nallygirl

Getting nervous guys ....uggghhh

My last nutritionist appointment is January 4th -- the worst time of the year to be weighed!! in addition to the holidays and all the parties - i was also at an all inclusive in Jamaica for one week a couple weeks back - i've gained some weight and I'm afraid that the weight gain will make my insurance deny me - I can't stop freaking over this ---- anyone know anything regarding this?

After my last nutritionist appt they will submit all my paperwork and we'll go from there

Hey Renee! I'm in the exact same place as you in this process! My last nutritionist appt is also on Jan 4th then everything gets submitted for approval. I'm so freaked out that I haven't lost enough weight and I'm sure I'm going to be a wreak while I'm waiting for the approval to come through! Good luck to you!!

Woohoo how exciting!!! Good luck tomorrow Linnie!! I have my last 6 month visit on Jan 4th and can't WAIT to be where you are!!! Sending you best wishes for a great surgery and a speedy recovery!! :thumbup:

Congratulations AmyBeth!! I'm so happy for you!! I just had my psych eval today and it was a breeze thankfully!! I had heard so many stories of people filling out 300 question forms or sitting with a psychologist for hours but this was super quick and easy!! Now just one more nutrition visit in January and I will hopefully have approval and a date for the end of the month! Hopefully!

Hi Kristen! I also have Cigna and had to do the 6 months of diet and nutrition classes. At first I was so bummed about it but now that I have one month left I'm almost greatful for that time to prepare, research and fully understand what this process entails. Surprisingly the time has flown by! As for having secondary insurance I'm not too sure how that works but I'm sure your surgeons office handles questions like this all the time. You should give them a call and see what information they can provide for you. You may also want to call BCBS to find out what their requirements are before signing up. Hope this helps and good luck!!

It seems like everyone has a little something different to do on their 6 month diet. I am heading into month 5 and opted to take the diet & nutrition classes through my surgeon's office. It costs me a little more than if I had just gone to my PCP but like SDTeaGirl I was too affraid to have something messed up. I would imagine as long as the doctor is signing off on your paperwork that it wouldn't matter if you saw him or a nurse. I agree though you might want to verify that with your surgeon or your insurance. Good luck with your program! :thumbup:

I can imagine how disappointing a 6 month wait would be but fortunately for you it's flown by!! I'm pretty much half way thru my testing and i still have 3 months left - i just jumped on that testing to just get it done - i hate things like that looming over me!!!! I'm so excited too!!!! I know it's drastic but it's what I need!!! Have you been approved yet? My insurance doesn't approve till the final nutrition class and psych appt

Nope no insurance approval yet. I did confirmed though that Cigna does cover the surgery but won't know about approval until I've finished my last class and psych eval also. My BMI is 40 and I have a comorbidity (sleep apnea) so I don't anticipate any issues with approval. My surgeons office has been great though about keeping things moving. They've said I will be tenatively scheduled for the end of January because the experience they've had with Cigna is they approve quickly! I hope they're right!!

Hi Renee! Thanks for starting this group! I'm half way through my 6 months so I guess we are kind of at that same point! I was so disappointed when I found out insurance would require a 6 month medically supervised diet but it honestly has flown by!! I think the next 3 are going to go even quicker since I need to start making appointments and getting testing finished! If all goes as planned I should be getting banded at the end of January but if not I will definitely be in February! It will be a GREAT start to an amazing year!! 2011 can't get here fast enough!! Good luck with your journey!

Hi Everyone!! I'm in Northern VA (Fairfax). I am a Paralegal working for an IT company and also a part time student.

Hi danide! For me the only person who knows that I am starting this process is my mom...I had to tell someone for support! Since I have a 6 month medically supervised diet I have to go through for insurance I don't want to tell everyone now then find out 6 months from now that I can't get the surgery for whatever reason. My plan is to wait until I have everything in order and a confirmed surgery date before I tell anyone else. Even then I only plan on telling my closest friends. I'm sure eventually people will ask and I will have no problem telling them about it. You should be proud that you are taking a step to better your health. The people who love you will support you! Good luck!!

You all are amazing!! Thank you for the great information! The $300 is for the medically supervised diet through the surgeons office. There is a $100 fee for 2 nutrition classes. There is a $180 fee for meeting with their nutritionist. None of this would have been covered by my insurance anyway and like someone else pointed out 6 months of co-pays would be almost $300 if I went through my PCP. I guess I just need to call the sugeons office and find out if I have to pay all this up front or if they will let me do payments at least for the $300.

Thank again for the info! I love these boards...so much great information! :thumbup:

Thanks! I was pretty sure I could do it under insurance and they were just trying to make it sound like I needed to do it through them. I'll have to check it out more. Good luck with your surgery!!!

I had my consult with the surgeon this week and it went pretty well. I have to do the 6 month medically supervised diet and fitness plan for my insurance requirement. My surgeons office is charging me $300 for this! Is that normal to have to pay for the medically supervised diet? Couldn't I just do this through my PCP? They are also charging me for nutritional classes, a nutritionist consult and other things they say I need to complete. All together I think its around $550 I'll have to pay out of pocket. I kind of feel like I'm being nickle and dimed but since I've never done this before I was just curious if this normal. Has anyone else experienced this?

Karma and Alisomniac - Thanks so much for the advice!

Looks like I worried for nothing...my PCP didn't even ask me any questions other than who is your surgeon so I can send them a referral!! YAY! She said she knows several patients who have Lap Band and love it and she thinks it would be a great idea!! One hurdle down now I am just waiting on the referral to come in the mail so I can make the appt with the surgeon. Then I also have to do the 6 month medically sup diet. My PCP is sending me for a sleep study too since she thinks I have sleep apnea...which in a way is a good thing...just one more thing to add to the list for insurance! Hopefully the rest of the process goes smoothly!! Thanks for all the advice and reassurance!! :laugh:

Thanks LRTAB and Amy!!

Tinksmom - Well as far as the PCP approval goes, according to my insurance (Cigna) this process needs to be initiated by my PCP if I want insurance to cover the costs. All insurance would really tell me is that yes they cover it if I have a BMI of 40+, that I will need to go through a 6 month medically supervised diet program and that my PCP will be able to give me more information once she initiates the process. Something about she needs to call a number and have me prequalified. I'm sure it will be fun dealing with insurance throughout this process! :wink: I will feel much better tomorrow after the appointment once I get this whole ball rolling!!

Thanks for the advice everyone!! :w00t:

Thanks so much for your response! My PCP has been my doctor for almost 8 years now so she should be very familiar with my weight issues. I'm probably over thinking the whole thing and won't have an issue at the appt but once that thought popped into my head I had a momentary freak out! The appt is tomorrow morning so I'll be keeping my fingers crossed til then! :w00t:

Hi there! I've been researching WLS for a few months. I've attended a seminar for Lap Band, verified my insurance will cover it after the typical 6 month medically supervised diet and psych visit, I found a surgeon, discussed my decision with my family and have an appt with my PCP on Thursday morning to get the ball rolling.

As I was talking to a friend about it tonight she asked me the one question I never asked myself..."What if your doctor says no...what if they tell you all you need is diet and exercise?" Now I'm freaking out and starting to panic!! Has anyone had this happen?? What DO I do if she tells me no?!! I have fought this battle for 15 years, my BMI is 41 at 33 years old. I am ready for the rest of my life to begin and I can't do it on my own anymore. I'm sure I'm not supposed to say this but I NEED this surgery!!

What do I do at my appt?! How do I get this point across to my PCP?? What do I do if she tells me no?? Any advice is greatly appreciated!!