Mert

I have an appt. with my surgeon for the first time on the 18. I will take the approval letter w/ me and see what he says. I'm sure he'll want to run some tests on me.

I had given up and was making plans and had a surgery date in Mexico today when RRRIIINNGGG It was BCBS calling to say I am approved !!! Right here in Houston ...no self pay...no robbing the 403B acct. I am approved in Houston GOD IS SOOOO GOOD.

Did Dr. Speigel send something in or was it something I sent into insurance?? Anyway just at the point of giving up and going to Mexico, literally, and BCBS TRS ACTIVECARE called and said I was approved. approved!! Must I eat my words?? This is nothing short of a miracle.

There is always the Monterrey option. I've heard only good things about Dr. Roberto Rumbault.

I'd stay away from Speigel's office. My consult was drive-by at best, the wife was discouraging about my insurance (why? too much trouble?), office staff unprofessional. Example: I'm trying to get back the material I sent them before I decided to run. they told me I needed to send $25 to get my medical records. They claimed they never rec'd the money order. His office operates on a cash only basis...what is up with that? Day before yesterday I rec'd an envelope from their office that was supposed to contain the psych eval my psychologist had faxed them. Instead I rec'd an empty envelope from them, addressed to me, that had never been sealed. ay Chihuahua........Needless to say I have since found another sugeon, but I wasted time with those ******* ... and what about their hokey adverisements?? yuck. Don't waste your time. We have a lot of good surgeons to choose from here in the Houston area. You CAN have a caring doctor who takes his time, efficient, kind and professional office staff, great aftercare, and experienced doctor. You can have it all. :clap2: :clap2: :clap2:

WOW I am impressed with the reviews. I would not hesitate to use him if I was self pay. Which I may be, if insurance does not come through. I'm glad I learned about him here.

thank you for that post of complication comparisons. it was an eye-opener for me

I haven't had surgery yet, but I can tell you some things I know I'm avoiding. I am two classes away from getting a certification I want but these last two classes aren't online, they are in person! yikes. What if I get to the classroom and they have those chairs with the attached desktops? So I quit working on the certification. I avoid people I haven't seen in a long time because I have gained one hundred plus lbs. since they saw me last. I avoid retreats at my church because I don't want to share a room with anyone and probably nobody wants to either. I avoid amusement/theme parks. I can't hold up, stamina wise, and the bar won't go over my belly on the rides. I avoid photos and people don't want to take my picture either. I avoid my big brother because he is a skinny person and very critical of me, so is his wife. I'll stop there. I'm just starting the process of surgeon/insurance at BMI 49.

thank you, I appreciate it. I originally went to Speigel because I talked to someone who had gone to him and she was happy with him. I was impressed with his experience also. Turns out, I am being lead a different direction now. Hopefully I won't have the same difficulty with office staff at Methodist.

I went to an informational seminar and got an appt to see Dr. Garth Davis on July 18. Although I am virtually starting over, I am much more comfortable with Methodist Hospital and their doctors. The Lord works in wonderful and mysterious ways.

Em, let us know what they say. You are lifted up in prayer.

barbara465, Point well taken. I am my own best advocate. I have been doing my own legwork for some time now. I just hadn't double checked with the insurance on what Speigel's office staff said they had already sent in. Some major problems in that office and my reaction is to run ..... Now looking for a new surgeon....

I want to warn anybody who plans to use Dr. Speigel in Houston and has BCBS or other insurance. I have had a difficult time with them. I rec'd misinformation from my caseworker in his office that has set me back in time in getting approval from insurance. Beware! Consider another choice of surgeon if you can! I'm switching to a doctor in my network. I'm just sick that I wasted time with Speigel. 20-20 hindsight, wish I would have gone with my gut feeling about Spiegel's office, his TV commercials and billboards ... so I am set back, but definitely not defeated. :straight

I love it.

Ok Everybody, it occurs to me that I am being too whiney and I need to just do it.:straight

Thanks Ericsmom, So that looks like a normal list of hoops to jump for the insurance company? I will keep you in my prayers on the 5th and congratulations on your surgery date. Please let me know how it goes. mm

Dolphin Dreams, did you even have to prove weight loss attempts, medically supervised? I am on plan 3, the supposedly best one, or at least most expensive. Here is what they asked for from me: 1)History and physical info incl. height, weight, and co-morbidities 2)Initial Evaluation 3)Documented history of morbid obesity (5 years) 4)evidence of at least 12 consecutive months of medically supervised, non-surgical methods of weight reduction with documentation that such efforts failed. the supervion must be provided by an MD, DO, or Nurse Practitioner. The weight reduction methods must include nutrition therapy, behavior modifying exercise or increase in activity, medication therapy and maintenance therapy. 5)psych evaluation 6) Documentation of willingness to comply with pre-op and post-op treatment plans 7)Documentation of procedures to be performed, with pertinent CPT codes. #4 is the tough one. the doctor in the network, Dr. Davis does provide a medically supervised weight program that costs for 6 months....$3800. I called and asked BCBS if they would pay for this (spoke to Meriah on 6/27/06) and she said "NO". hooboy:faint: Then I spoke to Janis, supervisor who Meriah transferred me to. I told her I had been to one doctor or another almost every month for the past year. I asked her did it have to be every month. Janis said no. Janis can look at their records of pay outs and see when I went to the doctors. Did they ask you for all this too? It is true I have been to doctors alot b/c I'm sick and worried about this metabolic problem and continual weight gain...:sick I'm sick and tired of being fat, sick and tired. OK this tirade is over:clap2: If you are still with me thank you for reading all this mess.

Tired Old Man, I heard a NASA official say "We are paid by the taxpayers to be risk takers" I dont think so! I can't even stand to watch the shuttle stuff on TV. It is too anxiety provoking. We need to keep them in our prayers, 'tis true.

Freebekie and Sallyjo, I appreciate the kind words. This waiting game is no bueno! I already sent in a complete blood chemistry,that showed high cholesterol despite taking 20mg of lipitor/day, borderline glucose, depite taking 2000mg glucophage/day, a 24 hour urine test that showed slightly elevated microalbumin, a hormone assay showing testosterone elevated (polycystic ovarian syndrome) and on and on. I plan to send in more stuff from the internal specialist. And PCP doctor's notes showing discussion of diet, date/weight over a long period of time. Then I will start calling them. Gee, I'm convinced that I need the band, surely those insurance guys will be!:paranoid surely?

When I googled it up I got that LAP-BAND Advocacy Center is part of obesitylaw.com in California. ok. mm

Paula, I see. Well, I know where you're coming from I have two kids myself. I am happy for you for that weight loss. You must feel great and the kid's teeth are lookin' good too. Thats about as good as it gets. thank you. mm

Thanks Randi for that resource. In it they mentioned the LAP-BAND Advocacy Center...hmmm another lead. BTW, your awaiting approval smilies are right on. mert