TracyinKS

ALSO look in your Insurance brochure and look for your MAXIMUM ANNUAL OUT OF POCKET and know that at the top end it will be most you pay.

I called his office today, because he is on my BCBS network, and the person taking the calls said that he requires a seminar first, and the next one available is January 25th. I then called Dr. Malleys office and talked to the NICEST woman, and she signed me up for his January 6th seminar.

Hey all! Well I backed out of my appointment this morning with the WLSC, and called Dr. Malleys office, I am now set up to attend his seminar on Jan 6th, 2007. The lady that answered the phone was SOOOOOOO nice, she told me that she was his very first lap band and she thought he was awesome, she said he has done over 500 bands and NOT ONE PERSON has had an erosion. He doesn't sew over the buckle which they had been finding was a big source for erosions........ so yes, I think I've made the right choice... And the BIG WONDERFUL NEWS is that he takes blue cross, so he is IN NETWORK for me and my in network hospital is going to be Menora. I'm excited.

STAY strong! She is jealous of your success (even if she doesn't realize it) Prove her wrong, HOLD ON you are doing GREAT!!!!!!!!!

CONGRATS and welcome!

Welcome to LBT.. I'm new here also, but I haven't been banded yet.. this seems like a great forum!!!! Lavette: maybe the sugar in the OJ upset your stomach.... or the acid in the tomato.

Morning all.......... well I was a net junkie last night and I spent pretty much the better part of 5 hours researching doctors and found out that I actually have 4 surgeons in my area that are listed on OH AND are in my insurance network! So, I cancelled my appointment for this morning witht he WLSC because they are out of network, and I would of had to pay $150.00 for today's visit...... as soon as Dr.Opie's office opens I'm going to call and see what the process is.......... also I broke the news to fdh last night, and suprisingly he was supportive..... said he loved me no matter my size, but he knew that I wasn't happy with my weight...... an amazingly sensitive moment from him! (this is the same guy who doesn't know what color my eyes are!) LOL I am even more set in my thinking now, I am going to be a bandster in 2007!

I think the Malley surgical center IS HIS NEW PLACE.. the posts at the beginning are dated in 2005 I go for my consult tomorrow with the WLSC

Hiya all! I live in leavenworth, and I go for my first consult appointment tomorrow morning at the WLSC off 135th st in OP......... anyone have experience with them. I look forward to becoming a bandster......... it has taken me over a year to decide to go for it, but now I'm taking the bull by the horns.

hey there...I for one appreciate this thread... ALL of it...... I go for my first doctore appointment tomorrow, and I am one of those... "If I can't chew it it ain't food" type of people... all liquids is pretty harrowing.. BUT.. I think FEAR is my biggest motivator... FEAR THAT I WILL SCREW UP MY BAND because I can't stay away from food for 2 weeks........ FEAR that I will waste money and precious PTO time and FEAR that I will FAIL again. I've lost over 80 lbs 4 friggen times..... and it is SO dang depressing that if I jump off the LC bandwagon and have a taste of a trigger food, I will wake up days later with strewn hoho boxes and dried icecream on my chin... and the pounds come back..... and I fail again

OK..... My company is switching to BCBS in 2007..... we had the option to go PPO and CDHP (HRA) I went with the HRA, and I do already know that we DO have a provision for WLS in our Insurance SPD...... my question is... Has anyone used an HRA for WLS? The way I'm reading this is that my MAXIMUM out of POCKET ANNUAL should max out at $4850.......... which sounds like a lot, but faced with self pay it is better than $17,500......... and if this is true, I COULD possibly beef up my FSA account to cover that.... I'm sorry if this is sounding like gobbletygook... (I am a benefits person, and my brain is doing the math for what SHOULD happen):cry

I'm filling out my paper work right now getting ready for my appointment tomorrow morning.... and I am adding the Co-morbiity of PCOS and Skin Tags... seems I read somewhere that there are a bunch of unsung comorbitities that qualify.....

I agree with Alexandra! remember Ports are used in other cases... (my grandma had one to distribute pain medication to her back) and I'm sure there are all kinds of other uses in the medical field... CODING IS KEY

Blue Cross Blue Shield as a company has a written exclusion, BUT.. talk to your HR/Benefits person and as for the SPD (Plan Document) if they don't know what your talking about ask them to go to Corporate, and find out if WLS is covered. Our company is switching to BCBS in 2007, and after a chance conversation with our head hauncho.. I found out that we have a PROVISION for WLS, which over-rides BCBS exclusion policy.

The place I am going has a "deal" with Capitol One, it is a "cosmetic" loan, I haven't gotten a bid on it yet because I'm crossing my fingers for Insurance.

Thanks everyone... I actually have a dr. appointment tomorrow, they said they will verify insurance and tell me how much I will be expected to pay. oh.. and YES... I've been doing lots of reading and research! This place is great!:biggrin1:

Hiya .... I am in the same boat.. I have only told my mom that I'm thinking about it... she will bug me about it, but has admitted that she has thought about it herself before she retires. I have not told any co-workers and ESPECIALLY MY BOSS!!! We are in adjoining offices and he would be bugging me all day everyday about it.... I will use a week of PTO time and he will never know... my significant other... might as well be my dh, but we are not married.. so what do I call him... ANYWAY when I met him 2 years ago, I had just lost 80 lbs on Low Carb and I was in 12's..... now I'm back up to 20-22's and he makes fun of me everytime I try to get back on the LC wagon... (long story) ANYWAY.. I FEEL YOUR PAIN...... I will not tell him what I'm doing until I have the insurance approved and a date set... I really think that the band will be the tool to help me maintain a loss...... I applaud you for doing this alone! and KEEP US POSTED

Hey FutureBeauty: I am in the KC area and just talked to someone from her office yesterday. How did you like her and the facility? Did you self pay or did you go through insurance? How long before you got through the entire process?

The big thing to remember with insurance is that it is YOUR company that tells them what to insure and what NOT to insure.... (I'm a benefits person for my company) We are switching to BCBS in 2007, and I had to go to their Columbia office last summer for "train the trainer" type meetings. It was there that I got into a conversation with our head hauncho benefits guy from OUR corp office. He told me that even though BCBS has a written EXCLUSION to NOT cover WLS, WE have an exception in our SPD (Plan Document)... this was big news to me, because we don't cover things like birth control, tube tying, or ANYTHING dealing with infertility.... I'm going to have to jump through hoops, BUT I should be able to get the approval..... I just don't know at what coverage level... 90%, 80% or 60% Contact your BENEFITS person in HR... and if they don't know ask them for a copy of your insurance S.P.D. or ask them to follow up with corporate.... the insurance company is going to be quick to say no, because that is their job.

GOOD LUCK! I just start my process of insurance approval land tomorrow

I finally got the nerve up to call back the people from the WLSC... I had signed up for a seminar, taken an online survey, and asked for more info.. several times, but always chickened out when they called me..... Well yesterday I called them back and tomorrow I have a consult appointment, they faxed a boatload of paperwork to me to fill out and have ready. I will then have the road to insurance approval. Even if I don't have insurance approval, they offer a self pay price of 17,500 for EVERYTHING including the consult and a year of unlimited fills......... I am nervous about having foreign objects in my body, but I don't want to go the gastric bypass route. I have 2 close friends that went that route and both have done wonderful, but I know it is not for me...... They both say it is the best thing they ever did.... one is about 4 years post op and the other one is 2 years post op.. both started out well over 300lbs and both lost well over 100 lbs....... Anyway.. I just wanted to post an intro, and thank everyone for all the info.:girl_hug: I hope to be a bandster in 2007! Tracy 263.8/263.8/149;)

thanks for all the posts.... I have my first consult on Wednesday, and I'm trying to read up on eVERYTHING!

thanks wheets! Yes my questions were subjective kind of like talking to myself in an empty office.. (boss is gone today) LOL I've been doing some research and I did find a list of KS doctors on OH... The "better" half is going to be a problem.. he says he's supportive, but really he is not... that is another issue all together... anyway... thanks for all the answers, and congrats on your sucess....

I am in the KC area... in the research phase... I am also in HR for my company and I full well know that this is NOT included in our policy...simply because I work for a catholic organization and things like birth control are not even covered let alone elective wls...... it really stinks.... don't fight with HR! Its not their fault, it is the governing entity.. corporate benefit administration committee's

I live in Leavenworth KS... (KC METRO) what is my first step... whos the best local doctor? Where do I find the nearest seminar? How much do I have to pay (cash payer)? How much are fills locally? How long will I need to be off work post op? How do I tell my better half that I am thinking of having the lap band? HELP:help: