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Gastric Sleeve Patients
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Everything posted by vsgredesignme

  1. I just got my insurance approval for surgery on January 7! Anyone else around that time? My surgeon is Dr. Eric Sommer at the New York Bariatric Group. I'll be having my surgery at Hudson Valley Hospital Center. For other pre-oppers that are curious: I have UHC Oxford Freedom PPO. They approved me in 24 hours. I have a BMI of 53, no comorbitites. My insurance required: 6 Months Weight Loss Program with Doctor (no diet, I just weighed in) Psychiatric Evaluation BMI > 40 with no comorbidities or >35 comorbidities. My bariatric center required: Cardiac Clearance Pulmonary Clearance Mental Health Clearance Dietary Evaluation sleep Study Endoscopy After Approval: PCP Clearance 2 Hour Bariatric Class
  2. vsgredesignme


  3. I only lost a net of 5lb in my 6 month pre-op. I kept yo-yoing.
  4. vsgredesignme

    Cannot get requirements in writing from UHC

    Hi there, Here is the link to UHC's Bariatric Surgery requirements. It's this one they sent to me. To clarify, my surgeon is just taking down my weight once a month, documenting it and will submit the required paperwork. I tried using my weight watcher's weigh ins but it needs to be a physician monitored program and you have to weigh in at the office. These apply for UHC and Oxford. However, if you are a state employee it will be different. State employees just need to show weight loss attempts and there is no waiting period at all. You will just need to go through a few evaluations and pre-op testing for approval and your surgeon's office will walk you through that. https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Bariatric_Surgery.pdf Bariatric surgery, as a primary treatment for weight loss is proven for the following: 1. Class III obesity (BMI > 40 kg/m2) 2. Class II obesity (BMI 35-39.9 kg/m2) in the presence of one or more of the following co-morbidities: Type 2 diabetes Cardiovascular disease (e.g., stroke, myocardial infarction, poorly controlled hypertension (systolic blood pressure greater than 140 mm Hg or diastolic blood pressure 90 mm Hg or greater, despite pharmacotherapy) History of coronary artery disease with a surgical intervention such as cardiopulmonary bypass or percutaneous transluminal coronary angioplasty Cardiopulmonary problems (e.g., documented obstructive sleep apnea (OSA) confirmed on polysomnography with an AHI or RDI of >= 30 (as defined by AASM Task Force. Sleep.1999;22:667-89) History of cardiomyopathy Additional information for medical necessity review, where applicable: Bariatric surgery is medically necessary when ALL of the following criteria have been met: Body mass index (BMI) = or > 40 kg/m2 or BMI 35.0-39.9 kg/m2 with one or more of the medical comorbidities described above. Documentation of a motivated attempt of weight loss through a structured diet program, prior to bariatric surgery, which includes physician or other health care provider notes and/or diet or weight loss logs from a structured weight loss program for a minimum of 6 months. (NHLBI, 1998) Psychological evaluation to rule out major mental health disorders which would contraindicate surgery and determine patient
  5. vsgredesignme

    anyone getting sleeved in DECEMBER?

    Getting SO close to December. My last weigh in and pre-op appointment will be around December 15. The last few months have thankfully flown by. Hopefully that keeps up.
  6. I don't have a date yet but it will most likely be the end of December given my weigh-ins, etc. So exciting
  7. vsgredesignme


    From the album: csdesigner

  8. vsgredesignme


    From the album: csdesigner

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