bartoe

So I've started the grievence process and have a "hearing" date on 11/3 to explain to them why i want MY doctor to perform the revisional surgery because the doctor they want me to see is a complete idiot (i mean who mistakes a 60-year-old women for a 26-year-old patient and then lies to the insurance company about what the patient says?) anyways i'm FREAKING out at the moment because I am going in front of a committee and the thought of it makes me want to be sick to my stomach. I have no idea what to expect and I'm not sure if there is anyone who'd even be able to give me information on what to expect. I'm just really frustrated that they won't listen to me. they even had the balls to use my words of "imposition on her caregivers" what they didn't bother to read was my sister was involved in a near fatal head on collision and survived with a shattered left hip, left arm and fractured ankle...so she's an "imposition" to them. sorry i just needed to rant to someone who doesn't know me lol. if anyone has any helpful advice i'd appreciate it greatly!

Hello, I was wondering if anyone has PHP/Cofinity of Michigan and has either been approved or denied and if they have could you please tell me what surgeons you had at that time? Thanks :thumbup:

Hello, I was wondering if anyone here has had surgery performed by Dr. Kemmeter in Grand Rapids, MI and if so I am hoping someone could give me some insight on my situation with dealing w/his pre-op coordinator Nettie? I saw dr. kemmeter on 5/05/09 to discuss my surgery options ( I have a lap band that is causing issues of acid reflux and a hernia) and decided that doing a revision to RNY was my best option, so on 5/11 I called his pre-op coordinator Nettie and left her a message that Monday . Never heard from her so I figured because I called at 2 PM she may have left the office (I was calling to tell her what my decision was so they could start the authorization letter and forwarded it to the insurance company ). I never heard from her all day Tuesday or Wednesday , so on Thursday morning I called and left another voicemail. She STILL never returned my phone call. I waited until the weekend was over and called on Monday - still no call back. Finally when I called on Tuesday she exclaimed that "she had been expecting my call" which seriously pissed me off because I left my number several times. I told her what my decision was and what needed to be done, so she looked at my insurance information and told me I needed to get my lab blood work done and so she would fax the paper work over to Sparrow Hospital in Lansing, MI and then call the ins company to see if any other requirements were needed (Cofinity/PHP ) and if she found anything out she'd call me right back. Well within 20 minutes she called back to tell me that she was angry because they were requiring me to go to some weight loss seminar even tho I already had weight loss surgery and that she left a message w/the director and that maybe if i could call and talk to someone they could clear it up. So, I said okay and that I would get back with her. So I called the ins company and apparently she never told them that I had the lap-band done so all new patients who are wanting any sort of GB had to go through this program but now that they now I've already been though it I am a different case and they are able to let them know when the authorization comes in. So I told the women thank you and called Nettie back and lvm for her on wednesday after 4pm. She called me back and I explained to her that I had spoken to the insurance company and that they were not aware that i had the lap band procedure done, Nettie inturpted me and said "no, you didn't" and I said "Yes, i have had the lap band" and Nettie replied again "no, you haven't" finally after her third denial of me having this surgary "I said I have had the lap band in place since August of 2006 and that dr. kemmeter is doing a revision on me". Nettie then paused, i could hear her rifling through my file to come back and go "your right, but i did tell them". I also explained to her that they may want me to go through the Sparrow Weight Management Program before they could give an approval and it's required, however with my case it could be different. After Nettie had faxed over the blood work paperwork to Sparrow the week of 5/10/09 I went and got my labs drawn only to discover that Sparrow had lost my paperwork and were going to be doing a "rainbow test" and that they would call me on Monday 5/18 if anything else was needed. I don't trust Sparrow after they misdiagnosed me only a few months back so I called on Tuesday to Nettie to find out if everything was okay or if i needed to go back to the labs. I did not hear ANYTHING back from her after that. I had to trust Sparrow, thus I placed a call and that ensured me that everything was fine and I didn't need to come back in for any additonal blood work. I left the message on Tuesday 5/19/2009 and as of today 5/28/2009 I have yet to get a call back letting me know everything was fine and that I don't need to worry about anything. I even left the message asking her to call me back either way because I had more questions for her. I had also let her know that my insurance company was not changing so I wasn't in as much of a rush (if we were changing insurance companies I was trying to get the surgery done before july 1st) but I would still like to procedee and get everything going so we could schedule a date. I know for a fact after calling the front desk and asking if she was working last week that she was out on Thursday and Friday 5/21-5/22. I am now at a loss. I love my doctor but she is getting to the point of me wanting to go and hopefully find another doctor who is willing to take me on as a patient. I have called my insurance company a few times and she has still not put the authorization through (as of 12:10PM) and I am at a loss for what I should be doing. Do I call her back and let her know that I am following up from last tuesdays voicemail that i left with no call back? or do i just wait for another week or so and then call her back?

can I ask what made you decide to go to a vertical sleeve?

I am considering it if it's an option that the insurance company will pay for. Like someone previously said, I like sugar WAY too much and that's some of my issue w/myself plus i've gotten horrible acid reflux and a hernia so i can't make my band tighter to help me lose weight which there goes the purpose of the band... can i ask what made your decision to do the rny rather than the sleeve?

Hello :thumbup: I was banded on 8/14/06 and have had problems w/the band since Jan 08. I've had several fills and un-fills and nothing has been working. In November I was rushed to the Emergency room w/complicated pneumonia and Fluid on my right lung that was attributed to acid reflux and in December 08 I had an endoscope and it's been shown I have a hernia as well. My lap-band dr would like to do one of two things 1. Replace and re-position the lap band + repair hernia 2. Do a Revision to one of the gastrics + repair hernia I've been reading up. I have about 80-90 pounds that I need to still lose and I don't know what gastric surgery is best for me. I'm still up in the air. I'm just worried that if he re-does the lap band I'll come back with 2x worst acid reflux than before.... Anyone here have had the gastric and the sleeve done if so how are you doing on weight loss and other things?

actually, I use to get the side effects of Metformin and I finally learned that drinking skim milk or some milk product w/it worked wonders! I know this because I was away on a vacation and was taking the meds w/water and got horrible cramps and diathermy. When I started taking it with milk I never got the side effects :thumbup:

oh god yes! i lost 104 pounds about 6 years ago and EVERYTHING changed, men were looking at me, people would smile at me, hold doors open for me, super nice to me etc....then i noticed as I gained weight people would stare at me, not hold doors open, treat me like I was a brick wall or being ignored at...the thing is I am fat because I ate AND because I have PCOS which makes my body hard to process sugar and it caused me to gain weight....I don't think a lot of people stop to give thought to that they automatically assumed i got fat for eating 10 mcdonald's meal a day when in reality yes, i was eating more than i should but i was also making smarter choices (i.e. grilled chicken, veggies etc) and yet some people YET to see this....however I know that men are HUGE contributors to discrinimate against larger women...I've been through enough rejections and have been told a few times on occasion "your a really nice girl but your size isn't my type...good luck". It gets frustating and its no wonder why some people revert back to their old habits...its their "comfort".

I go to Paul Kemmeter at Grand Health Partners their number is 616-956-6100 and they are located at 2060 East Paris Ave Suite 100 he does both GBS and LB

Hello, I am probably going to have a band revision done at sometime this year due to a hital hernia (my first dr. stated in her paper work I did not have one before the surgery and now 3 years later I have one) and my current LB doctor would like to do a revision and fix the hernia and maybe reposition the band....has anyone had this done at all? I had such a hard time trying to find a new doctor as my old one left to open up a new center in Chicago...sometimes I regret my decision to have the surgery if I knew then what I know now about other LB doctors not wanting to take on new patients....what happens when you move/or your doctor leaves the practice? Thanks!

I just had an endoscope yesterday because I was diagnosed w/Acid Reflus (which I can totally handle) and they have determined this hiatal hernia is what has been causing my coughing/vomitting at night since April '08. He stated that basically instead of having my band "pouch" I also have a hernia "pouch" and he suggested that I get my band deflated a tiny bit. Anyone else have this and how are you getting it treated? Also is this something that's normal w/the band? I can't find any of my literature to confirm.' Thanks!

yeah he actually said it to me....of course he was being serious but being a doctor and all he laughed about it...i literally called my mom bawling my eyes out and told her i would NEVER go and see him again and I haven't....any one have any ideas how to report non-professional behavior? oh and does anyone know when Dr. Deol's new office was opening up?

i called Ann Arbor (U of M) and they haven't even STARTED to offer the lap-band and they don't take outside patients, the ones in lansing never called me back, and dr. nathan tomita well i saw him twice and both times he treated me like i was an idiot and the last time said TO MY FACE " are you sure dr. deol left? it wasn't that you were difficult? " I wanted to smack him...so I fished people for information on livejournal.com and obesityhelp.com and someone referred me to mmpc weight loss center....i met dr. paul kemmeter and he's wonderful! next week i'm getting my band deflated because i'm going over-seas for a month and even though i've had it for over year I'm still weary....when i got overseas