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Started the process last week!

Hi all, I had my consult with my surgeon last week and wasnt sure what to expect..supervised diet, 3 months, 6 months...so when he told me I would be fulfilling the requirements in 6 WEEKS it kind of floored me. So, tonight I go to my first support group meeting, next week is my first appt with the nutritionist and the physical therapist. When I asked about my insurance they said I was "pre-qualified" and that when I finish the six week program that they will file for final approval and set my date once that came through. I'm a little nervous about what this means and I hate to do all this work and pay into these appts only to be shut down. Not sure if I'm overreacting and my insurance will be fine, or if ill be waiting in limbo for this to happen. I'm also concerned about having the surgery in late November as I would be coming back into work during the holiday season (I manage a VERY busy Starbucks). Any thoughts or words of encouragement would be great! I go back and forth on whether I'm doing the right thing (I'm a TERRIBLE worrier), but I've found that the more people I tell the stronger I get. Everyone has been so positive!!! :)

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Alisa, I completey understand what ur going through... I had my consult today and have a tentative surgery date for 10/30. I was surprised that I didn't have to do the supervised diet due to attempts in the past year to lose weight. All I have to do is get my psychological evaluation, nutritional evaluation, medical necessity letter written by my PCP & my labwork. I work at a high school as a social worker in the school based program. So, I am a little on edge about being out of work so early in the year but was told I should be able to return in about two weeks so that was comforting to know. Plus, I've only been in my position at this site for about 5 months as of this month. I was so excited about my consult I didn't ask the surgeon any questions but I've been researching the lapband procedure since it first came out. I know it's scary and exciting at the same time. So happy I decided to take this step in my life. Keep me posted on your progress.

Hello!

Prequalified just means that as long as you meet the criterion, your insurance provider does cover the lapband procedure. Not knowing your specifics or those of your insurance provider I am going off generic procedure. The doctor must perform and/or order tests that are required by the insurance provider and/or by the physician for the procedure. These include things like education with a nutritionist, an EKG, a psych consult, perhaps a sleep study, standard blood tests etc. Your doctor is basically going down the checklist to satisfy the insurance carrier and their essential requirements for surgery to ensure you are in the best health and qualified for the lapband. Once that checklist is complete, they submit the paperwork to your provider to endorse that you did complete the tests and that you are qualified. Insurance reviews and either approves or disapproves it. Typically they only disapprove those who never met the basic criterion, those who are borderline (just to be penny pinchers) and than those who have a secondary medical issue that may pose a risk or disqualifies them as a candidate for surgery. Otherwise, this is pretty straightforward and all it requires is your time.

As for recovery, one week is essential. Usually by week two people are up and at em, however, they are still guarded. If you feel that you have a strenuous job that won't permit you to sit down, drink etc as needed than take caution and either do the surgery at a more opportune time, or prepare to take time off? As a nurse who works 12 shifts, I was feeling normal and returned back to work week 3. My job does not allow for frequent sitting, is very stressful, prolonged periods w/out drink/food, so I needed to ensure I was 100% before going back.

Hope this helps! :)

Sounds like you are good to go. You can contact your insurance company of you have specifics that you are worried about.

If you are concerned about the timing of the surgery, you can always postpone it until January. If you had to follow a three month diet, you probably wouldn't be able to have the surgery until then anyway. Good luck!

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