1st evaluation was Fri now I'm hitting some road blocks...

[jordan1079 6]

Did my first evaluation on Friday and everything went well! They gave me the next couple things to work on ....

EKG...done

Bloodwork...done

**5 year weight history....ummm having issues...urgent care I visited back in 08 moves their files after 2 years to a storage facility and the office manager said she would try to help...not holding my breath because that isn't her job to get them.....How important is it to have a 5 year weight history?? and what if I can't get all 5 years?

Scheduled my Psych evaluation for April 23....and it's completely covered..yay!

Due to having once a year sleep apnea episodes I have to have a sleep study done......earliest I can get in is May 5th. BUT my insurance doesn't cover it and it's $4500!!!!!!! My God! The woman I talked to on the phone said my insurance (Anthem) "may" cover a home sleep study. Crap!! Not what I wanted to hear...

Also my insurance paperwork says that the 6 month mandatory weight management is waived IF you have a BMI over 50 and I do! But during the evaluation nobody said anything about it. I don't want to lose any weight until I know that the WM is waived. I feel bad for saying that because the whole purpose of me doing this is to lose weight but if I have to do the 6 mtn WM then I wanted it to start on Friday so I can get moving. Does it take the Dr. time to go over your paperwork before you know what you have to do next?

Ohhh and one more thing.... I have to get Medical clearance from my PCP but was asked when my surgery is....told the nurse I didn't know and that I just started this journey and she said that Med clearance is only good for 30 days so I need to do that closer to surgery time.

I feel like I came out of the gate at a good pace but feel stalled with no where to go. Any have any experience with this kind of thing? Almost feels like a test they are giving me....."how bad do you want this???" BADLY!

[pantala 125]

Can I relate? Oh Yeah. That's why I ditched the whole insurance circus and researched going to Mexico. I'm getting sleeved March 28 and the experience so far has been like heaven compared to what goes on here and trying to get insurance to cover me. You are treated like a valued, adult client. At a little more than the cost of one sleep study, I am getting the surgery, two nights in a full service hospital and 2 nights recovery at a Marriott, all tests, and any needed follow-up consultations by phone or email. Oh and my husband can be with me and only has to pay for his food.

I hope things work out for you on your current path, but if it gets to be too much, at least consider Mexico......

[SpaceDust 585]

Regarding the home sleep study, that is often what insurance supports when there isn't any obvious medical necessity. For example, my insurance covered a friend who was having obvious symptoms of health impairment that was likely to be sleep apnea, and whose PCP referred him for the study. However, I wasn't having any overt symptoms, just needed it as part of prepping for the sleeve, so I had to go the home study route.

It isn't a big deal other than the annoyance of wearing the equipment overnight. They send you home with some equipment so they can monitor your breathing, pulse, oxygen and so on while you sleep overnight. You take the equipment back in the morning, they do the analysis of your recorded stats and then you have an appointment to discuss the results and determine next steps, if any. It was quicker to get the home study scheduled than to wait for the in-clinic study.

[VSG4aHealthierMe 6]

I too am interested in the answer to the five year history! I don't know if I will need them yet but trying to be proactive about gathering what I can. I moved here about 3 years ago and only saw my ob/gyn b4 that... they are also the ones who prescribed weightloss pills(appetite suppressant) to help me lose the weight. I called and they said anything older than 2 years was moved and destroyed (can they legally do that?). So as I said I too would love to know the answer in case it pops up in my case.

[VSG4aHealthierMe 6]

Sorry, double post.

[taurabird 142]

I would call the RN case manager at your insurance company that submits your case to the MD for review and ask her exactly what she is looking for and ask her to define the terms she uses. I say this because my insurance paperwork read that I needed documented evidence of medically completed weight loss program within the last 2 years". The nurse said that a letter from my primary stating how long I had been seen by him and all the different types of weight loss attempts I had done during that time was all the were looking for so I urge you to directly contact the case manager and have her spell out exactly what they want.