Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Newbie here I'd love some advice on my situation



Recommended Posts

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 :(

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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).

Share this post


Link to post
Share on other sites

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!:)

Share this post


Link to post
Share on other sites

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 :)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×