rroswelltx

Ok well here is an update. I called my insurance this morning, and didn't say anything to them about the situation. I just wanted to see if I had approval yet. They said it was denied. I ask why and they said all that it said was they did a Peer to peer consultation with the doctor and it was determined that the answer was DENIED. I wonder if it was because the doctor told them it couldn't be done till January and of course they won't be my insurance then and they know it!!!! ARGH, so no approval and no doctor. Guess I will start over again nect year on Aetna which I have been told is extremely difficult to get approved through. Thanks ya'll for listening.

I'm sorry ya'll this may be rather long winded, but I am so angry! I have been looking at this surgery for over 1 year and when I finally decided to do it in Sept. I was working with a Dr. Fox. They didn't kow if I would have time to get it pushed through my insurance by the end of the year, and since my insurance was going to change to a harder insurance (Aenta) Jan1 2006. So I kinda gave up till next year. Well one day on line I did a BMI calc through the barix Clinic web site. I filled out a form for information on their clinic. They called me, and talked to me at length. I told them the situation with my insurance and they said they believe we can get it pushed through, so I decided to give it a shot. So I had my consultation with the surgion the end of Sept. He KNEW very well that the lap-band was the ONLY surgery I would be interested in. He told me that the Barix clinic had only recently started doing the lap-band several months ago, and I would be a good candidate for it. I explained to him about my insurance situation and he said that would do everything the could do to have it done by year-end. OK so at that time I got excited, I got letter of medical nec. from my PCP, I got the physic eval, I got letter from cardiologist, foot doctor, nutritional eval and all the required stuff. It was turned into insurance last week. I have talked to the patient counselor at the barix clinic on the phone just about every day asking questions, and talking about it getting done before the end of the Year!!! I talked to the insurance company yesterday and they said they would have an answer by end-of day TODAY!!! OK here is the kicker. Last night a nurse called me from the barix clinic because I had some questions about what size band etc. that they use. I was told by her, that they are scheduling their FIRST lapband surgeries for the first week in Jan. I explained to her that wasn't possible that the Dr. and everyone knew I had to have it done my end of year, and she said. Well I don't know why they would have told you that, we have NEVER done a lap-band surgery here, this will be the first one, and the doctor has completed his training but has to have an Inamed rep and another surgerion here to supervise his first ONE!!!! I was floored, they had never told me he hadn't done the surgery before, in fact led me to believe the opposite. She said well he has done thousands of the RNY and GB so this is a peice of cake for him. I told her then I would not be having surgery there, because after Dec., my insurance would change and #2, I didn't want to be the FIRST patient of someone who has never done it. So in closing, I may get my insurance approval today, but it was all for nothing!!! My hopes and dreams are dashed, and I am livid. I hope I explained this well enough, but I was so decieved by this clinic it is UNREAL! Thanks for letting me vent!

What do you mean you almost ALWAYS have to have more than one surgery with the LB? I never heard that. Please explain.

Thank you Emily. Congrats on your surgery date. I hope my date will be between Christmas ans new years. Praying anyway. Thanks for the support.

Thanks for the info, now i went to ticker.com and made a ticker but where do I add it in at. Thanks

I am right there with ya girl, I also quit smoking, it has been 3 weeks now. I am waiting for insurance approval and my nerves are SHOT. I am fighting the nicotte demon as well. We got to hang in there though. You are so close to your new life. My prayers are with you. Regina in TX

I am just not getting any work done this past week, all i can do is read these boards. LOL! It makes me feel like it's actually gonna happen if I keep reading. Thanks you guys for talking to me. I went on another board and it seems like I get ignored Guess they are just not as nice and supportive as you all are. How do I put a signature on here? Regina

I actually live in Royse City, TX, ever hear of that? Both are in the Dallas metroplex. Regina

If I get approved before year-end I will be having it done at the Barix Clinic (Dr. Hall) in Wylie, TX. If they deny it then I have to start all over next year since my insurance is changing to Aetna. I hear Aetna is alot more difficult to get it approved. So I am just praying that they will approve it now, for the best Christmas present ever! Regina

Hi, let me introduce myself. My name is Regina. I have been reading these boards for about 1 month now, just lurking. Everyone has been an inspiration to me. I have not been banded YET, and I am keeping the faith that, it is YET! They are trying to get me in before the end of the year but I am waiting on insurance approval. I have First Health in Texas. I called them today and they said I should have an answer in the next 24 hours. I am soooo nervous, the wait is killing me. I can't even get myself to start eating like a bandster because of my nerves. This is depressing, I am so pumped about starting a new life and I want it NOW. I am 5.5 and weight 255, BMI 41. I am 37 yrs old. I know I am not a bandster yet, but please I need prayer and encouragement. Thanks for listening. Regina