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RitzysWeightLoss

LAP-BAND Patients
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Posts posted by RitzysWeightLoss


  1. I used Lehman! Are you local? We should connect. He is an awesome doc...good surgeon.

    Yes. I live in Hopkinsville and would love to be Lapband buddies. When and where do you go for support groups. Maybe we can go together.


  2. Hi..I'm so upset and frustrated. I did my 6 months supervised diet and everything...my paperwork went in first of may and insurance denied Romney the 15th. Said I didn't do a doctor supervised diet. I met with my doc...she approved and then I met with a team.nurse..nutritionist ..pt...for 6 months. My doc called and did a peer to peer review with insurance yesterday and they denied again.. my doc said I can start over...meet her and the team once a month for six months... ughhh...I can not take that much time off work again for the next 6 months. I'm really sad...I so need this....sorry for whining

    I don't really understand why you have to meet with the nut team. For my doctors supervised visits, I just went in, got weighed and talked to my doctor for a few minutes. The entire visit may have lasted 5 or 6 minutes. The time waiting to see the doc was what boosted the visit to 30 minutes, easily done over a lunch hour. Also, make sure the doctor is using the correct forms, that was one of the reasons for my initial denial. They apparently couldn't accept just a written letter from my doctor, the information had to be on their forms.


  3. I had mine done at BACH in Fort Campbell...the process is super quick...no diet for me either...I guess they figure if your PCP refers you that they've tried everything else?

    Anywho...hopefully all your paperwork will transfer. It might be a matter of having it resubmitted to your doc at the MTF by each provider.

    Oh, that's where I'm having mine. I met with Dr. Lehman when I was denied by Tricare the first time and he is the one who suggested the sleep study. I'm glad to hear yours went so quick.


  4. I personally had no problem my insurance is all for it. However my daughter has many weight related conditions and twice they have said no to WLS. Their reason is because her conditions are treatable with medication. She just is not sure how to go about it at this point. Just wondering if those who ran into these road blocks' date=' how you went about getting it approved. Thank you and Happy Fourth of July one and all!![/quote']

    I was denied when I first applied because my percent of body fat was below 40 and I didn't have any of the REQUIRED co-morbidities. A doctor asked me if I snored and when I said yes, he suggested I do a sleep study to see if I had sleep apnea. Turns out I do, so I had my WLS office manager resubmit my paperwork with the addition of my sleep apnea diagnosis and was approved about a week later. I think the Insurance companies list exactly what their requirements are and if you can get that information, you will know what to do to be in compliance and get the surgery approved.


  5. Well, I contacted the MTF and they basically said they wouldn't even talk to me until I attended their introduction class. Luckily they had one that day so I signed up for it. During the class there were about 4 of us going thru the same thing, Although I was further along then most. Anyway, after the class we talked and they told me it wasn't really up to them, they were just doing what the were told, but they would take any paperwork from my civilian doctor and use whatever they could. I still have to redo my labs on Monday and they booked me for their July 11 four hour education class. Hopefully everything else will fly. I also contacted my civilian doctor and they are giving me everything tomorrow so I guess it won't be too bad. At least I'm already approved for the surgery, so it should be ok.


  6. Need help figuring this out, ive been lurking on this site since I decided I wanted lap band surgery and I love how supportive you all are. I've been trying to get my lap band approved through Tricare prime since January. I finally made it through all the hoops with my civilian doctor and fulfilled all their requirements and got Tricare to approved me, but since I am in an area with a military treatment facility, Tricare said they had to give them first right of refusal. The MTF decided they would do the surgery. I am really frustrated because when I called there, the bariatric nurse wasn't there but the person that I talked to said I might have to redo several of the steps using the MTFs requirements. For instance, they said they require a 6 month diet vs. the 3 month diet my civilian doctor required. They said I also might be required to attend their seminar and see their psychiatrist, along with a few other things.

    Does this make sense to you? I am so frustrated!

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