4jin

Oh...I was kinda aware all the records might not be required..since my BMI is over 40. But since it is just recently over 40 and not doctor documented yet at 40.... :kiss:kiss:kiss:kiss:kiss:kiss:huytsao:huytsao:cry:cry sshh...our secret I gained 10 to 15 lbs to get the over 40BMI terrible I know...but I have always had weight problems....Plus I just want to increase my chances of insurance approval. Am I the only one who has done this? Yes...with that said I just want to have it all for that just incase of if the doc decides not to submit it and then the insurance provider BCBS of GA decides to deny and I have to appeal. Better safe than sorry I always say...plus all my med records are from doctors that are over 800 miles away as I have moved to the state of Georgia. But it won't hurt to submit as much weight history with dates as far back as possible... Thanks everyone for your suggestions and support. Ah...two doctor's down.confirmed received...four more to go and follow thru! src="http://www.LapBandTalk.com/images/smilies/happy.gif" border="0" alt="" title="" smilieid="60" class="inlineimg" /></p>

The head nurse called me back and remembered me as a patient. The doctor had opened his own practice back when I was 4 months pregnant. I decided to follow him to his new practice even thought it was a 30minute drive...which in the state he practices 30 minutes is considered a long crazy drive to see a doctor. And I also referred him two patients who were cash paying no insurance and I know were responsible people and paid for all his procedures and are still patients of his...so he has made nothing but profit from them. Besides the fact that I was appalled because he is such a good natured, honest, humble doctor qualities that are very hard to find in an M.D....oh and he personally delivered by daughter on the holiday of XMAS during a terrible snow storm day! But she heard me out and called me back.... Needless to say...have the records and free of charge!! :clap2: then I said for her not to forget to give him the message that he will always be my best OBGYN!!!

Oh....in case anyone is wondering... info displayed on webmd for gastric bypass risks 1.9% of gastric bypass surgery patients died within 30 days after the procedure, which is four times higher than the rate of about 0.5% suggested by smaller previous studies. Nearly half of all early deaths occurred after the patient came home from the hospital. The risk of death within 30 days after gastric bypass surgery was nearly five times higher if the surgeon had performed less than 20 of the procedures than if the surgeon had more experience. Of the cases in which the patient died within 30 days after gastric bypass surgery, 81% were among the surgeons first 19 gastric bypass surgeries. :omg:

the band might make you think twice.. but compared to the risks for other gastric bypass procedures....thanks but no thanks... I will choose the band anyday. :biggrin1:

Welcome... I have not been banded yet...I am in the beginning process....didn't feel comfortable at first seminar I attended...have second one tommorrow hopefully this is the one!

How soo can I schedule surgery?! LOL Seriously...just listen to all the info they are providing to you. And just think of all the questions before you go in and write them down.... have them ready...because if you are like me you will forget them once there!

Anyone thought of buying the bodybugg?

Hey, buttercup... just a quick thought....oh first I am so sorry to hear that about your insurance policies and the doctor being booked that is terrible... Since you have gone that far and everything is set can the doctor guarantee you a date in january if not possible for december...if so?...can you try getting cobra on that insurance....a couple hundred dollars on cobra is still better than self pay... Plus you will have two coverages so your other new insurer can't exclude for pre-existing....I think... just a thought..... hey...big companies...think of all kind of loops.... nothing wrong with us little people trying to find one too! Just a thought for you to check out! :paranoid:eek:

I would then definitely go back to a seminar when the actual Doctor that will be performing your surgery is there. He will be able to answer your questions directly. And should have more experience on all procedures. Keep us informed.

You own this!!! You have worked hard for 6 months! You can do it! And by losing that last 16 lbs you will show that insurance company-ha...I told you this is what I want....and I want it bad-and now you will have to pay for it all!!! look thru your pictures...read a good motivational book that will get your mind in the right path to control your thoughts. It is probably fear sinking in that once you have achieved it begins your true life altering process of the new you coming out....the thin you! kick yourself in gear and go that extra mile!

I have attended 1 seminar. Then I learned my insurance does not cover that doctor...so I will be attending my second seminar on Thursday. I have never heard of this neither. I have been doing lots of research on the lapband as well. Erosion, hernias, slippage are currently the most known conditions that are derived with consequences of the band needing removal or replacement. The actual percentage of people that require it are very low. Compare that to malabsorption and surgery risks of nip and tucking and moving and all that they do for all other bypass procedures. With that said I would have to say he is being biased. Either he is more comfortable with RNY which is what he might know best surgically performed more of. I would contact his office and request his stats for surgery. He might just not feel that comfortable performing lapband if he does not have much experience performing it. We could probably contact wassabubblebut for stats on your doctor.

I have not been banded yet. But I too choose the lapband over bypass because of the less intrusive method and scientific records of longevity and survival. I also found in research that after bypass surgery 12 months to 15 months somewhere in between your old appetite hunger feeling starts coming back....and basically it is an endless battle again. From the research I read the sucess rate for lapband is greater over the 5 year or over factor because the lapband keeps you restricted......which serves as a reminder of your journey and your new experiences and also the band is more sucessful at keeping the hunger away on a longterm basis.... to me...that is exactly what I need to continue to make the best food choices for me... Hope this helps..!

I have bcbs of Georgia. I am still in the process, but I have documentation of just weight history of 5 years with BMI at 40. My current BMI is 41.5. I do not have any medical conditions besides the weight. I have recently developed asthma but just one episode so they excluded weight as a cause. I contact BCBS as well to make sure. They do only require bmi of 40+ or 35 or less but with at least 1 medical condition. I was on the same boat as you. I am looking at all my insurance options as we too have open enrollment. I was going to switch over to AETNA but they have stricter policy requirements. I just contact their customer service number and with my employer group ID number I gave them they gave me a written copy of the guidelines/requirements in order to qualify. Just give them both a call. But it sounds like you have done your homework already. Don't panic.... I was panicking because of the desperation to have this approved but was blocking myself mentaly of gathering good records or making the right choice. I have since decided to keep BCBS of GA which is what I have had and just pay the deductible of $500. At least it is better than having to be self pay. Hope this helps.

I would call the insurance company and ask for the CPT/ICD-9 codes for the procedure for coverage to make sure the billing specialist at the doctor's office is submitting the correct codes. I don't know why but they do have more than one code for the same procedures and if not submitted under the correct code your insurance can deny to pay that expense. Make sure you right down the info and name and title and date and time of person you spoke with. I haven't been banded yet...but I was told it is 100% covered and I will just need to meet my deductible of $500.

tulipstar, I am so sorry to hear about your port flipping. How does that even happen? Did they tell you? Everyone else I am on the same boat....except I have already called my insurance company...I know what they require....and I am taking steps to getting all my medical records in order to show documentation of my weight history over the years.... I have read a really good book about lapband. It is the story of a woman and it speaks from her life long struggle with weight how it affected her life all the way past surgery once she did get the lap band. It is a true story. The book is titled Fighting Weight. Her lapband surgeon is a lapband patient himself. It has also doctor and surgeon advice of the process what to expect, what foods most people are able to eat..etc.... I recommend it to anyone interested in the procedure...a lot of my questions were answered there in addition to this website of course. :biggrin1:

Wow...congratulations....I hope my insurance story will be just as smooth as yours..

Hi.... I moved from Ohio to Georgia 1 year and 4 months ago. When I worked in Ohio my employer covered it but at that time i thought I was being a looser and admitting I couldn't do this by myself and being a failure. + A couple of years later and various diets here I am at an even heavier weight. I have since found info about the lapband as back then, I didn't even know it existed. As a matter of fact it has only been 3 weeks since I discovered this lapband concept. A good book I recommend which is where I got most of my info on the procedure and how to get approved by insurance and the writers own personal journey from being a young girl to life after surgery is Fighting Weight by Khalia Ali and her lapband doctors. Even her surgeon has the lapband. I just called my insurance provider and the procedure is covered 100%. After the seminar you might want to start there before you choose your surgeon as the insurance might have already a specific choosen one. Hope this helps!!:nervous

Congrats....

"nothing tastes as good as thin feels" LOL....That reminds of this one diet period in my life where I went to HealthWise. It is a "medically" supervised program you buy the shakes, cookies and tea or juices that are supposedly filled with protein and follow sort of a SouthBeach, LowCarb Atkins type of diet....terrible....I lost fine in the beginning, but then plateau hit a hard one too....next thing I know she is cutting less and less items on my menu...next thing I know down to just liquids without pills..or anything..give me a break lady...and all i remember her saying was .... to motivate...think "NOTHING TASTES AS GOOD AS THIN FEELS" AHHHHHHHHHHHH!!!!!!!!!!! ok need to go to the psych forum.... LOL.....LOL.....LOL....

<p>deirdreboo8 ,</p> <p> I have not been banded yet...but I have been doing a lot of researching...and lots of question asking....</p> <p>I read on a book written by Dr. Fielding & Dr. Ren with Khalia Ali (daughter of Muhammed Ali) that it is normal before your first fill to feel hunger. They say that the time from surgery until first fill is for healing and getting accustomed to your new band. They say it is normal to loose or that some people even gain weight up to 10 lbs. Your stomach muscles need to attach to the band and settle where it has been placed. That is why strict diet instructions are given until your first fill-your stomach is swollen and tender from the band placement. </p> <p>But that once you get your first fill all hunger should go away and that is when your weightloss journey really begans. </p> <p> </p> <p>It is a great book it is titled Fighting Weight. </p> <p>Hope this helps...</p>

Well chiqui it looks like you are starting an excellent thread here. How are your emotions? R u cooking for your family? Are you tempted? Just want to start getting my mind in the right direction on what to expect afterwards as well. Take care!

Hi chiqui! I have not been banded yet, but is always nice to hear the experience before & after to have been pleasant. I hope to be banded before May of 2008. I am just beginning the process. I have my experiences posted on the thread under introduction: New and feeling Lost!! if you want to check it out. Congrats on your lost I can't wait to have those kind of results that is amazing. What is your husband saying with the 17lbs loss?

Hi ya' all who read this thread. I just want to be heard and find a connection with people who have a similar story. Here it goes... I have been overweight all my life. I can only remember a few times when I wasn't. I grew up with two brothers who ate what they wanted and were at normal weight. My mother would go out of her way so I would diet. I have been on every diet imaginable from SlimFast, to diet pills from GNC, joined gyms, Doctor paid for medically diets and exercised programs, Soup diet, cabbage diet, south beach, WW,.....on and on.... Some worked others were a joke..... But needless to say gained it all back. I am right now the biggest I have been in my life. I am so unhappy with my weight. I feel as thought a different person in my is trying to get out but none of what I do helps for the longterm. I am tired of feeling the shame, of looking in a room to see if I am the biggest person or not. but mostly I am tired of the loose, gain...loose gain...gain twice as much as I lost...etc... I researched last weekend gastric bypass as it has been something on my mind for years now..but couldn't help feel guilty or like a failure for turning to what some people refer to as the "EASY" way. I know I need a medical intervention to win this battle and be at a lifetime healthy weight. So I got over it and researched this past Weekend and came across this lap-band. I love it...I have decided this is what I need. I scheduled to what I thought was the informational seminar yesterday. It was an info seminar alright, but for Opti-Fast...what the crap...insurance does not pay, can only be cash or financed with the lender of the choice and cost $5,000. yeah right...walked right out... waisted 4 hours of my day in traffic, and away from family for that! So I called the number I called initially and was finally scheduled for the correct seminar but i have to wait until 12/5/07. My only concerns now are this. I am 5'2" and W 233lbs home scale. No comorbidities.... have documented doctor program from beg of this year in January until July 2007. Prior to that back in 2005 was the last doctor monitored program I did. I can probably get weight info from my gynecologist when my daughter was born back in 2002 of my weight prior and after pregnancy as I believe was a bmi slightly under insurance guidelines. I will have AETNA HMO effective 01/1/2008. I am snoring at night and began having asthma which I believe is weight related as well. My questions are as follow: Does anyone have any advise of how my case looks? Do I stand a chance at getting approval without a long battle? What is the process after attending the informational seminar all the way to the doctor's submittal to the insurance? HELP desperate to know!!:help::confused::confused:

Just stopping by to say...hi

Hi everyone I am in Dacula, GA. I have choosen Dr. Johnson. I hope to be banded sometime during of before May of 2008. I am at the beginning process.....if earlier great..!