heavy weights now. Lol.....But, the coordinator also said that sometimes they will use photos of yourself if they have the date on the photo to show your weight. I know it is very frustrating to work with insurance. There have been times that I have been sick and needed to go to the doctor, but didn't want to be weighed. Crazy, I know. Good luck with yours. Just talk to the insurance person in the surgeons office. They have more knowledge of what they can get the insurance to accept.


  6. Has anyone got their insurance to approve surgery without one of their requirements being met? Mine requires physician documented "morbid obesity" for 5 years. I meet all of the requirements except that one. I have been "obese" for that time, but not "morbidly". My bariatric office doctor said to not worry about it. I don't know if he has had luck convincing them or what. But, I am still concerned that I will be denied. Any thoughts or suggestions? Thanks.....


  7. Good, I have had two appointments in Dr Kirk's office. Today I had an exercise and behavioral along with a chest xray, pft, and ekg. I am just hoping insurance pays. I have a bmi of 40, but the insurance also says doctor documented mobid obesity for 5 years. I have been very over weight but not morbidly obese. Dr Kirk said not to worry, but I am anyway. I don't want to go through all these tests and then be denied.


  8. I have the same insurance. Also, I have bmi of 40. I just don't however have a physicians diagnosis of morbid obesity for the past five years. I have been terrible overweight, but not "morbidly obese". It have just crept up and up. I hope somehow I can get it past them. Any suggestions? Have you heard anything from the insurance yet?

    What's your insurance classifying this as? BMI of 40 and beyond ONLY or either 40 bmi or 35+ bmi with co-morbidity (like the National Institute of Health defines it as)??

    UHC is really trying to fight on this as my summary plan description states I need a BMI of 40 today (which I have) but I slso need a physician diagnosis of "morbid obese" for past 5 years and shoeing records.


  9. I have concerns. I can understand having tests to see if you are a good candidate for gastric sleeve surgery. I have coverage with my insurance (United Healthcare), but I don't want to have a bunch of tests and then be denied for some reason. I go tomorrow for EKG, chest xray and pulmonary function tests. The bariatric office require these tests. They called my insurance and found out my financial responsibility for these tests is $298.00 which I will have to pay tomorrow. At this rate you can be out of pocket quite a bit for no reason if you are denied at the end. I know i'm not the only one going through this. What are some of your experiences with this? Thanks for any encouraging words. This is just freaking me out being out money on tests I wouldn't be getting except to have surgey.


  10. You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

    tmf

    I contacted them. It is covered if your BMI of over 40 (which I am) or over 35 with comorbidities. I am just nervous that something is going to happen. Sorry, I'm just always "Nervous Nellie"....

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