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Basically what happened is.....I have UHC, but this particular plan does not cover bariatric care at all. So, I paid for the surgery myself. Well, in order to get insurance to pay on the surgery, they billed "unlisted liver procedure" instead of wedge liver biopsy...."unlisted procedure, stomach" rather than gastric bypass...."adhesion repair" rather than lap-band removal...and also charged for a (hiatal) hernia repair. Mind you, all of those things were to be INCLUDED in my revision surgery (that's why it's more expensive than a "virgin" bypass), but they had my insurance information from my (original) consultation and submitted it. Since the coding "appeared" medical, UHC covered a pretty significant portion of it. Thinking I should get a refund for anything that insurance DID pay, I phoned the office to find out when I'd get a refund check and, to my surprise, they said they would be keeping BOTH payments! Adhesions were expected, due to the band; I've had a hiatal hernia for OVER 10 years, but the op report reads as if it was "discovered" during surgery!!! Adding what they billed insurance PLUS what I paid up front, my surgery was nearly $58,000!!! That is ridiculous. The average for bypass is $22,000, which is what I "self" paid prior to surgery. Just a side note....I had NO complications, NO unexpected/unplanned procedure and the hospital and anesthesiologist both wrote off ALL charges except what I paid up front...only the surgeon billed/was paid by my insurance company. I tried to "appeal", but UHC wouldn't since it was not a denial. The insurance commission only regulates insurance, not MD's. The Medical Board only cares if you have "injuries" (for malpractice), they don't care about how the MD codes the surgery. Most patients don't mind because, had UHC NOT paid, they would not have billed me anything....they would have just " settled" for what I paid them up front. Because the patient usually doesn't get a bill, most don't mind and/or don't complain when the doctor submits "medical" codes and gets payment. It is a common practice by bariatric surgeons (even the "good" ones!), but it's wrong, wrong, wrong. I am continuing to pursue it because I work in the healthcare industry and I am just so infuriated by all the fraud, abuse and waste in "the system" that I am not going to let them get away with this, even though almost all of them do it!! Sorry to go on and on, but I am just SOOOOO frustrated and angry that I go on a rant when I discuss it. I asked all the right questions, reviewed the contract, etc., etc., and I STILL got "used". I am still trying to work with UHC to either ask the doctor for a refund or else tell him he needs to refund it to me...even if I don't get it, I don't want the doctor paid twice. If your insurance doesn't cover your surgery and you end up paying yourself....BE SURE that you have an "iron-clad" contract and understanding with your physician about what will be billed and HOW it will be billed. As a side note, even my PCP said it's "illegal as hell" (quote, sorry for the language) the way they billed it; it's not just me being upset because I didn't get a refund.
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Band to gastric bypass
terrydumont46 replied to marie beal's topic in PRE-Operation Weight Loss Surgery Q&A
same amount of time. I had a drain in for 1 week and that was a bother but my pain level wasn't higher. I just remembered all the do's and don'ts of surgery and that helped. I had a uncomplicated recovery. I love not having the band anymore. the little pouch of gastric bypass works for me like crazy. i always had to work very hard with the band to get the full signal. you will love your bypass. -
Finally approved for Revision Surgery
korilh71 replied to jenniebear2002's topic in Revision Weight Loss Surgery Forums (NEW!)
Having my band removed tomorrow. My surgeon will not do same day bypass I have to wait 3-6 months. Happy to see the positive comments about the revision. Sent from my iPhone using the BariatricPal App -
Band to gastric bypass
tebowfan replied to marie beal's topic in PRE-Operation Weight Loss Surgery Q&A
I had mine removed the same day as my bypass surgery -
why are people such HATERS!!!!???
gg2007BandSTAR posted a topic in PRE-Operation Weight Loss Surgery Q&A
I have decided that lap band surgery is definatly for me, goodness knows how long i have been struggling with my weight. Anyway i went to my nurse as advised by my doc to talk to her about loosing weight. As soon as i mentioned lapband she just went off on one: "i have known so and so person who has had it done and it hasnt worked for them", "its not a quick fix to loose weight" (which i tried to explain to her that i know, ultimately i am the one who has to loose the weight, but controlling and managing what i eat) but did she wanna listen...ohh no!! "surgery doesn't work" i told her to come to this website and thousands upon thousands are living proof it DOES! even when she was telling me about the stories of how it went wrong, i had to correct her half way through and tell her that the person she was referring to had gastric bypass and not banding. By the time i came out of the office i felt so small, and was on the verge of crying my eyes out!! why is it always the people that have had no issues with their weight and dont have a clue, what it is like to be over weight, are always the first one to shun surgery?? I have researched for years and making the decision to undergo surgery is not one that i have taken lightly. But staying the way i am now, is pushing me towards and early grave, and i refuse to walk that path any longer and have taken the stand to do something about my weight. As mentioned i have spent a very long time doing my research and am not naive, i know that things can go wrong and they do go wrong. But if i stay the way i am, i not even giving myself a chance. I have seem both the positives and negatives and have made an informed choice. When i came home i was so upset, but i am STRONGER than that, i know 100% that the lapband is what I WANT and its people like her that convince me EVEN MORE SO that i know im doing the right thing and pushes me to go further and prove them wrong! So i say not only for myself, but for people that have had people trying to talk them out of the lapband, if you know that it is for YOU. Go for it, and don't let the haters stand in your way! The more people hate the STRONGER I GET!! -
I heard of a woman in Colorado who died because her surgery wounds became infected. She didn't go to the hospital for it and died. I think I have heard of one other case like that too. Generally, if you die from a lap band, it's because you get infection from your wounds. This is extremely rare and if you get to the wounds in time, it's treatable. And yes, Bypass you can die from as well. However, there are more complications that cause death in those cases.
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So I just got back from a small family reunion for my Grandmothers 90th birthday. When I said large family in the title I wasn't referring to the number of people there but the size of the people there. I found out that a couple of them had had either bypass, sleeve, or the band in the past. The problem was they were all telling me how it failed and they just gained all their weight back. This was pretty eye opening for me to say the least. I know surgery is a just a tool in the weight loss tool belt and can be defeated. All the ones I talked to had one thing in common...they never went to a support group or held themselves accountable to stick to eating right post surgery. They mentioned how easy it was to fall back into the old eating habits and some were even pressured by their spouse to cheat on their diets. Now I am scared that this will end up being my fate...I will just have to make sure I attend the support group meetings religiously.
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Success in Tijuana with Dr. Ismael Cabrera
Caligirl88 posted a topic in Weight Loss Surgery Success Stories
My brother had bypass with Dr. Ismael Cabrera in August 2015. He has since lost about 80 pounds and hit his target weight! The procedure went flawlessly and my brother highly recommends Dr. Ismael Cabrera. What stood out to me the most was the quality assurance that was made with the x-ray to assure my brother there was indeed a new smaller stomach that did not leak. I did all the research on his behalf and am beyond thrilled that everything worked out best case senecio. I would do my sleeve with Dr. Ismael Cabrera however when I called to find out more info I was told prices just went up and they weren't able to get me a deal to get the price back down. Must not want my repeat business because lots of other surgeons are less expense. Guess that's the only downside I could find with Dr. Ismael Cabrera. -
Hi I had a band in 2009 - it was extremely successful. The band eroded when I was pregnant so I had to have it out last year. I was sleeved in February 2014 and I haven't had any restriction since day 1 ( I know all about slider foods/what I should be eating). I saw my surgeon yesterday. I was thinking of getting a bypass but he is talking about putting on another band. I'm having a barium swallow tomorrow. My questions are: has this happened to anyone else? Did you have another band or a bypass and what were the results. I would really appreciate some feedback - this situation is killing me:(
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Long-Term with the lap band...
emily_0192010 posted a topic in POST-Operation Weight Loss Surgery Q&A
Hello! I am currently choosing between the band and the sleeve. My main concern with the band is with the long-term effects of having an implant. I have heard that about 50% of people have their bands either removed or revised after the 5 year mark. Is there anyone who knows any more about this or who has had their band for a long time? I will be asking the surgeon about this of course, but in the meantime I would love to hear from you Thanks! -
Sorry I just got to reply. Was away with my daughter on a Civil Air Patrol mission. I just started walikg, I started small. I walked a mile, then mile and a half the following week. Eventually I was walking 3 miles. Then I started to jog-slowly. I used my music as a guide. Walk a song, jog a song, walk a song, jog a song. Then I started tryign to jog 1/2 mile straight. The next week 3/4. Add a little every week. I have a running body now who had Bypass 5 years ago. She really pushed me to go more, jog further, and encouraged me. Biggest thing I can say is just do it. I know it sounds cliche but our moto has been -"I can do anything for a 10th" which a 10th of a mile. You will feel the urge to go out and run once you start. I hated running when I started I was just going to walk but once I pushed myself out of that comfort zone and just decided I'm doing this for me and noone else I just went for it and got addicted. The couch to 5k is a great app. I use Nike runners app because it tracks my previous runs and I can walk or run. The key is- for me at least- is be your own cheerleader and push yourself outside of that comfort zone. You can do anything you set your mind to. Will you be sore- yes!!! Will you die- no!!! But the sense of pride you get from doing these small races means way more to me than how much weight I have lost. I no longer focus on pounds- they will come. I focus on miles and time. Once I took my mind off the scale I found I was less stressed about my diet and how I am doing post surgery. I focus on the miles and time and gettign those in and the diet kinda fell into place afterwards. If you eat crap or not enough protein your runs suffer and you can feel it. Now that I count miles and improving my time I keep my protein up and my diet looks good. I only weigh every 2 weeks now. I use to weigh 3-4 times a DAY!!!! It stressed me out!! Now I focus on how my pants fit, how much better my time and distance is getting and when I get on the scale it is only to make sure I'm still going in the right direction- which it will be because I'm burning a shitload of calories. I did get advice from my surgeons office and the dietician to make sure I ate properly with the increased activity.
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Hi there! I am considering getting either the lap band or Gastric bypass surgery. My doctor just sent the referal yesterday. I am 37 years old and have a load of health problems due to my weight. This is my deal; I have Diabetes, Cholestorol, knee and ankle problems and I have polycstic ovaries which prevent me from ovulating monthly thus having only one child (very thankful for him) I am mostly doing this for my health and energy level basically my quality of life. I dont expect to jump into a swimsuit anytime soon as I know I will have lots of extra sagging (not looking forward to that) Based on what I have been reading I may just opt for the lap band it doesnt sound so invasive. Please bear with me as I have LOTS of questions and have never participated in a forum; Here are my questions to you: :mad2: Lap band VS Bypas surgery ? What is a FILL? How soon did you hear from the Richmond location after the dr referal? How long b4 your surgery was actually scheduled? what are the regrets if any, you had after the surgery? any suggestions on things you should have considered before the surgery? How was Kaiser, were they sensitive to this issue? Did you go to many appointments, I live in Sacramento so I'm concerned about that Did anyone have marriage problems after? I'm afraid because I have always been chunky and my husband met me this way and my son loves me this way too (just not being so unhealthy) he says, I feel like a comfy pillow. I asked my husband how he will feel about this frastic change but he said whatever I need to do to get healthy because he is also concerned. and I know my son would rather I be healthy than always have aches and pains becuase he worrys about losing his mommy. Please HELP ! sorry for the long post but I have many questions and would like the honest truth not from a Doctor who hasnt experienced it.
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Why I'm Not Telling My Mother In Law
kittyforet replied to Disney Nut's topic in PRE-Operation Weight Loss Surgery Q&A
I haven't told my inlaws and hopefully never will. My mother in law, brother in law and sister in law are huge...my hubby is getting bigger these days too. My inlaws and husband have all been large, except my father in law... Hubby was always the smallest after his dad, but not so much anymore. 5 years ago my MIL was absent at my daughters birth because she was in Louisiana with my sister in law, who was getting gastric bypass at the time. I totally understand her being there for that. It's not like I was going to allow her in the OR with me anyway. My SIL has always been huge. Not sure of her exact weight but I know she wore 5x. She never made good food choices and exercise was a foreign word to her. Pretty much sums up my whole inlaw side of the family. Anyway back to her surgery. She was receiving state medical insurance so her surgery was free. Within 1 year she lost a lot of weight and looked great. Then something happened after year 2...She went back to her old eating habits and gained all of the weight back, and then some. She was given a huge gift in the form of free surgery that could make her healthy and enjoy life more and she trashed it. The main reason I don't tell my MIL...she is the biggest blabber mouth and if I fail at this everyone will know thanks to her. Then I'll be compared to her daughter and I can't take that. It might seem petty but I don't care. I worked hard to be able to pay cash for my surgery, my insurance excludes weight loss. If I want the world to know something, I'll tell the queen of gossip and you can bet in two minutes everyone in the USA will know. Not lying. I will be a success in spite of my inlaws. Sorry for the long post...guess I needed to get that off my chest. Sent from my iPhone using LapBandTalk -
You tube videos have me worried
kychick1294 replied to lynndtt's topic in PRE-Operation Weight Loss Surgery Q&A
The band isn't for everyone and I strongly suggest that you really research your options and what surgery would be best for you. I've lost about 20lbs in 2 years!! I'm completely annoyed with myself for picking the band so quickly. I lost 10 the first week and from there on its been a lose/gain battle. I worked the band to a tee for about 7 months.. If lose 3-4 lbs one week and gain it back plus 2 lbs the next. I was mentally and emotionally drained after it and just have up. Got all my fills and had good restriction but the weight just wouldn't come off.. Could not get lower than 320. I'm the kind of person who needs to see the number on the scale dropping.. If it doesn't I lose motivation. I'm trying to get approval for the bypass or sleeve as we speak. Now my neighbor lost 100lbs in 6 months, never has gotten a fill and eats all the fast food she wants... She doesn't exercise but her smaller portions did the trick. I have a serious food addiction so I need that fast weight loss to keel me going! Everyone's different so just do your homework!!! -
I am exactly 2 months postop today from my band to sleeve revision. I am down 42 lbs and am at my lowest weight in years...lower than I ever got w/that band I feel great and can't wait for another 2 months to pass!!! For anyone considering revising from that band, I can't say loud enough.. THE SLEEVE IS SO MUCH BETTER!!! Erika
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Potential Side Effects list
kellyw74 replied to Mr-Smith's topic in PRE-Operation Weight Loss Surgery Q&A
Just so you know, there aren't ANY drugs that you can not take with the sleeve. I take slow released drugs and do fine with them. The bypass restricts medications you can take. My dr. told me that there are NOT any pills that are restricted with the sleeve long term. Being cold sucks, but it comes and goes. Kelly -
Has anyone had Band removed and Sleeve Done in one Surgery and had a PROBLEM after the surgery?
ctsleeve replied to JewelJ's topic in Gastric Sleeve Surgery Forums
Hi, I had my band for three and a half years. I had the band to sleeve revision in one surgery, which went well. Ask your doctor how many leak tests s/he does. The disgusting swallow on Day 2 was one of mine (and it also took a while for that to go through my sleeve because of swelling). My surgeon did a leak test with blue dye during the surgery as well. Different doctors seem to have different theories and practices about leak tests. Good luck and best wishes for your surgery and a quick, uneventful recovery! -
Weight Loss 13 Days Out
dfwtxfemme replied to meggiepoo's topic in POST-Operation Weight Loss Surgery Q&A
I am pre surgery deciding between the sleeve or the bypass but I agree hang in there but I also wonder how common is this I know its life changing a slow process, I also I'm afraid of doing all this and not working -
Are they going to do an endoscopy prior to surgery? That was a requirement for me. I wanted the sleeve and the doctor wanted to do the sleeve based on my starting point when I first saw her (BMI was around 40 then) but she wouldn’t make the call until she did the endoscopy. She said if there was a lot of evidence of GERD she would most likely go with bypass. Endoscopy was clear so sleeve it was.
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Congrats on getting started!! I have Aetna, so they require a 3 month nutrition and diet program. I had a little bit of probs cause, long story, my husband had a heart attack and triple bypass at age 37 back in feb/March. I had a net gain during those 3 months. Aetna states U cannot have a net gain. And I had no weight for 2013. So I was denied. (July) Then i appealed - denied again. (Aug) I hired Lindstrom obesity advocacy (They were EXCELLENT!!) And was approved Oct 3rd!!! I started my first meeting was January 7th 2013. And my surgery is set for 2 days before!!! I'm so happy and even tho it took a while, it was worth it. The denial definitely hit me hard and the next denial was even worse. But it lit a fire in me that I wanted this and I had to get real serious whether or not this was for me. And it is!!! The denials made me get my head together and with lots of family and friends support I have fought thru and here I am!!!! So the whole process took me a year, a friend of mine, who I went thru the whole process with, was sleeved on aug 11th. So I am only a little behind. Now is my time!! Any questions let me know and good luck!! Keep in touch!
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Are You Happy With Your Choice?
andersonlj replied to MiTurner247's topic in Gastric Sleeve Surgery Forums
So far.....I do not think that I would have or ever would have the bypass. I think that I would just try to maintain whatever weight that was possible for me. I do not think that my life with the bypass would be a very happy and healthy one. I have worked with a couple of people that have had the bypass and yes they have lost a ton of weight but I am not sure that they are truly happy with their own decisions. -
Are You Happy With Your Choice?
Ms skinniness replied to MiTurner247's topic in Gastric Sleeve Surgery Forums
If I had chosen to have the bypass, It would have been fine. I didn't like the malasorbtion effect. Both surgeries are great for weight loss and with both surgeries, you can gain weight back. We will always have our triggers to eating the wrong foods unless we get a handle on it right now. It is highly beneficial to have a therapist walk with you through the process helping you discover what your triggers are and to use better coping skills to change those triggers. This is part of my on going journey to a new me. Love IT! -
Look up chef dave - he had the gastric bypass and I believe he has a "for dummies" book too - Kaylee Ann ~ Surgiversary: 6/11/12
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My surgeon told my pre op group about a gastric bypass patient that had just came out of surgery the day before. The hospital accidently got the lunch trays mixed up and this gastric bypass patient got hamburger and fries as his first meal right out of surgery. He was a quarter of the way through the meal before the nurse questioned it. The patient thought it was okay to eat since that is what the hospital served him. If you make a mistake, I think you should own up to it and not look elsewhere for validation.
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I'm being banded on July 27th. Today was my second day of pre op protein. I feel totally full and satisfied with the protein and I'm very surprised that I'm not hungry and obcessing about not being able to eat. Of course, it's only the second day. What I'm noticing on here is that there are definitely two camps of Lap Banders. Some of you sound very upbeat and determined to follow the program and make this work. You seem to be losing weight, not at a fast rate, but steadily. Which is what I want to do, after all I didn't get fat in a month and don't expect to lose it that fast. The second camp seems discouraged and even wishing that they had never had the surgery. I am feeling a bit worried. I don't want to make a mistake, but I really need this to work for me. I decided on the Lap Band after doing a lot of research. I was very uncomfortable with having either the sleeve or bypass because it just seemed very invasive and I didn't like the thought of actually changing the anatomy of my stomache or digestive system. I'm not saying it's not the right decision for others but I felt that it was not right for me. I am totally committed to following the rules, before and after surgery and taking things very slow as I progress through my dietary restrictions: clear liquids, full liquids, puree and soft. I'm reading all that I can and I have purchased the bullet processing machine and I'm practicing pureeing foods and freezing some things in ice cube trays for after surgery.\ I guess I'm just looking for some reassurance. I know it's not an easy fix and I'm praying that I have an easy post op with no complications. Good luck everyone.