DrHekier

In our clinical practice we have seen that a lot of patients have a hiatal hernia and they don't even know about it. They might have had vague symptoms, such as occasional GERD or mild nausea from time to time, but were never diagnosed with a hiatal hernia. Most LapBand surgeons will closely look for a hiatal hernia in the first part of the surgery, and if you have one fix it at that time. Don't worry, it won't interfere with your surgery.

Great! Thanks for the update! I don't understand the confusion and why our office is getting so many phone calls. We will give them the number you posted. The Internet is great! Thanks sarahbethlane :thumbup:

In the past few weeks our office in Texarkana has received multiple phone calls by patients in Arkansas who had a LAP-BAND® placed by Dr. Rex Luttrell. It appears that these patients are unable to get a hold of Dr. Luttrell and they indicate he may have moved his practice to an unknown location since the office staff can't answer to his whereabouts. I'm trying to save our staff multiple phone calls by posting this. In order to accept a new patient we would need to get a copy of your operative report and clinic visit notes to evaluate prior to accepting you as a patient. Thanks,

In your doctor's defense, in my experience Aetna is one of the worst payors for Lap Bands and we physicians never know what they will do. I once had to wait 9 months until I got paid by Aetna for a LAP-BAND®, and of course this was pre-authorized by them in the first place. My biller was calling them every few days for several months and getting nowhere. Only after I intervened and started calling every few days for a couple of weeks, did they relent and agree to pay. A lot of patients aren't aware of the hassles that the doctors office goes through to get paid. I don't know the specifics of your situation, and I admit I am biased, but I have to take the side of the doctor's office over the insurance company. Especially Aetna. Even when they say they pay, they might take many many many months. Most importantly, congrats on your impending LAP-BAND®!:smile2:

Unfortunately if she has an exclusion it is almost impossible to overturn that. In desperate cases, I suggest seeking the services of an attorney advocate for weight loss surgery patients, Walter Lindstrom. Obesity Law and Advocacy Center Walter himself has undergone WLS.

Work with your doctor's office. Each policy is different. One person's BCBS of TX policy may have different requirements than another person's Regarding what might work: we once had a patient that lacked one year of her five year weight history as do you. We provided a picture of her that was taken during her "missing year" which showed that she was at a similar weight as noted on her doctors notes for the years before and after. Good luck!!

I wouldn't worry about it. It looks like someone submitted for approval for an infusion pump, which is not commonly used in Lap Band surgery and a nerve injection which is never used. This seems to have nothing to do with your surgery. Congrats!

Regrettably there is a surgeon from Little Rock that is still practicing Lap Band surgery that reportedly has lost privileges at multiple hospitals in Little Rock. I understand he has resorted to taking his patients out of Little Rock to a small hospital in a small town that has given him privileges.

We have a primary care physician we have trained to do fills in the Ft. Smith area. Let me check with him to see if he will fill patients that are not from our practice. The potential conflict lies in the fact that if you develop some sort of issue with your Band that would require that advice or intervention of a surgeon, he needs to make sure that you have a surgeon that would be able to see you. I will be out of town for a week so if I don't post a response or PM you, feel free to PM me as a reminder.

That doesn't sound right. Are your surgeon and hospitals certified as a provider for the Centers of Excellence? We've been doing Medicare Lap Bands for many years and this doesn't sound right.

This does not sound right. Here in Texas we have been doing the LapBand for over 5 years, and I have never heard of a 5 year dietary requirement. Many insurance providers require a physician guided documented 5 year weight history showing obesity, but not a 5 year physician supervised diet. Ask your customer service rep to give you the link to the clinical policy bulletin on obesity treatment on their website or for them to email it to you. Sounds like some miscommunication or misinformation.

Our practice was invited to a conference last year that had many of the top Lap Band surgeons in the world. Many if not most of us have our patients go on a low calorie diet before surgery to shrink the liver. It is more imporant in men, and in larger patients. Here is a link to some papers describing liver shrinkage in response to low calorie diet: SpringerLink - Journal Article The effect of a low-carbohydrate diet on the nonal...[surg Endosc. 2007] - PubMed Result Change in liver size and fat content after treatme...[Obes Surg. 2006] - PubMed Result

Every insurance company is different. Your Lap Band surgeon's office should be able to help you. They might know right off the bat what your insurance company requires specifically. Here in Texas, many require a prior weight loss program. For some that can include programs such as Weight Watchers or Jenny Craig, but others are more strict and want physician documented weight loss plans. If your local Lap Band surgeon's office isn't sure call the insurance company again and use our template found on our site Texas | Arkansas Lap Band Insurance information. Good luck

We are trying to set up a conference call this week with a primary care physician in the Fort Smith, AR area who can do fills on our patients. We would also work on getting a support group set up there. We did recently start a support group in Nashville, AR which is a bit closer to you.

Regarding Fed BC/BS, as we said earlier, as long as your ducks are in a row, they should cover the procedure without any problems. I've personally met Dr Luttrell at a Lap Band conference last year and got to know him over several days. It was a pleasure to get to know him and he seems like a great guy. We're all cheering you joining the LapBand club! Congratulations on your upcoming surgery!

Fed BC/BS was brought up on another thread a few months ago. They do not require pre-certification which should make you extra careful that all your ducks are in a row. You'd hate to have surgery and then after the fact find out you didn't meet their requirements and have to pay out on your hospital bill and surgeon bill. Our office is very strict to make sure all requirements are met before we perform the surgery.

Our group is a certified Center of Excellence, if it is a Medicare issue for you. We are possibly a bit closer than New Orleans.

Capital one health care financing has good terms if your credit score is good. One of our patients got an interest rate of 1.9% recently. Another one got a loan with an interest rate of 10.99%, so it all depends on your credit score. I don't know the link off the top of my head, but I think we have a link in our website which is in my signature below.

Today we performed our 476th Lap Band! We are proud of our patient's accomplishments. Check out our seminar schedule on our website to come to our next seminar. We also encourage all prospective patients to come to our support groups to talk to our patients.

I don't think it would make a difference one way or the other.

A fair number of our patients have a hiatal hernia which we repair at the time of surgery. You would probably want to have a recent upper GI study or endoscopy study to document the extent of the hernia. If it is rather large, such as having most of the stomach in the chest, that might be an issue.

We have many patients from Arkansas, being on the Texas/Arkansas border. Our group and hospital were recently designated as a Bariatric Surgery Center of Excellence by the ASBS/SRC. If we are close enough to you, we would be happy to help.

Don't worry. Some people can feel it, others can not. Don't worry it's still there. I remember about 3 years ago one of our patients called us frantically to say that her port flipped and didn't feel right. She rushed over to the office and said "Here feel this, feel this under my scar on the right side of my belly." We told her "The port is on the other side ." She couldn't tell where the port was. For some people however it is more noticeable.

Sounds like you might need an unfill. Nighttime regurgitation/reflux is often a sign of excessive tightness. Don't be worried about an unfill. Sometimes that is what you need to LOSE WEIGHT. I saw three patients in clinic this week that were unfilled during their last routine visit 6 weeks ago and LOST WEIGHT since that time. You see, when you are too tight, you are going to resort to eating foods that get through your band. That usually means (1) thick liquids such as ice cram or shakes and (2) Fried or crispy foods such as tortilla chips. If you are to tight an get an unfill you may find your eating habits improve and you lose weight. Good luck.

Just a reminder to all the folks who had their surgery in Texarkana that our support group in Mt. Pleasant meets tonight (Monday May 21) at the Mt Pleasant hospital at 7:00PM. The support group schedule is on our website at Lap Band Surgery Texarkana- Serving Oklahoma, Texas, Arkansas, Louisiana ; click the link for 'free seminar' on the homepage. PS Not sure why the link to noscales . com is not showing above.