6 Freaking Months!??!

[margo281 0]

I just got off the phone with Dr. Storeys office (Houston) and they told me that after 6 months with them and being monitored by a dietician and exercise they will submit it to the insurance company. I am not willing to wait 6 more months. I told the girl I would be dead by then.

Did anyone have to wait like that? Is that the norm?

How absurd for them to even say that! If people could get the weight off by just watching what they eat then they could just waive their magic wand and it would be done now wouldn't it!!??!!

It's not like getting fat has happened to me overnight, I have been battling weight all my life and with hypothyroidism thrown in there to mix it all up.

Its not like lap band surgery is a quick fix for goodness sake its still major surgery and I don't think anyone out there thinks its an easy solution. But how freaking fat do you have to get before enough is enough?

Sorry to rant an rave but this is frustrating!

[marjon9 6]

Most of the time I think this is an insurance requirement. It's not about whether anyone thinks we can lose the weight with diet and exercise, it's about whether the insurance company can avoid paying for the surgery for as long as human creativity can devise.

If you have any way of paying for this yourself or financing it there are options to get all the way to band-land in a couple months or less. And there are some relatively affordable options to get there, in the 10,000 dollar range for self-payers. If you able to consider this there is a lot of information in this forum you can search for, and if you post questions you will get lots of info.

Good luck.

[kedasmom 10]

Dear Margo, I started with my first meeting in 4-26-06. This did not include my appointent with my own Dr. I just met the Dr. who will do the surgery 12-21-06. He said about 8 weeks to surgery.:notagree I thought about throwing in the towel but it finally is coming to the day

[KelinTx 1]

Margo, My band Quest started with my first initial visit in January of 2006. My insurance company had requirements (many) that had to be met before they would consider paying for my surgery. Once i met all the requirements my surgery was approved in TWO DAYS!! The down side was it took from 1/07 till my surgery day of 9-13-06. I had my 3rd fill yesterday and was down a WHOPPING 66 lbs !! The 66 lb loss includes my two week pre-surgery diet. Hang in there it is totally worth the wait.

[barbara465 2]

Why don't you make sure you are covered then attend one of Dr. Spiegel's or Dr. Spivak's seminars. It doesn't take that long to get processed. Make sure in your history you list all the diets you have been on and the results. I didn't have any problems and it was quite fast.

[ReneBean 3]

Margo -

If you have EVER been on a doctor supervised diet - that will usually fill the requirement for the insurance company.

Just get the medical records. I have heard people that have used weight watchers membership and other things as well.

I used old history of weight loss.

That being said, I had to fight the insurance company for four months to get approved - but not because of that.

You can always submit for pre-approval yourself - but that is a lot of work.

You can also try another doctor who isn't going to Baa like a sheep when the insurance company calls. If your doc won't be more assertive, you will have to be.

Sorry!!

[Alexandra 55]

Margo, six months in the long term doesn't mean anything. Really, if this is something you are determined to do, there's no harm that will be done by a six month wait.

So many insurance carriers have some kind of pre-op management requirement that I guess your doctor's office decided to make it mandatory. I know a lot of people complain about it, but I honestly think it makes sense. Weight loss surgery is a big, huge step and MANY people who think they need it or who medically qualify just aren't ready for it mentally. And that's the worst way to go into surgery; it leads to frustration and failure later on.

Bite the bullet and start the process. Six months is nothing when compared to a lifetime of feeling and being healthier.

[faybie 0]

I am sorry that you have to wait 6 months with this Dr. I think you should try Spiegel or Spivak too. I agree with Kelin, it will be 100% worth the wait, don't give up!

[Randi 0]

Believe me, the actual procedure is the surgeon's bread and butter. So, it's highly unlikely you would be held up from having the lapband surgery by their office. What is more likely is the surgeon's office is now offering the supervised diet and exercise program to meet your insurance carrier's requirement and to ensure their office retains you as a client.

Call your insurance carrier and ask specifically what the requirements are for CPT Code 43770. I think you'll find that is where the official word of the six-month supervised diet and exercise program came from. The surgeon's office is just the messenger of your insurance benefits and entitlements.

You'll also find that should you decide to self-pay for the procedure and have all your pe-operative requirements completed, you'll have a surgery date so quick it will make your head spin.

[sherilynn 1]

I was able to submit years of medical records from my OBGYN which documented my being over weight for more than 5 years. I also submitted logs from weight watchers. And having started seeing a nutritionist right away when I started my inquiry of the band, knowing that would be an eventual plus in getting approval.

I started my journey in June doing serious research, joined this board in September, and here I am, just 3 weeks away from my surgery date. I know you're mad, upset or disappointed - we've all been there at some point. Trust me, you'll need 6 months just to get yourself well enough educated to make this huge change in your life.

Good luck.

Sheri lynn

[LuckyGirl 1]

i had to do the 6 month thing. It goes fast and having insurance pay is well worth the wait! Total, I 'll have to drop less than 3k for the whole thing. I think it's worth it and I love my band - less than 3 weeks out of surgery!

[revolution 0]

In Canada, specifically Montreal, to get the operation, you're on a waiting list that is now up to 7 years, unless you're super super super super obese, which is 3-5 years, so count yourself lucky that you've only got 6 months. I waited 2 years for mine and the only reason I waited 2 years is because I heard from an insider that a new clinic was opening up and the list was short. Short = 2 years.

[juliegeraci 7]

Sorry you have to wait so long. I hope it improves for you.

[revolution 0]

Oh it has. I'm getting banded next week! Thanks

[laurigee 545]

Margo....My insurance company doesn't pay for the surgery at all. If you are getting it payed for and only have to wait 6 months count your blessings. Every thing in life doesn't always happen at our pace and some times exspecially when someone else is paying for it we have to go at their pace. I had my surgery within 2 months but it came with the hefty price tag of $17,500. I am sure if you are willing to self pay there are alot of surgeons who will get you in alot faster. You have to decide which is more important to you your time or money. Good Luck to you and I hope the frustration of having to wait doesn't discourage you from going forward.