alysia.rush

Leaving for the hotel today, and surgery in the Morning, again, lol.

Surgeons have preformed Bypass's for over 30 years. Its has the most research and is the gold standard as someone else mentioned. Plus it helps u eat right or u get dumping. So it almost forces u to choose better food. Sent from my iPod touch using the BariatricPal App

That's relieving, im waiting in surgery lobby for mine in a few hours Sent from my iPod touch using the BariatricPal App

Im having mine today, just waiting @ surgery lobby now. Yikes! Good luck tomorrow guys. Sent from my iPod touch using the BariatricPal App

Start the liver shrink diet, its usually 1,000 cal diet. High protein, low carb. You will be hungry, regardless.

iI go for my Appt with the Surg. on Dec. 7th. They submit the papers at that time for my final submission for surgery approval. And at that time I also start my 1,000 low cal liver shrink diet for 3 wks. Surgery would be scheduled. within 4-5 weeks later. So around January. Perfect start to A New Year. How are you doing? Hope all is going well for you?

I'm on Medicaid (apple Health) my insurance is with Amerigroup. I have been approved for stage 2 with them. I have been going to the NUT twice monthly on my 6mo. medical diet plan, and meeting with my referring doc once a month. I got stage 2 approval April 18, I go to my first appt at U.W on Tue. for a consultation with the registered Nurse.not sure what all they will do there. Or from then on out. I already did a psych evaluation. I already lost my 5% weight. Looking for other ppl. that have , or are going through this processes at this facility. that might be able to answer questions, or want to chat about the process. I am curious, if im approved for stage 3 surgery, how long would this faculty take typically to schedule surgery.Any one know???? Any did they send you home with Vitamins, my NUT said they will?

I did everything on there to do list so far, upper gi, met with their social worker, had upper endoscopy, met with their NUT, went to the P.T got cleared on every thing so far but have to go back for another session of P.T before she signs me off for being cleared for surgery. Then once that is done I can have my meeting with the surgeon to see if I am good for surgery or not. If so then I will have it scheduled in 1-2 months. I dont go back to P.T until sept. 6th. So if im lucky I think I can get surgery at the earliest by late oct- nov.

Can you have "lozenges" after surgery?? Sent from my iPhone using the BariatricPal App I'm not sure, I don't see why not. we would only be sucking on them. But I am going to ask first for sure. They where very inexpensive so I grabbed them. The spay tastes like you ate toothpaste lol. The lozenges I think are orange which sondes more pleasant.

I found it at walmart next to the mouth wash in the toothpaste isle , I got that and found there was also TheraBreath lozenge's for a couple of buck so I grabbed a back to try.

Do you still have them, I am not sure if I can get messages because I am not a paid member. I messaged you though. Id love to have them If they are still available.

MEDS CHAPSTICK UNDERWEAR ROBE TOOTHBRUSH/ PASTE HAIR TIE/ head band MAGAZINE/ crossword puzzle/ soduko/ cryptograph and pencil BOOK SMALL BLANKET FOR RIDE HOME and pillow Biotene mouth spray.and losengers instead of the wash back scratcher eye mask/ earplugs heating pad gas x strips

I know you had your surgery today By your post, Just hope it all went well and that you leave an update for us on how it went and how you are recovering and feeling. Best of luck with your new journey.

Here is my list so far: MEDS CHAPSTICK UNDERWEAR ROBE TOOTHBRUSH/ PASTE hair TIE MAGAZINE/ crossword puzzle and pencil BOOK SMALL BLANKET FOR RIDE HOME and pillow Biotene mouthwash. back scratcher Eye mask,/ earplugs

I hope you get better support. Even if you dont, find a way to ignore the negativeness It is you that must stay positive.If even alone as hard as that maybe. I know how it is. I am alone in it with no support. My own husband is non supportive, and I have no family. Best of luck.

im gonna get mine done around Dec too, but I have two kids, So I might wait till after Christmas. Also At U.W excited. I am on Amerigroup Medicaid.

I have pcos, and I take metformin, I dont have any of the co morbidities, but my bmi is a 43. I am not exactly sure why I was approved for stage 2, if it was because i have a bmi over 40 and been over weight for a long period of time and had attempted and failed so many times or what. I think your doc is just being lazy. You could drive over to my doctor. Its about an hour and a half drive, but she would do it for you. her name is Dr. Rachel Bickling at Jefferson Healthcare In port Townsend. She is a great doctor. and Jefferson healthcare hospital will pay for the NUT also because medicaid dont cover it.

Here is a link to the letter that the university of Wa. sends with the stated Medicaid reqirments DSHS: to qualify for surgery. http://www.uwmedicine.org/services/weight-loss-management/documents/DSHS-letter.pdf Dear Patient Name, We received a referral regarding your candidacy for weight loss surgery. This letter contains useful information necessary to proceed with bariatric surgery at the University of Washington Medical Center. If you have medical coverage through any program with Washington Medicaid (Apple Health), including any managed care plan, all services involved in the bariatric surgery program REQUIRE PRIOR AUTHORIZATION. Current managed care organizations are Molina, CHPW, Amerigroup, United Health Care and Coordinated Care. The requirements for the bariatric surgery program are set by state law (WAC) and the University of Washington is required to follow them. If you start the program before receiving approval, the services will not be paid for. Please contact the insurance carrier for the required forms and guidelines. Stage 1 (Preliminary Approval) To qualify for the bariatric surgery program the following requirements must be met. If you do not meet the requirements, you do not qualify for bariatric surgery under Medicaid rules and Washington Medicaid (Apple Health) will not pay for this type of treatment.  Age -You must be between the ages of 18 and 59.  Body Mass Index (BMI) - You MUST have a BMI equal to or greater than 35. (This number is determined by your primary care provider or by using standardized BMI calculators that can be found on the internet.)  Medical conditions/Comorbidities – You must have ONE of the following conditions: o Diabetes Mellitus and/or; o Degenerative Joint Disease of a major weight-bearing joint(s), such as knees or hips, and you need joint replacement surgery immediately as soon as weight loss is achieved. o Other rare co-morbid conditions (such as pseudo tumor cerebri) in which there is medical evidence that bariatric surgery is medically necessary and the benefits of bariatric surgery outweigh the risk of surgical mortality.  You must NOT have multiple sclerosis (MS), which increases risk of mortality. While there are a number of other medical conditions that are often a result of obesity, they do not qualify for Washington Medicaid (Apple Health) approval. In the case that your condition does not satisfy the requirements, we recommend you continue to explore other options with your primary care provider (PCP) to find a non-surgical weight loss solution. Those who believe they meet the above criteria should contact their PCP who will request prior authorization for Stage 2 of the process. You and your PCP must be willing to work together Stage 2 (Pre-Surgery Stage) You and your PCP must submit a completed the Prior Authorization forms determined by your HCA/Medicaid plan for Stage 2 and fax your medical records for review. Medicaid will review your request. You and your PCP will receive an official letter from Medicaid with the approval or denial of your request. If you are approved for stage 2, you will receive an approval letter. When/if you receive a letter of approval, READ IT CAREFULLY! You and your and PCP will need to complete each of the requirements including keeping a record of when you complete each requirement. Stage 2 of the Bariatric Surgery Program consists of evaluations and a supervised weight loss to prepare you to make lasting changes in nutrition and behavior needed for this surgery to succeed. Successful completion of the Stage 2 requirements will improve your health prior to surgery and encourage the lifestyle changes you will follow for the rest of your life. During the first 6 months of Stage 2 you will be required to:  meet with your health care provider once a month to review your progress;  meet with a dietician for counseling twice a month for at least 6 months (your provider will give you a referral) ;  lose at least 5% of your body weight based on a documented weight at a recent medical in a 6-month period of time. You must maintain your weight loss until the time of surgery;  keep a journal of active participation in the medically structured weight loss regimen. Additional insurance requirements may be necessary. Contact your insurance provider for a complete list of requirements. After 2 months into the 6 month supervised weight loss process your PCP can refer you to UW Medicine Weight Management Center to enter the patient in the Bariatric program and continue both programs simultaneously. The phone number is 206-598-2274; Fax 206-598- 6014. We will need the following items: Referral from your Primary Care provider, clinic notes outlining current co-morbidities and weight loss attempts and the Stage 2 authorization letter from Washington Medicaid (Apple Health). We will contact you to set up the following appointments for the final steps leading to surgery: Bariatric Seminar – You will be scheduled to come for a required Bariatric educational seminar. Surgical Evaluation – After the seminar you will be scheduled for a consultation with a surgeon who will evaluate you for the actual surgical procedure. Psychosocial Evaluation – Scheduled at the University of Washington Medical Center with a licensed psychiatrist or social worker. University of Washington Medical Center 1959 NE Pacific St. Box 356165, Seattle, WA 98195 Page: 3 Important! Keep your approval letter and complete the checklist you were sent. You and your PCP must keep a record that the requirements have been met. The completed provider or client checklist must be presented to the UW staff before Stage 3 will be requested. A copy of your journal of active participation may be requested as part of the Stage 3 authorization request.  You must continue your regular visits with a dietitian and Primary Care Provider to fulfill the Washington Medicaid (Apple Health), requirements while enrolled in our program.  You must maintain your weight loss till the time of surgery.  You must be non-smoking for two months prior to starting our program Stage 3 (Authorization for Surgery) Following the process above, the UW Medicine Weight Loss Management Team at will complete the necessary steps for approval and scheduling for surgery. This process involves submitting all of the stage 2 records to your Washington Medicaid plan for final review. Once Washington Medicaid (Apple Health), has made a determination, you will receive an official letter informing you of your approval or denial for Stage 3. If approved, you will need to immediately fax the UW Medicine Weight Loss Management Team a copy of this approval letter to 206-598-6014. Once we receive a copy of this letter we can schedule your surgery. We hope that these guidelines clearly explain the process for you to obtain approval for bariatric surgery. If you have additional question, please contact our clinic at 206-598-2274. Sincerely, UW Medicine Weight Loss Management

You can even talk to your gynecologist for a referral for bariatrics if your primary doesn't want to do it. Maybe try there. I grew up In T- Town lol. I would call your doctors office and tell them that you know for a fact weight loss surgery is covered on your insurance and you just need a referral, and you want the process started. That you have that right, They should have a referral coordinator in there office that handles that type of thing, try talking to them direct instead of your doctor. tell them you need it done and that your doctor is telling you its not covered but it is, id even write down the wac. or print a screen shot of the part that says it is covered. Dont take no for answer. And if they do it and insurance says no, appeal it.

What town do you live in? My doctor was willing to put in the request for me. Sounds like yours just is not. I would talk to another doctor. Because it is covered, it just needs to have a pior authorization. read page 65 it states: https://providers.amerigroup.com/ProviderDocuments/WAWA_Provider_Manual.pdf Surgical Procedures for Weight Loss Consistent with strict guidelines of WAC 182-531-1600, surgical procedures are covered for weight loss as determined medically necessary. Amerigroup reviews each case for medical necessity. The Washington administrative Code (WAC) specifies detailed criteria required for coverage I live in port townsend< the only part so far that is not covered is the Nutritionist. You will be an a medical required diet for 6 mo. and will need to see one every 2 weeks for 6 months. My hospital is letting me see theirs and they are paying for it under a charity fund. So see if you can find something like that or sliding scale, ask and call around. I would start by call other doctors and ask if they can reefer you to bariatric surgery. Do not give up. Im not, not this time, I gave up years ago, not now. If you have any questions I will try to help. I go to U.W tomorrow for my first appt. there , excited and nervous.

Not sure if you already found the info you are looking for or not, but I also am in medicaid and amerigroup. the only approved place is University of washington because it is a center of excellence. call the u.w weight loss management center. I have my consultation on tue.

im in Jefferson Co. wa Port Townsend

Just dont give up, and if you do get denied, do appeal it. Im in the same boat, and worried I might get denied too. Ive already lost 21 lbs. My bmi is over 40. and I dont really have any comorbidity. I am almost borderline diabetic. I do take metformin the diabetic medication. every doc assumes I am, but im not. I do have back issues but not needing surgery. im In WA. state on Medicaid- Amerigroup

I hope not, Ive lost close to 100 lbs on my own twice in my life before, but I always gained it back within a year, my referring doc said to keep going with the weight loss and my Nut said I can maintain the weight but has be doing more exerciser.

Molina is making you do 12 physical therapy and 12 behavior therapy appointments on top of 12 Nuts? Im on Amerigroup they said 12 nut apps and 6 doc, get a pysch eval, keep an activity log, and thats all other than what all the University of Washing will be doing as far as there testings and such, my nut said I will meet with a nut over there twice and a physical therapist once I think, and then another pysch eval over there possibly?