Lapband Talk Members:

I'll try to condense the situation as much as I can. The following are the facts with my (about to retire & skinny) filipino doctor and my 6 Month Diet Program. Although I didn't know this beforehand, I found out that my doctor has a prideful attitude about weightloss thinking you can do anything if you put your mind through ect....even though he knows my families history of obesity and my brothers successful lapband surgery where he was 429 lbs and now down to 160lbs.

* 12/14/10 - 1ST DOCTOR VISIT - given phentermine to help with weight loss (Weighed in at 284lbs at 5'9)

* 1/18/11 - wife works for the state and we now have lapband coverage through our insurance.

* 2/1/11 - found out that the lap band is covered through our health insurance with a 6 month weight assistant diet plan

* 2/23/11 -2ND DOCTOR VISIT (lossed 6 pounds - now at 278) TOLD DOCTOR ABOUT HOW I WANT THE LABPAND PROCEDURE and how my insurance will cover it with a 6 month diet program. Told him the insurance company will take the 6 month diet program and make it retroactive when I first started seeing him back in December. I originally wanted to go with him because he is familiar with my families obesity (we lived right behind him growing up) and HE KNOWS ABOUT MY BROTHERS SUCCESSFUL LAPBAND SURGERY

* 4/14/11 - 3RD DOCTOR VISIT (lossed 4 more pounds - now at 274) Re-emphasized the insurance program requirements for lapband. Again the doctor was kind of negative again....HE HAS THE MOCHO ATTITUDE saying its not a big deal....just lose the weight even though he knows my families history of obesity.

*5/25/11 - 4TH DOCTOR VISIT (gained 2 lbs - now at 276). Doctor got mad that I gained 2 lbs. I told him hey...I lossed every other visit...stop giving me a hard time. Again...he was kind of arrogant and prideful when it comes to losing weight.

* 6/14/11 - 5TH DOCTOR VISIT (lost 6.5 lbs - now at 269.5) Told the doctor that we needed to submit the paperwork and have him fill out a sheet that my lapband surgeon's office told the doctor to fill out. The form was documenting each visit and documenting if I followed the behavioral modifications and dietary modifications ect...

I just got off the phone with my insurance company and they said they denied me because I did not conform to the behavioral and dietary modifications based on what the doctor submitted. She said however, I can dispute and appeal this denial. So the question is....NOW WHAT DO I DO? Please note that my doctor never asked me if I did certain behavioral modification of diet even though I did. I just think he was turned off that I wanted the surgery and how I was trying to get it approved through insurance. To me...you can't blame me for wanting to get the surgery.

ANY ADVICE ON WHAT I SHOULD DO? PLEASE NOTE MY WIFE'S HEALTH INSURANCE IS ONLY GOING TO BE AVAILABLE FOR ANOTHER 100 DAYS (UNTIL AUGUST 31ST).I really want this surgery and to not have to go to Mexico to get it. It would only cost me $175 out of pocket with my current insurance provider and wouldn't have the added risk of traveling to Mexico. The option of going to another doctor is not a valid choice since I my insurance coverage is only valid for another 100 days.

Discouraged,

MD

It is obvious that your doctor is making excuses because he just doesn't want to do it. Maybe because he's nearing retirement and is cutting back his practice? See a different bariatric surgeon fast for a second opinion and use that in your appeal. Then have that surgeon do the surgery.

That said, I will caution that this procedure is not something to be rushed. I had to go through ten months of meetings with nutritionists, support groups, psychologists, etc. as REQUIRED by my insurance BEFORE they would even make a decision on approval. The only people I know who got banded within 6 months of deciding to do so were self-pay. Everyone I know who was insurance paid didn't get their surgery until about a year after their initial consultation with their primary physician to get the referral to the surgeon.

Good luck.