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so i was ready to set up my appt and whn the dr office was verifying my insurance they found that my insurance does cover it but under the network but with a referral from my primary dr. so now im on my way to see my dr tomorrow to try to convince her for the referral. what to say?

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Oh dang! I will be praying that goes well for you. The number 1 thing is to be completely confident in your decision. Don't leave any air of uncertainty. I had to get my gastro doc to agree with my decision to make my bariatric surgeon ok with it. I have had issues with a stricture previously. I was so nervous! But the gastro was totally cool and supportive!

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so i was ready to set up my appt and whn the dr office was verifying my insurance they found that my insurance does cover it but under the network but with a referral from my primary dr. so now im on my way to see my dr tomorrow to try to convince her for the referral. what to say?

If you have any of the number of things that a lot of us in this situation needing to lose weight have or close to having, losing weight makes a lot of those easier to handle and may even eliminate them and any doctor knows that. Every doctor I went to for whatever reason, arrhythmia, sleep apnea, etc., kept saying "If only you could lose weight." I think as long as you have tried to lose the weight on your own and have fallen short you would have a convincing argument for the sleeve. Good luck. Hopefully your doctor knows about it or you have some information to share. I am surprised by how many do not know so much about it, but they are learning.

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Have you ever asked? I had gone in to see my PCP about my depression and she asked what I felt was the root of it and I blubered on about school, home, my weight and she says "have you considered bariatric surgery? I think you'd be the perfect candidate" and 5 days later I was sitting in a seminar and 6 weeks later I have been poked, prodded, and screened in every which way possible. In the years I had seen her and other physicians in the same office no one has every said a word to me about my weight, but the moment I opened up about it they were ready to work with me. I hope it goes well! I agree, be confident, know what you want. In my case my PCP is nearly as important as my surgeon. She is the one holding my hand thru this, not to mention she gets to see me every 3-4 weeks for 6 months.

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I told my PCP I wanted Bariatric Surgery. She asked me why, I told her my negative experiences and how my life was going downhill fast...

She didnt put up a fight.

Less than a week later I was in orientation.

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i had never asked i asked the insurance an they said no. yes its not like i havent tried but its hard when you have all this weight on you

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i went and i THINK i conquered. she said since i didnt have diabetes, high blood pressure, and i could possibly be stress eating the insurance could deny it. i told her that im trying to prevent those. she said she would put in the referral, adding that it wasnt a guarantee. i honestly just wanted to tell her "look im trying to save myself 13k, ima do it with or without insurance thats how important this is, damn"!!! lol

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I am self pay and my surgeon would not schedule my surgery without a complete physical and referral from my primary doctor. She was more than happy to refer me. I actually discussed the surgery with her before I ever met with my surgeon for my first consultation.

Hopefully your doc will be as supporting as mine!

Sent from my KFOT using VST

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    • 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. 
       
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    • 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.
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    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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    • ChunkCat

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      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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