My odessy began with a conversation with Lynda Mayes. She was looking into lap band surgery herself and suggested that I do the same. It started me thinking, so I decided "Why not?"
I went to an information seminar on Nov. 22, 2005, where I met Dr. Adam Smith. He was extremely knowledgable about the lap band and has had the procedure done himself. I would find out later that his wife was also banded.
He had a no-nonsense straight forward approach. I liked that. He was open to questions and even though he was called away for an emergancy (he was on-call for the hospital that evening) I received plenty of answers to my questions.
A plastic surgeon was also there that night to answer any questions that we might have.
At the end of the evening, consultation appointments were made and I chose to see him on Dec. 7? I'll have to check. Turns out we had an ice storm blow in so all appointments were cancelled and I was rescheduled for Dec. 29, 2005.
When I met Dr. Smith for my consultation I had already begun my research into the procedure, so I was very aware of the complications and the rules that would need to be followed. He gave me a physical and said that based on the information provided, I would be an excellent candidate for lapband surgery. He did tell me to be careful about what I read on the Internet, but I already knew that you can't believe everything that you read.
I consulted with my PCP Dr. James Hinton on Dec. 30, 2005, who agreed with Dr. Smith that I would be a good candidate for this surgery. I also requested the 5 years of my medical history be sent to Dr. Smith per insurance requirements.
I met with the Nutritionist on Jan. 16, 2006, who proceeded to go over what I currently was eating and how that would change after the surgery. Due to having been through my Diabetes education courses, I was already quite aware of changing how I eat. She asked if that would be a problem and I told her I've been changing the way I eat for the past two years, this would not be a problem.
I had my psychology evaluation on Jan. 17, 2006, that evening. I was looking for a day appointment, but Dr. Klinefelter had an evening cancellation that was much better for both of us. It was interesting visit. I had to take a battery of tests to see if I was mentally ready for the change and then we had an interview to see if there was anything in my past, such as abuse, that would prevent me from not being able to follow the bandster rules. He did ask if I'd ever been diagnosed with OCD and said not officially, but I do have it. He told me that I most likely would be a good candidate for the surgery.
That was the last of the official appointments I had to keep. Now all I needed was for my file to be completed and sent in to Blue Cross Blue Shield TRS of Texas. The waiting had begun.
Once I found out that my information had been submitted, I decided that I would call the insurance company once a week to check on the approval status. Thursday would be the day. The first time that I called I was told that the nurse had reviewed my file, everything looked to be in order, and that it was sent on to the Dr. for review. The second time that I called I was told that I was being denied due to the fact that I had not had a psych evaluation. WRONG! I told them I looking at the claim that says you've already paid for it, so I know that I've done that. Well, they couldn't find his notes giving his recomendation, so I would need to get them to them. I emailed Nancy at forthworthlapband.com and told her the situation and she promptly resent the information that BCBS had so conventiently "lost". The third time that I called in I got a verbal approval and was told that my letter of approval would be in the mail to me and my surgeon. I couldn't wait! When the letter finally arrived, I carried it around in my purse for a week. This was the end of February. Now all I needed was a date.
The beginning
in picardy3's Journal
A blog by picardy3
Posted
My odessy began with a conversation with Lynda Mayes. She was looking into lap band surgery herself and suggested that I do the same. It started me thinking, so I decided "Why not?"
I went to an information seminar on Nov. 22, 2005, where I met Dr. Adam Smith. He was extremely knowledgable about the lap band and has had the procedure done himself. I would find out later that his wife was also banded.
He had a no-nonsense straight forward approach. I liked that. He was open to questions and even though he was called away for an emergancy (he was on-call for the hospital that evening) I received plenty of answers to my questions.
A plastic surgeon was also there that night to answer any questions that we might have.
At the end of the evening, consultation appointments were made and I chose to see him on Dec. 7? I'll have to check. Turns out we had an ice storm blow in so all appointments were cancelled and I was rescheduled for Dec. 29, 2005.
When I met Dr. Smith for my consultation I had already begun my research into the procedure, so I was very aware of the complications and the rules that would need to be followed. He gave me a physical and said that based on the information provided, I would be an excellent candidate for lapband surgery. He did tell me to be careful about what I read on the Internet, but I already knew that you can't believe everything that you read.
I consulted with my PCP Dr. James Hinton on Dec. 30, 2005, who agreed with Dr. Smith that I would be a good candidate for this surgery. I also requested the 5 years of my medical history be sent to Dr. Smith per insurance requirements.
I met with the Nutritionist on Jan. 16, 2006, who proceeded to go over what I currently was eating and how that would change after the surgery. Due to having been through my Diabetes education courses, I was already quite aware of changing how I eat. She asked if that would be a problem and I told her I've been changing the way I eat for the past two years, this would not be a problem.
I had my psychology evaluation on Jan. 17, 2006, that evening. I was looking for a day appointment, but Dr. Klinefelter had an evening cancellation that was much better for both of us. It was interesting visit. I had to take a battery of tests to see if I was mentally ready for the change and then we had an interview to see if there was anything in my past, such as abuse, that would prevent me from not being able to follow the bandster rules. He did ask if I'd ever been diagnosed with OCD and said not officially, but I do have it. He told me that I most likely would be a good candidate for the surgery.
That was the last of the official appointments I had to keep. Now all I needed was for my file to be completed and sent in to Blue Cross Blue Shield TRS of Texas. The waiting had begun.
Once I found out that my information had been submitted, I decided that I would call the insurance company once a week to check on the approval status. Thursday would be the day. The first time that I called I was told that the nurse had reviewed my file, everything looked to be in order, and that it was sent on to the Dr. for review. The second time that I called I was told that I was being denied due to the fact that I had not had a psych evaluation. WRONG! I told them I looking at the claim that says you've already paid for it, so I know that I've done that. Well, they couldn't find his notes giving his recomendation, so I would need to get them to them. I emailed Nancy at forthworthlapband.com and told her the situation and she promptly resent the information that BCBS had so conventiently "lost". The third time that I called in I got a verbal approval and was told that my letter of approval would be in the mail to me and my surgeon. I couldn't wait! When the letter finally arrived, I carried it around in my purse for a week. This was the end of February. Now all I needed was a date.