I go to my seminar tomorrow and I have my consultation with the surgeon on Tuesday. I really hope to have a surgery date by the end of the month. The insurance company (UHC) is the only thing that can stop me now....

Good luck Big Al,

Hope you get your insurance approval quickly and without much effort.

Not sure if you are open to suggestions and I don't know much about UHC, but I can't help but feel that the letter I wrote and gave to my PCP when I asked for the surgical referral helped seal the deal. It was sort of like a resume with sections such as: Personal Objective (to lead a long healthy life, feelings about my future if I don't lose weight, how I am not looking for a quick fix... but a tool); Current Profile (weight, height, BMI, Age, weight related medical issues, family history of weight related illness); Weight Loss History (all the diets, supervised WL programs, self-help books/programs, gym memberships, personal training, etc.); Why the Lap-Band (listed out the reasons why I wanted this WLS vs. others like Gastric Bypass); Research (included some of the websites and books that helped me learn more about my options).

I feel that this letter was extremely helpful because even thought my surgeon had me fill out tons of paperwork listing all past WL attempts and including documentation to support these attempts, I was told none of this would be sent along with the surgeons request to my PCP for insurance approval. The surgeon's office planned only to send a letter of request from the surgeon. Well my PCP had my WLS Resume and he included this with my request for the surgeon's referral and I truly believe this is why my whole attempt to get approval took about 1 month start to finish.

My surgery date is set for 2/3/2004. I hope things go as quickly for you.

Congrats! I am glad that things are moving along for you now. You're planning to go to Port Huron for banding, right? I think you'll be very happy with them.

Good luck.

Everything went GREAT at Port Huron. I went to the seminar and met with the Dr the next day. Everything seems to be on track. They gave me a surgery date for 2-27-04. This is provided my insurance company approves it. I think with a BMI of 46 that this shouldn't be a problem. I went to my PCP yesterday for her referal and she was glad to do it. Hopefully Port Huron will be able to send my stuff to the insurance company by early next week. Thanks for all your help, I'll keep ya posted!!!

AL

Good luck, Al! our fingers are crossed for a quick approval by your insurance carrier. Let us know!

AL-

Are you having Dr. Bhesenia or Dr. Boutt do your surgery? Dr. Boutt did mine and Bhesenia did my aunts....both were wonderful. I'm sure you'll be pleased that you chose Port Huron. I go for my 3rd fill on Monday, Jan. 19th. Good Luck with everything!!!

I am having Dr.Boutt do my surgery. He seems really nice and down to earth. I am ready to get this done!!!

I'm sure you'll be happy with Dr. Boutt. I have no complaints about him or anyone in that hospital. From the pre-op nurses right down to the food service people. Everyone was incredibly nice!!!

Yeah AL!!!! I am so happy for you!

AARRGGHHHH!!! I had my appointment with my PCP for my referral letter, everything went well and I have had a copy of the letter for over a week now. Well, I got a call yesterday from my surgeons office and they said the letter was great except...... My PCP has to specifically say in the letter that she gives me a medical clearance. She did say that I would be a good candidate for the Lap Band but I guess that's not enough. So I call my PCP's office and explain this and they call back and say that I have to come in for another office visit so they can listen to my heart, lungs, etc and I also have to have blood work done......

I really, really, really don't need this kind of delay. My surgery is scheduled for less than a month away and I don't see how it will be possible to get insurance approval in time but my surgeon's office said to keep my fingers crossed. If I don't get it in time I will just reschedule but I was really set on next month.

My Psych exam was last week and I still haven't got the letter from them yet either. BTW, did any one else's Psych exam take 2 hours? They guy had me take a test that took over an hour to complete. It was like 345 questions....

I'll stop venting now, just had to get this off my chest...

AL

My psych exam was about 2 hours too...but I never had to take a test. Oh well, I'm sure they'll get the report to the surgeons office in time. Are you dealing with Tammy at Port Huron? She's awesome. When you go back to your PCP, tell them that you need a full pre-op physical. You'll have to have this regardless, so they might as well do it while you're there. Maybe that's what they're planning on doing to give you "clearance". But I'd double check. Good Luck!!!

I went back to my PCP and jumped through all the hoops including blood work so that is finally done. She is going to have the new letter ready for me to fax on Tuesday.

I should have gotten a call from the psych saying my letter from them was ready Thursday or Friday but I didn't hear anything so I am going to call Monday.

So it looks like I should have everything sent to Port Huron by Tuesday. I still don't see how this whole thing is going to get sent to the insurance company and them make a decision on approving me or not by my surgery date of Feb.27.

If they deny me I'm really in trouble. This whole Last Supper thing I've heard about is kicking my butt. If it's not tied down, I'm eating it.

Crossing my fingers and hoping for the best!! :confused:

AL

Al, I don't know if this will set your mind at ease or not but surgery approvals are often done within 30 days of the surgery. In fact, in most cases the approval is only *good* for 30 days. So don't worry about the time frame. If everything is in order, the approval can come really quickly.

Good luck!!

Yes it is normal for your phyc eval to take two hours. Also I will tell you the UHC is very good about covering the surgery as long as they don't have an exclusion in your insurance. Good luck!

My blood work that my PCP wanted done before she would give me a medical release came back. It turns out I have an elevated liver enzyme count.

Soooooo, because of this I had to go to the hospital for an ultrasound on my liver last Thursday and am currently waiting for my PCP to get the results and write the letter. Hopefully nothing is wrong and this won't delay things further. I still have to send the letter to my surgeons office so they can submit it to the ins company to try and get approval....

I know I've said it before but I don't see this coming together for my scheduled surgery date of 2-27 but I am trying to stay optimistic.

I guess I need to hurry up and wait......

Hi Al,

I just thought I'd share my experience with you. I think I will be the most patient person on earth by the time I get my band!

After waiting 9 months for my initial consultation, I did my pre-op tests in November, and the my stuff was sent to my insurance in early December. I got my approval and was scheduled for surgery on December 23rd. My pcp than talked with my surgeon and decided that I needed to see an endocrinologist for some tests. Endo said that everything looked good, but he wanted to test my cortisol levels "just in case". Sure enough, I got the results back the Friday before my surgery, and my cortisol levels were high. So my surgery was cancelled until I had more tests. Fast forward to last week- after more tests, it turns out that I have high cortisol levels because I'm obese, slightly depressed, stressed and taking birth control pills.

So, now I'm waiting for the letter from my endo to get to the surgeon so that I can reschedule my surgery.

Lots of wasted time and money! However, I feel much more prepared and less stressed this time around. I have had time to do more research, talk to more people and I am more convinced than ever that the lap-band is for me.

Anyway, I really wish you luck and hope that everything works out and you don't have to delay your surgery. Keep us posted!

Good Luck,

Melissa