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@@ChefSaraKay Were all of your Supervised Diet appts 30-day apart?

I'm curious if mine will do. We pulled some past appointments that were sporadic but in the consecutive months.

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I had talked to a few of my doctors about weight loss on a few occasions and they documented what we talked about. Some of the appointments were in the same months so my surgeons office said they could only count one of the visits out of the ones that happened in the same months because it has to show 6 different months. I hope that answers your question. Good luck with your journey! I am almost 3 months out and 53 lbs down!

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Had UHC and approval was easy but did have to do the six mos nutrition classes. Needed clearance from cardio, polmonologist, & psych, too. They required co-pays and there was a $250.00 inpatient deductible, too. The total bill said $26,000+ so I feel like it's a small outlay of cash in retrospect.

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  • I have United Healthcare Gold Compass HSA 1600.
  • I took my Online Seminar at Bariatric Specialist of NC on 1/19/16
  • Initial Consultation 2/18/16
  • Started my 6 month supervised weight program 2/4/16 - 7/18/16
  • Worked with my case manager to get all required documentation 7/18/16 - 8/26/16
  • Documentation will be submitted to Insurance for approval on 7/28/16
  • The Dr. office is tell me its a 7 to 30 day approval process. But on average they get a response back in 15 Business days. We will see. I'm soooo nervous.
  • Then I have to wait for the final results consultation appointment.
  • Then they say it will probably take 3 weeks to get on the table.

If your just starting now, and trying to get it for 2016 out of pocket with insurance. I don't think you will meet it. I'm sorry I know how stressfull this is. I am so ready for my surgery. I really pray I get approved and fast.

These are the requirements my case manager says my insurance requires.

  • A referral from your PCP
  • BMI above 35 with obesity-related health problems (or BMI above 40 without health problems)
  • Participation in consecutive 6 month "clinically supervised" weight management program
  • Letter of Medical Necessity from your PCP
  • Medical clearance (Psychological Clearance for surgery from a mental health physician, Nutritional evaluation from a Registered Dietitian, Gastroenterology, Blood Labs, Pulmonary, sleep Study)
  • 5 Year weight history

I hope this helps,

CK

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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.
      · 0 replies
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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! 🤣
      · 0 replies
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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      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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