spoiltmom

Congratulations!! What insurance do you have?

I live in a small town. We only have one surgeon's office that does Lap Band but he gets GREAT review so I decided to use him. But I can't get anywhere with his insurance lady and you can tell I'm making her mad. I've called my insurance company 4 times and 4 times they have told me that a 6 month supervised diet is NOT required! Okay so I go in on Tuesday for my psych and nutrition eval so I called her to ask her when she will submit this to my insurance for approval and she said not until I've finished my 6 month diet. I then told her that I was told no diet is required and if for some reason there is they will tell us in writing when the surgeon submits the paperwork. She said that is NOT how she does things. She said the 6 month diet IS required by my insurance company and she will NOT submit anything to them until it is completed. She then told me to quit calling my insurance company and call her instead b/c she knows more about it then they do. Edited to ADD: She said she does NOT DO APPEALS and that's why she wants the diet done before submitting it. Well I feel like I'm being cheated:( If the diet isn't required then I could get this submitted and approved 5 months sooner. But instead she's going to make me wait the 5 months and finish the diet first that my insurance isn't even requiring. I don't want to make her mad b/c that is the only office in town that does Lap Band but at the same time I'm mad and I don't feel like she's listening. I used to do medical billing for a living so I'm not a complete moron and I know what to ask the insurance company and I'm getting different answers than she is. My insurance company said they would call and tell her no diet is required but I know that will tick her off b/c she thinks she knows it all. What do I do now??

So give me some ideas of life after banding. What do you typically eat every day?

I think my MIL will be supportive but FIL will be very discouraging and I'm closer to my FIL than to my real dad. I have to tell her though b/c I was out today at the family doc and I'll be gone most of the day Tuesday for my Psych and Nutrition eval.

My insurance covers it BUT there are no psychologists or counselors here that take my insurance SO If I use a counselor its $150. It's $350 to use the psychologist. My insurance will reimburse me but only at like 70%.

I mean may be wrong but once your insurance approves you I don't think they can go back and deny you however, the problem may be that the surgery has to be postponed if your liver is too big.

My surgeon notified me within 2 days. I'd call and check on it if I were you.

Well they made me empty my pockets and take off my shoes. They wouldn't even let me weigh with my car keys in my pocket.

Are you sure you haven't injured that leg? I have bad edema that's only in my left leg but mine is due to a bad knee injury.

I go next Tuesday for my psych eval and my nutrition consult. I'm on a 6 month supervised diet b/c my surgeon's office said my insurance required it. I go for my second weigh in tomorrow. But I've been on and off the phone all day long with my insurance company- United Healthcare and every person I spoke with said the diet is not required at all so I'm hoping that means I can get approved sooner!! Meanwhile I go to the family doc for my weigh in tomorrow. I've never had my cholesterol levels checked. Would it hurt to have that done also? I already have Hypothyroidism, sleep Apnea, Hypertension, GERD and arthritis in my knees but my insurance company said that they consider hyperlipidemia as a comorbidity also. I'm trying to EVERYTHING I can to get this covered! And BTW, how many of you had to pay cash for the nutrition and psych exam? My insurance covers the surgery 100% but not the nutrition or psych visit. I'm not complaining though at least the surgery is covered.

My cousin was banded a few months ago and she was able to eat normally before surgery so I'm wondering what is the purpose of the pre op diet? I see most people are doing a liquid/soft diet pre op. Why is that?

with all these appointments. So far my mom and DH are the only ones who know I'm trying to get Lap Band. My problem is though I don't really want to tell my MIL yet but my dh works all the time so my MIL is the only person I have that can babysit while I go to my appointments. My kids are 9,3 and 3 months. It may be fine for them to go to my monthly weigh ins at my family doc but I can't see taking them to my nutritionist, pscyh or surgeon appointments. I've never lied to MIL and she truly is the only person I have that can baby sit and I don't want to take advantage of that. So should I just sit her down and tell her what's going on and tell her it's a secret or what? What would you do?

Thanks! Your stats look really good BTW!! Congrats!

We eat out at least once a week. Will I still be able to do this after I get banded? I know that's probably a dumb question but I really do want to understand everything that I'm getting into before hand. We occasionally eat mexican food which is something I truly love. Will I still be able to have it?

What I mean is I was talking a girl I know who had Gastric Bypass. She had it several years ago and now she has about 40 pounds left to lose. She said it's hard b/c now her stomach is bigger and holds normal amounts of food again. Will you ever get like that with Lap Band? I would think not but I'm just asking:)

Thanks! I can't wait to get through all this.

My nutrition eval is set up for the 8th and I still have to schedule my psych eval. what happens at these appointments? What sorts of questions will I be asked?

Thanks! New clothes definitely sounds good:)

I used to do medical billing. You need to send in a formal appeal letter and attach a copy of your pre authorization approval.

If I'm approved my surgery and all medical bills relating to it will be covered at 100%. So what other expenses will I have? I see some of you posting about Optifast and Vitamins and I saw a supply room full of vitamins and protein powders at my surgeons office. I'm just trying to get an idea of how this will all work.

All right. I'm at 221/37.5 BMI. My insurance company wants me on a 6 month supervised diet. I started almost 1 month ago. My surgeon's office talked to me today and told me to say I'm dieting but not to lose any weight. Now my questions are- My doc specified on my diet that I DON'T have to journal what I eat. She doesn't want to see what I'm eating. If I don't do a journal is the insurance company still going to be happy or should I do a journal just in case and keep it for myself? At one time I followed Weight Watchers and I still have my old journals. Should I just copy those and recent dates? I hate, hate, hate lying to anyone especially my family doc but I've tried so hard to lose the weight on my own and I can't:( Thanks everyone!

I only weighed 112 when my thyroid started acting up. That was 14 years ago. Since then I take a huge dose of Synthroid every day and I'm still gaining weight:( It helps it does it's just not a magic fix. Will they still do your surgery now? Per my insurance company if they find a disease that could be making you gain or hold onto weight then that must be treated first before they will do the Lap Band.

My BMI is 37 and I have hypertension- controlled with meds, sleep apnea and knee arthritis. Today my insurance company United Healthcare told me that in order for me to qualify my hypertension must be UNABLE to be controlled with meds and my sleep apnea index must be at least 16. Mine is only 8. So does this mean I won't qualify unless I gain more weight and get my BMI up to 40?

I'm calling today to find out what the policy is. The first time I asked my insurance company I was told there is no 6 month diet needed, but my surgeon's office said they were told that I do have to do the 6 month diet so today I'm going to call my nurse case manager and see if she knows the real story.

Congratulations!!!