trekker954

My process sounds quite different than yours, I'm going through a large hospital though with three bariatric doctors on staff, not to mention numerous residents. I attented the orientation (which was free), where various areas were discussed. A bariatric resident spoke on the different WLS and processes, although with one of the bariatric nurses. They had a basic overview of expectations, what we can/can't eat (or drink, aka no alcohol); hair loss, etc.... We had the insurance gal do a basic overview and requirements for "most" companies. Next was to schedule an appointment with the surgeon you want. That appointment was crazy. They took my vitals and weight, a resident took my history as well as provided me with all my labs, and numerous other tests orders I would need. The nurse went over the requirements for pre surgery. The doctor came in for about 5 minutes and briefy spoke with me;looked at my history, informed me he'd also be removing my gallbladder. Poof he was gone. Overall, I was with his staff probably about 45 min to an hour. The next day, I did the required Nutrition group class (not covered by insurance - but covers all monthly visits with the NUT post surgery) This class was four hours, really good, discussed pre and post op menus, .food labels, I have a Primary Care Physician who provided a Letter of Medical necessity and has monitored my diet/s since 2008 on and off. So any physical I've had is with him. While the WLS surgeon requires numerous labs test, chest xray, and endoscopy - he does not have me scheduled for any type of "Physical".

I didn't even know people faxed anything anymore. I scan (as does my office protocol) everything, then email it. You then have a good tracking of it. No more paper running out of fax, no more crumpled papers, and no more when the fax grabs two pages instead of one. Even with that said, today I had to drop off all the original paperwork for my insurance company with the hospital. I had originally scanned, emailed it. But they wanted original signatures, probably for their benefit, not necessarily the insurance. Keeping my fingers crossed this will happen fast.

I too needed it prior to getting insurance approved. I really had a tough time finding a psychologist in the area familiar with this requirement. Granted I was looking for a visit Chrsitmas week. But I had tentatively scheduled an appointment, where he said it would take about two hours. We'd talk and then he was going to put me on a computer to take two psychological tests. Yikes. He made my appointment a couple of weeks out and then in that time, I found someone who could see me sooner. I went, we spoke for about 20 minutes. He asked a lot of questions and liked that I had evidence of being committed (worked for same company 30 years, married for a gazillion years, had well adjusted kids, and had the family support) and no evidence of drug use, etc. That was about it. My insurance did pay the "office visit", however, he did have a heafty charge for the "evaluation report" sent to my surgeon. Total out of pocket was $171. I was not happy about that. Between all the co pay visits, and extra testings for clearance by my cardiologist, pulmonologist, PCP weight loss program, I'm definitely shelling out a lot of money.

I was surprised you had staples removed. these must not be the internal ones. My surgeon sews AND staples the stomach. He does not leave drains in either. Just wondering where were these staples that were removed the next day.

good topic. I too fly a lot and often to Asia. I asked my surgeon (have not had my surgery yet) and he said I could fly 10 days after. That's a bit too soon IMHO being the more experienced one. I am hoping to fly once I get on pureed food. I believe not only the flying may be difficult, but being in China for two weeks on business, having to attend luncheons, etc. I figured I can survive by ordering Soup and maybe mushy fish, or just soup and toss a tablespoon on GENEPRO in it.

I had my psych evaluation last week with no issues and have been cleared. For me, this was just a formality to check that box. So we got talking about why the need for a psych eval. Besides the fact, the look to make sure the person is committed to the process and also doesn't have a food disorder, he was talking about how WLS changes people's lives so much and for many, many, MANY, their marriages fall apart. I recall seeing a show recently, maybe a 60 minutes clip, on this woman whom her family wanted her to lose weight but she was deathly afraid because she didn't want her marriage to end and was so afraid if she lost the weight it would. But seeing many posts here about that happening. I guess if you are not in a good marriage, it is bound to happen. But I'd say if it isn't good to begin with, its a good thing.

I'm not a big fan of any fish, but I guess I must learn to become one. I do like shrimp and losbster if its dripping in butter. yikes!!! Royal always has a fish, chicken or Pasta. lunch there is always tuna or egg salad, that may go down easy (well except for the mayo). I haven't even had my surgery yet, but travel is the thing that is making me most nervous. I would take a cruise ship challenge anytime over a 20 hours flight to Asia. I guess I will just bring lots and lots of Protein powder packets.

You'll be fine. You won't even feel the ship move this time of year. As far as Haiti, its just a beach break there, all the food comes off the ship for their BBQ there although I don't think any of that food will be tolerable for you. They'll have the typical BBQ, hamburgers, hot dogs, bbq ribs, fried chicken, potato salad and Desserts. Take a swim and relax in the morning and then walk back on board to get some Soup or whatever you bring for lunch and you can go back out again.

I have to get a psyc consult as part of my pre-op. They do not have one assigned to the hospital. Does anyone have a name of someone in the area who is familiar with this request. The first two I called said they aren't taking on new patients. I don't consider myself a "patient" as they will only be seeing me one time to fulfill this requirement. Can someone help?

so glad i found this thread. I too travel extensively for work. I guess many like me, have status on the airlines and in the hotels. I see that as a big challenge and another reason I'm in this predicament with all the nice offerings in the lounges. We travel in pairs (the boss assigns teams at the beginning of the year, and there is a guy in the office no one likes to travel with BECAUSE he won't socialize and always turns down client invitations to dinner and drinks. Now I might see if he'll be my partner for 2016 as that would keep me out of restaurants and such and long happy hours. I'm still nervous about it though. And when I'm not traveling for work, I cruise a lot. Oy vei.

My boss is a motor mouth as well. So unprofessional. If I were to tell him, he would close the door and call as many people to gossip as he could. What is sad, is he is only in his forties (younger than me) and extremely obese and his young son on the same slippery slop. I may have no choice if I wish to request episodic tele-work which I know I would be eligible for my second week at home. I already work from home on Mondays. I will likely have my gallbladder removed during WLS though. I have plenty of sick leave stored up, but anything more than a week, I'd kind of have to disclose.. Then take vacation time the second week. Not to keen on that. Guess I will have to decide soon.

LoriF how long did dr.szomstein keep u in the hospital.

I'm a little concerned. My potential doctor had me complete a very simple form, mostly asking my insurance info. I called a week later to ask about when we can set up a consult. The office staff said they submitted my insurance first, as they first want to see if its covered before they even meet me. huh? I would think they need to provide my vitals to my insurance rather than what I say I am height/weight. Does anyone else think this is odd. This is through a hospital and checks all the BCBS requirements for doctors/center of excellence, etc. What if I meet the doctor and don't feel comfortable with them although great reviews.

After much research I emailed a bariatric surgeon I am interested in having do the sleeve procedure. He called me and we had a nice conversation, he told me a lot about himself which I already researched. Said I sound like a good candidate, Healthwise and all. So I said, you work with Federal Blue Cross blue shied. He said yes, but you should consider self pay. Now I'm pretty sure I meet all the requirements BMI 40 (occasional can drop to 39), have documented numerous doctor supervised weight loss programs on/off over the past five years,(two doctor supervised the past two years alone) as well as documented weight watchers, jenny craig, and others. I believe that is one check that many insurance companies want you on a supervised program for a few months. But if I can prove to check that box why would I have to do that all over again. Anyway, this doctor said insurance companies, want you on weight loss programs, psychologist reviews, nutritionist meetings, blood work, and so on. He said, why don't I pay the $12,000 up front and submit to get reimbursed rather than wait for approval. HUH? I wasn't born yesterday. he isn't making sense. will blue cross really make me go thru much of this downtime, when I can prove I've been there; done that. And I would certainly hope he would run blood work, ekg and all that other stuff typically done before any surgery whether covered or not. And it will be. I was a bit disappointed. I told him I would give my insurance a preliminary call and get back to him. BTW, this doctor who has the words Lapband in his official business name (I think that is why it took so long for my to cross his path) said that some association (forgot if it was AMA) is no long endorsing lapband surgery. More bad than good coming from that. This conversation took place when I said I was only interested in the sleeve. He said he had done 10 sleeves just this week.

I also have BCBS FEP, but just beginning stage to finding a doctor, let alone deal with BS yet. I do have a question though I hope some can clear up, especially being other FEP members. At what point do you apply for insurance. I keep reading all the hoops one must jump through. I have had supervised WL programs documented (I hope BCBS would waive that requirement to be on a WL program for (is it 3 or 4 months) and the psych evals and nutritionist. So those are what I have read here. Say during my first doctor consultation and like that doctor and he weighs me and I meet the BMI 40. The doctor (assuming it is BCBS doctor and Center of Excellent hospital) that I am looking at. So is that when he would submit the required insurance; and is that when I assume they will come back and say I need to do the WL program, psych, nutrist and then will be approved? If I go on a WL program for 3 months, I would not doubt drop under the BMI 40. Is that when they deny things? Or if you check every box, regardless if I dropped to 38 or 39 BMI would they acknowledge my dedication. I'm just don't understand are you approved but then have to meet all those requirements, or is the weight in prior to asking about insurance coverage. Also, if insurance gives you the requirements you must meet first, are you chosing your own pyschs, nutritionist, wl programs, or are these professionals, based on the bariatric surgeon recommendations. I hope I'm explaining my confusion.

Do they require that you go to a Center or Excellence? Mine did, and I have BCBS. You are correct, they do indeed.

Thanks. He is listed in my bcbs network. Why would I pay 12k when there is a good chance all I have to do is a Co pay. Oh, his first question was if I had any previous "belly" surgery. Ugh, he is only about 2 miles away. I will keep looking. I had even signed up for fep bcbs online wellness program. Hopefully they will acknowledge my lifelong attempts.