juliansmom2003

CONGRATULATIONS! I am here along with the other jealous ones.... I have to complete my 3-month program before my paperwork gets submitted, so I'm vicariously living through all you lucky approved peeps :-)! Congrats again!

Sorry I wasn't being very clear. So, the 3-month pre-op surgery program is required by my insurance company. Part of that is the nutritionist--they want me on a 1500-calorie meal plan (which isn't a problem for me), but i have to make sure I have a mix of 7 starches, 3 fruits, 2 dairy, veggies, 8 oz protein, 4 servings of fat. I'm not sure which is more important--the calories or the mix I'm getting them? I'm going to just call and find out. I'm just so new to this. Not to mention, I have to catalog and write down the nutritional info for everything I eat every day. I understand why it's important, but it's just something I need to get used to right now. I know this is all new and I need to just take one day at a time. I feel better today, I think I just had a weak day on Friday and needed the support of people telling me that I will get through this and everything will be okay.

WOW! You gals are lucky--my surgeon doesn't submit the paperwork until I complete the stinking 3-month pre-op program :-(! I'm just dying to get a surgery date--I think it will make all the hoops worth it to know I'm working toward a definitive date!!

So, I managed to fill my day yesterday as much as possible. I had my barium swallow (not too bad afterall!) and chest x-ray (pulmonoligist requested it for my consult because I used to be a smoker), and signed up for my 3-month pre-op program (New Beginnings). So the nurse gives me my diet plan (1500 calories, and the distribution of starches, proteins, etc.) and today I am just sitting here with my stomach growling thinking how hard this is. I have to motivate myself that I can do this. I have blown through all my pre-op requirements so quickly that my case worker said she would send my chart in a whole month early (after I complete my last check in appt with the nurse), so I have shown the drive and commitment to jump through the administrative hoops, but I guess I just need a little push to motivate me that I will get used to this! I knew it wasn't going to be easy and hate to sound like I'm complaining, but I'm just worried if changing what I'm eating causes me to second guess myself, how am I going to get through bandster hell? Any advice, ladies? :cool2:

Eeek. Mine is next week and I am sooo not looking forward to it. It'll be good to check something else off the list, but again, not looking forward to the yuckiness..... Good for you for having that step behind you!!

I am very excited to say that I will be using Dr. Goldstein for lap band surgery in October/November!!! I thoroughly enjoyed his seminar and after my initial consult with him was even more comfortable with my choice! Anyone in the area undecided on who to choose? See one of Dr. Goldstein's seminars and you'll understand what I mean!!

Congratulations and good luck! I hope all goes well!

Wow! Thanks for the heads up! I'm double glad I'm being tested for it now!!

I went for my consult last week and my appointment with the nutritionist is next week. The doctor told me it when I complete my trusty little check list, that we can submit all the paperwork to the insurance company (he said approval typically takes 2 weeks) and schedule a date. The longest requirement is the 3-month nutritionist/psych program, so that puts me in October/November time frame for surgery. I too was told to lose 10 lbs before surgery, which the nutritionist should help with, so here's to the next 3 months going FAST!!!!! Good luck!

Wow, how exciting! Lots of luck to all of you that are being banded this week! I hope all goes well and can't wait to hear how you're feeling!!

Congrats on the first step! I attended my seminar last week and left SO excited to get started!!! I was told it typically takes about 3 or 4 weeks to get that initial consult with the surgeon after the seminar, but I got lucky and my consult is this Friday (they had a cancellation right before I called!!!) I'll also be going through the insurance approval process during this time as well, so wishing you luck on that part!! (I'mReady--hope you enjoyed your seminar last night as well!) Here's to the start of our great journeys!!!:biggrin:

I was worried about the exact same thing. I asked the admin at my surgeon's office who assists with the insurance approvals and as long as your primary supports you, writes you the letter of medical necessity, as long as you're participating in a supervised program prior to the surgery, you should be fine. There is a sample letter of medical necessity on the Lap Band site, but the doc can mention that you've made several attempts to lose the weight (Atkins, slimfast, etc.) to no avail. Believe me, they don't expect us to consult our docs when we decide to go on slim fast LOL. Hope this helps! Good luck next week!

Oh yes, my insurance requires the three-month supervised program (the New Beginnings that the surgeon makes us do). That is the actual requirement, so I'm thinking that after I complete that, then they submit everything for approval? My thing is that I don't want to fork over that much money if they aren't going to approve it, but I guess as long as I go through the program, why would they deny me? LOL, I think I may have just answered my own question. Thanks for responding!

Okay, so in completing all my paperwork for my initial consult with the surgeon, I notice they want me to record the type of food I've eaten for the 2 days before the appointment. Now that I've written it down (today would be day 1) , I notice that I'm not snacking between meals. It's things like these that make me question how the lap band will help me if it doesn't look like I'm eating a lot, you know? Am I even making sense? I just want to be sure that I am in fact a good candidate for the procedure. I meet all the insurance requirements (BMI, etc.), but will this help me if I'm not really overeating? Does anyone have any insight into this that you could help me with?

Hmmm, I'm not sure how STD works (if it's state paid, I imagine it would vary by state). I do think there's a minimum amount of time you need to be out in order to take it though. I'm hoping a week vacation and a week working from home might be my solution to this....do you have the option to work from home at all?

Sheesh, does that include the surgery?!? Seriously, that sounds really high to me. My program is $1,450, but includes pre and post op support groups, all testing, psych, nutritionist and additional testing. I know any medical expense over $1,000 is typically tax deductible, but that doesn't help right now. Any way you can research other surgeons to see what else is available to you?

I am so excited after attending the Lap Band seminar last week -- my first official step!! The surgeon mentioned not to get discouraged because it could take a few weeks before being able to get an appointment, but I got REALLY lucky when calling yesterday. They had a cancellation for THIS Friday morning, so I snatched that appointment right up :-)! The next step after going to this consult is to contact New Beginnings (their pre-op program) to make my initial consultation with them. I was wondering--does anyone know when a surgery date would be assigned or when the insurance approval process begins? I know everyone is different and I plan on asking at my appointment from Friday, but I'm just trying to at least get a sense for how it works. I have to pay $1,450 out of pocket for the pre-op program, which my insurance doesn't cover, so I'm hoping they don't wait for me to go through that first to then get declined from my insurance company because I simply cannot afford to pay out of pocket for the procedure. I have Keystone Health Plan East (Blue Cross Blue Shield)-PPO Plan. Does anyone have any insight into this?

Thanks for posting, Tia! It's wonderful to hear that you had a good experience with the actual surgery part. I am thinking I have a longer way to go that most of the people on here. My seminar is next week, so these fears haven't hit me just yet. I'll remember this post when I'm getting closer to surgery though! Thanks again for sharing and lots of luck on the road to "skinny" :-)!

Congratulations, everyone! I'm so happy for you all! I can't wait to hear updates as you continue on your journey!!! :smile2:

Sorry it's Keystone Health Plan East (PA). Thanks!

So, I haven't even had my initial consult yet with the surgeon (seminar is July 2 and they won't let me schedule the consult until after I attend the seminar), but I am wondering about the pre-op diet and nutritionist that is part of the pre-op process/insurance approval requirements. If you end up losing weight, do they then discourage you from the surgery? I'm just curious to see how it went for those who have lost weight as a result of the pre-op nutritionist advice/dietary restrictions? I'm just worried that somehow, I'll be given a "no" at some point. Thanks for any insight!

Congratulations!!!! How exciting! I'm just starting the journey. After a month or two of research, I am raring to go, but the next seminar my doctor is doing is on July 2 because he's on vacation and I can't schedule my consultation until after I attend the seminar!!!! Seeing posts like these for those who are ready to go just really gets me even more excited! Please keep us posted on everything! Lots of luck next week!!!

So, now that I have registered for my seminar, I have been obsessively researching the doctor, the hospital, the insurance approval process and the hidden costs I might be hit with unexpectedly that might delay my surgery because I am sooooo ready! In obtaining the insurance requirements from Keystone Health Plan East (Blue Cross PPO), I noticed that there needs to be confirmation of failed attempts at medically supervised diets/weight loss plans. I saw my primary physician last week and she said she'd write the letter of medical necessity, I have a BMI of 43.5, and I have to attend this New Beginnings program, since my surgeon (Adam Goldstein) is part of the Virtua healthcare system. My question is this: would it be sufficient for the doctor to include in her letter that I have failed several attempts to lose weight or are they looking in my file for specific medically-diagnosed weight loss plans? I meet every single item in the criteria, and would be crushed if I hit a snag like this and can't get it covered (no way I'd be able to do self pay for this). Can anyone help clarify the medically supervised item for me? Thanks SO much!!!

Hi Lisw55. First congratulations to you on your surgery. How very exciting for you!! I'm in Burlington County and considering Dr Adam Goldstein or Dr Kipnis. Obviously I want to be as prepared as possible with out of pocket expense, and I'm sure my keystone won't cover New Beginnings, so if you don't mind, could you share with me the cost? Do they take a payment plan? Thanks for any details you can provide. Lots of luck losing :-)!

OMG these posts really hit home for me. My husband constantly says how much he loves me the way I am, how he loves my body and curves, that I don't need surgery--we just need to eat better and exercise more (mind you, he is as thin as a rail and doesn't gain weight :confused:). I went last week for an appointment with my primary to get her thoughts on me being a candidate for this and she couldn't agree more. I am currently 100 lbs overweight and have diabetes, bp issues and heart disease on both sides of my family as well. When I told her the surgeon I was considering, she gave him rave reviews and told me she'd provide the letter of necessity for the insurance to cover it. Even after that appointment and telling my husband what my doctor said in agreement and the process I would need to follow pre-surgery, he still told me that he'd be supportive of whatever my decision was, but he didn't think this was something I needed to do. I really think that some of the hubbies may not 'get it' if they are not in the same situation. The mentality is----to lose weight, just diet and exercise and it will come off, but for some of us that have been on this roller coaster all of our lives, that is just not the case. Hang in there. You have a great forum for support and a bunch of people not only going through the same thing, but will be there to help whenever you need it. ((HUGS))