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Newbie here I'd love some advice on my situation



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Hello everyone Im Sabrina from Chicago for as long as I can remember I have been overweight and have been unsuccesfully trying to lose weight since junior high....after a year of reasearch I've decided that the lap band procedure is something I could benefit from...I made an appointment with my doctor and he also agreed that bariatric surgery would be helpful and he also said he's sure I'm a candidate..seeing as tho my BMI is 47 and I have hypertension..and also a history of failed dieting and excercise...the receptionist ( I believe that's what she is called...lol not sure) tells me to call my insurance co and see I'm covered I have United Healthcare Choice Plus...they told me yes 100 percent since I fall under a certain class of obesity....so I'm excited now...they gave me a care coordination number to give to my doctors office so that they could "request authorization"...I gave all of this information to the receptionist and she said she would call....after several weeks she finally calls and tells me they didn't give her any information...so I call my insurance company back get her some more information and a new number to call...more weeks pass I have come in several times for non related appointments like a blood tests and a physical for work and evertime I ask she says she hasnt called yet ....today...she tells me well I know for sure you will need to be on a supervised diet for one year with ***( which I dont have) before so I will call next week...because its not an urgent matter...huh???I feel like I'm getting the run around here why can't she just call so I can get the process started...she isn't even 100 percent sure about the 1 year diet thing.....why not just call so I can get the process started...I'm really frustrated...I've waited so long for this and I just want to get the process started so I know what to do next...but I feel like she is purposely making me wait? Did you have a similar situation??? From what I have seen it seems as though people pick their bariatric surgeon first...am I doing things the right way by going through my doctors office? Im so confused and a little discouraged :(

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I am sure you are very frustrated. I have good news ... take your healthcare into your own hands and your frustration will lessen (I say lessen because some insurance companies do require a supervised diet for 3 to 6 months, maybe more). I suggest you take a look at your insurance (based on your employer) website. There should be information about prerequisites for the surgeries that are covered, including Lapband. Once you have this information in black and white, you will know if you even need a referral from your primary care physician (some insurance companies do not). If you do, get your referral and then find your surgeon. If you are going with a WLS specialist they will likely have a connection for all the testing you will need before surgery.

Don't allow your primary care doc and certainly not the receptionist take your power. This is your health, your life -- take control.

This forum is a great place to find support.

You have taken the first step and you are on your way! All the best to you.

~fran

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There are three Centers of Excellence in the Chicago area, one in Evanston, in the city itsself and one in Oakpark. These are hospitals

with excellent reputations and well trained staffs. If you can, give one of them a call and I can almost guarantee you a great experience.

(I grew up in Naperville).

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Go to a Center of Excellence-they are the pros when it comes to this type of surgery. I never once had to call an insurance company myself-nor did I have to do a supervised diet-but your insurance may require it (or not). Don't go through this without a center of excellence-they are amazing. Even if you need to travel-it will be worth it!

Good luck!:)

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Call your insurance and ask them what they require for you to get authorized for a LapBand. You have all the power as it is your insurance and you can educate yourself with what you need based on what they tell you. I handled all the calls to the insurance prior to even seeing our surgeon, for my husband and I. Both of our insurances were more than willing to send us the documentation to give to our Internal Medicine doctor so that she could insure we had our bases covered and the correct testing. Don't be afraid to call, you just need to let the insurance representative know you are calling to verify what you need to have a LapBand done. I work in a Center of Excellence and had issues with the surgeon's office losing paperwork, etc. I got a note book and wrote down every time I called the insurance, the physician's offices, and when we had specific testing. It worked well because I could refer back to who I spoke with, the date and time :) Arm yourself, don't trust your health to a receptionist :) Best of luck :)

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