abeaher

So I had my first appt yesterday with doc Turnquest in Houston.......I was so nervous....the bariatric coordinator (a medical asst??, I thought she would have been a nurse, but she was nice) is who I met with first. I have been gathering a TON of records and info in preparations for this vist for MONTHS and it was a B***H, let me tell you! I am a nurse and usually have a lot of patients with office staff, but it was a nightmare to get my records (one office tried to charge me $50!!!!) Anyways, so I go in TOTALLY prepared and almost more knowledgable about my approval process than her and she still tells me that I need: 1. letter from PCP 2. Medical clearance form PCP 3. Pulmonary clearance 4. Psych consult 5. nutrition consult And I am really frustrated at this point. I know that these are all things that would benefit me, but I have been researching for 4 years, dieting since I was 10, had just seen the respiratory doc, just had an EKG (for no reason), just had a total blood workup, etc. Plus my ins does not even require all of these things! So I tell her fine.....whatever I have to do and then I see my surgeon......I LOVED HIM!!! He was AWESOME! and when I was discussing all of these future visits,appointments, tests I was being told I needed, he immediately said, you are only 28 years old with no significant hx and you just had surgery a year age(c-section) you don't need any of that!! He said to have the nutrition consult for pre-op reasons and then we will schedule the surgery. I was ELATED!! It just goes to show you that you should ALWAYS talk to the doctor about EVERYTHING the office staff tells you! Yaaaa go me!!:whoo:

Hello Everyone, My name is Amber, I am 28 years old and I know I don;t belong in the thirties, but with three kids, a husband, full time job, 2 weiner dogs and female cat( I think is prego) I don't feel twenty something most days. I live Northwest of Houston and will see my surgeon for the first time this afternoon. Fingers crossed for ins. approval.

This is a copy of part of an email response from my doctors office regarding what I would need to do prior to the initial appt to speed up ins approval. Hi Ms Beaher Yes there are a few things that you can do before your appt. These can be done in any order you will need to meet with a nutritionist which can be done at Houston Northwest Medical center # 281-###-2600 call this number and go ahead and schedule an appt this month and next month(December) your insurance may require a three month physician supervised diet and exercise program, So you will need a total of 3 consecutive months (keep your appts around the same time each month). Also your insurance company requires written documentation that you are mentally ready. So you will need to meet with a psychologist I can provide you with some physician that are familiar with the lapband procedure. Also make sure you bring all your medical records a five year history with your weight on the documents and any information to determine your health. If you can obtain a letter of recommendation from your primary care physician that would be great. Well I look foward meeting you the beginning of the year. Happy Holidays You may not need all of this....it is all dependent on your ins. plan and what the ins company tells you doctors office that you need for approval. Have you read your plan? DOes it indicate what is required for approval? hope this helps

Also, Hyperlipidemia (high cholesterol) is considered a comorb ......eat a supersized quarterpounder meal before the test...hehe Just kidding, you will probably have to fast. Good Luck

I must say, I am scared to death about being banded and not being able to give up the alcohol. I come from a long line of Morbidly obese and even super obese alcoholics. I found a website yesterday that has an outline of questions for the 12 steps so I am trying to work through my step four. Man it sucks digging up old dirt that you have buried and "thought" you had overcome. You are right Alex about the sponsor, I find it hard to trust a total stranger that they will not judge me if I mess up. I had a bit of a bad experience the last time I started attending AA meetings. The AA and CR meeting are few and far between where I am and most charge for childcare, with three small kids that part sucks.

minpinmom I read on one of your posts that you are in Conroe, I am in Magnolia. Tried to email you, but my work comupter blocks EVERYTHING. Where are you in your journey? I see my surgeon for the first time today, fingers crossed for ins. approval.

This is a great idea! As so many of us with weight issues having compulsions that have led us to this point. I will admit that I do not struggle with the compulsion to overeat, although I have had my moments. My struggle is with alcohol, it is my escape from "feeling fat" or being embarrassed in social situations about how I look. I have tried to stop many times and am not successful. At AA and Celebrate recovery I got stuck on number 4, I think from just lack of knowledge on how to complete that step. Anyways, it is a terrible habit and my children are starting to reach an age where they are aware of it. I am concerned that this will be my greatest obstacle with the lap band as the eating is not really a big problem. Anyone else who struggles with alcohol? and is having the band or has the band? I would like to hear from you.

is hyperlipidemia (aka high cholesterol) a comorbidity?

Is hyperlipidemia (aka high cholesterol) a comorbidity?

Is hyperlipidemia (aka high cholesterol) a comorbidity?

thanks for the replies, I really appreciate the support!

So I am preparing for my appt with my bariatric surgeon Jan 8th and trying to get all my records together to shorten the approval process for my ins. I am only 28 years old so the extent of my medical visits for the last 8 years have been ob/gyn visits for my 3 kids. Last year I did go to a "wellness" clinic for fatigue, exhaustion and just general well being, thinking that if I was not so tired all the time I might have energy to excercise, cook healthier meals, etc. I thought I might try a different approach since the dieting I have done since 1990 (10 years old) has not worked so far. I have been seeing this wellness doctor for 10 months about every 2-3 months and she has found a thyroid problem and been treating me for that as well as my fatigue, stress, etc. Bottom line... she won't write my a letter stating that I have seen her for " weight related issues".......WHAT!!! And no where in her notes does it say anything about our discussion regarding my claoric intake, daily excercise, weight history, etc!!! And we discussed that at EVERY visit!!!! HELLO..... IT IS A WELLNESS CLINIC, me walking in at 230 lbs, you would think she would have noted somewhere that she asked about my weight problem...how else would I have gotten to 230 lbs. I am a nurse and I know that docs don't have time to note EVERY word, but is she not treating my "wellness" which to me includes my nutritional state. As we all know the "damper" obesity is on "wellness" What a joke, I am so irritated. Anyone have a similar situation? Thanks for reading, I am not one for long posts. my sone wanted to put the smiley in.

So I am preparing for my appt with my bariatric surgeon Jan 8th and trying to get all my records together to shorten the approval process for my ins. I am only 28 years old so the extent of my medical visits for the last 8 years have been ob/gyn visits for my 3 kids. Last year I did go to a "wellness" clinic for fatigue, exhaustion and just general well being, thinking that if I was not so tired all the time I might have energy to excercise, cook healthier meals, etc. I thought I might try a different approach since the dieting I have done since 1990 (10 years old) has not worked so far. I have been seeing this wellness doctor for 10 months about every 2-3 months and she has found a thyroid problem and been treating me for that as well as my fatigue, stress, etc. Bottom line... she won't write my a letter stating that I have seen her for " weight related issues".......WHAT!!! And no where in her notes does it say anything about our discussion regarding my claoric intake, daily excercise, weight history, etc!!! And we discussed that at EVERY visit!!!! HELLO..... IT IS A WELLNESS CLINIC, me walking in at 230 lbs, you would think she would have noted somewhere that she asked about my weight problem...how else would I have gotten to 230 lbs. I am a nurse and I know that docs don't have time to note EVERY word, but is she not treating my "wellness" which to me includes my nutritional state. As we all know the "damper" obesity is on "wellness" What a joke, I am so irritated. Anyone have a similar situation? Thanks for reading, I am not one for long posts. :rain::clap2:my sone wanted to put the smiley in.

Thats GREAT! keep it up, I am struggling with starting, I get past the first 2 weeks and then stop. Then it is so hard to get started again! Good luck!

Hi firedust, We have a lot in common! I am 28, my new ins kicks in Jan 1st, and I have been reading and contemplating lap band for about a year now. I don't have quite as much to loose, about 80 lbs. I have been lurking on the boards for about 2 months, I am soooo anxious to get the process started that this helps me stay focused and motivated. I notice that most of the EXTREMELY successful bandsters are those that DO have a lot to loose, so the fact the you have 200lbs to loose might acctually contribute to your success! Welcome, we can count down to our NEW YEAR ans NEW YOU together. Keep me posted on your journey.

Onceuponatrip, I did not think I had sleep apnea, as I am 28 years old with a BMI of 39 and have three small kids. I thought I was just tired all the time because my kids wake me up and my hubby says I don't even snore very loud, but I was diagnosed with SEVERE SLEEP APNEA and go for my 2nd test next weekend. My sister jokingly called to congratulate me on my new found disorder because it will help with ins approval. YOu never know, you might have it and just don't know it.

I was told by my psych doc that most ins. will cover part of the consult but not all, meaning they will cover the consult itself but not the report that the psych has to type up to be submitted by your bariatric surgeon to ins. He said the key to getting them to cover the small part of the consult is when you call for precert you HAVE TO SAY that you need a consult for "weight related issues" ie. depression, not a consult in preparation for bariatric surgery. He told me that this would get the precert but I would have to pay out of pocket for the report, which was $150 plus my copay for the small part that they would bill ins for. so I basically would just be paying for the whole thing anyways. Hope this helps, you know it is all in how you word it with ins.

When you switch insurance everything is transferable as far as care you have recieved. For example, aetna requires a 5 year weight loss history in some cases, it does not matter what insurance you had when you had those appointments or what doctor you saw. So if you start now BCBS should honor it, I would just make sure your doc takes BCBS so when you switch over you won't have to switch docs. Good Luck!!!

Private insurance usually will not cover elective procedures like the lap band although it's medical necesssity can be argued. I had private insurance for a couple of years when I was in college because I was too old to be on my parent's and ins. was not offered at my job, it was REALLY crappy, it covered me if I got sick, but that was about it and even then the deductible was REDICULOUS. I would start researching your jobs benefits first.

We are getting new ins in Jan and I have my 1st appt set with 2 different surgeons for the 1st week of Jan to see which one I like. I also contacted the Dr office to see if there was anything I could be doing now to prepare and was told that I should go ahead with my psych and nutrition consult as well as getting all of my records together. Apparently the process can take up to 2 months from the time you walk into the surgeons office and are on the table for the procedure, and that is iff ins approves you right away. There is another post of a girl that got UHC with her job, made the appt like 5 or 6 days later, was approved immediately and was scheduled for surgery like 2 or 3 weeks later. She said that the premium had not even come out of her paycheck yet! As long as you have proof that you have been covered prior to the change there should be NO problem. I babbled......sorry. I love these boards! I'm so excited! abeaher

That is what I have, are you a teacher? My doc is recommending that I do all of these things (nutrition consult, psyc consult, etc) prior to my appt with him in an effort to make the ins approve my surgery. I don't know if I should start the process or wait. it is a lot of money to do all of this stuff under my current ins. AMber

can anyone give me their experiences with UHC, BMI of 40 or below with no comorb. Thanks

Can you tell me why they cont to deny you. I have UHC and am searching for info on other experiences. What was you BMI, did you have other issues. Thanks

I am getting UHC in Jan and will have my 1st consult with Dr. Turnquest in Houston jan 3. I am concerned that I won't get coverage because my BMI is 39 and I don't have co-morbidities. I will do the surgery regardless, but I am looking for financing options in the event that insurance denies. Can anyone help? I can only afford about $250-$300 a month on a loan payment. starting weight 223