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Mount Sinai Hospital, New York, Fidelis Medicaid the process?

Hello Everyone. First and foremost I just want to say I am so happy I found this website. I live in the Bronx, NY area and I am going to see Dr. Subhash Kini from Mount Sinai Hospital/St. Lukes. My first appointment with him will be the 23rd of August. I am excited and nervous because I really need this especially because I gained so much weight and don't know what to do anymore. I tried so many weight loss programs and yo-yo diets but no help. I mean I lost but gain back and double triple what I have lost. I feel lost. I feel depressed and most of the time is due to my weight. My social life well let's just say I don't have one not like I really did before due to the fact that I am a mother of three beautiful girls and a wife. So social life can't really hang out unless is at my house and really people just rather hangout at lounges and all but anyways my weight doesn't even let me want to hangout. My highest weight now is 254.8 lbs at 5'5" which brings me to a BMI of 42.5 Morbid Obesity. I can't breathe half the time, I have insomnia and I can't do half or more things that I normally would do. My health is going down the drain although I don't have HTN or Cholesterol or Diabetes which definitely runs in my family like mother, father, aunts, and uncles etc have it. I don't know if I suffer from Sleep Apnea and I guess I'll find out because that will be one of the requirements. Talking about requirements whyyyyyyy. I have Fidelis Care NY Medicaid and they supposedly require 6 months weight management and x amount of exams ughhhh I guess I'll see what they say in the visit. So I feel like I have tried it all for 12 years and counting and nothing helps. I need that push that tool to help me finally lose all this excessive weight i have put on. I don't know if there are others who feel the same way but if you do I'm here. I hope to find friends here and to have some support because I honestly don't have one. My husband is not here or there. My only two friends do not agree but they don't get involve either but is not like i can talk to them about it. I try to have a few people to talk to but unless they are going through the same thing they really won't understand and really don't want to be talking about it. I am doing my research on the surgery through google, YouTube and other programs. I have done about 4 seminars.... I know........ Hope is not to much of me in one forum. I think I'm going to document my journey here and definitely thinking of YouTube. I'll keep you guys updated on that. Anyways enough of me anyone else here going through the same, going with the same doctor, hospital, from NY, no support system???

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On 8/18/2017 at 4:14 PM, Luisajfc said:

Hi! Your story sounds so similar to mine. I'm from the Bronx too mother two , weight is practically keeping me from doing things I used to love... so many common thing with you, my surgery day was schedule for Nov 28 it's gonna be in Bellevue Hospital.

Hope to hear more from you and your future documentaries, just know you have support here!


“There will be obstacles. There will be doubters. There will be mistakes. But with hard work, there are no limits.” —Michael Phelps

Awww Thank you for sharing! I'm happy for you having your surgery date even though I don't know you personally just knowing we have similarities is as if I do. Definitely going to keep updating about my process in here. Tell me about your process how has it been? Did you have to do insurance requirements? How is your Doctor? I'm happy my first appointment is tomorrow and I'm anxious to see what happens....... Thank you for your support and know also I'm here if you need support. I have notice I'm always good in supporting others and giving advice often I'm being called Dr. Phil but never take my own advice... LOL So I'm here for you. Love the quote!!

"Three months from now you will thank yourself"- Weight loss quotes (This one is literal LOL from August to November)

Awww Thank you for sharing! I'm happy for you having your surgery date even though I don't know you personally just knowing we have similarities is as if I do. Definitely going to keep updating about my process in here. Tell me about your process how has it been? Did you have to do insurance requirements? How is your Doctor? I'm happy my first appointment is tomorrow and I'm anxious to see what happens....... Thank you for your support and know also I'm here if you need support. I have notice I'm always good in supporting others and giving advice often I'm being called Dr. Phil but never take my own advice... LOL So I'm here for you. Love the quote!!
"Three months from now you will thank yourself"- Weight loss quotes (This one is literal LOL from August to November)



The process is fast with my insurance and this hospital, I just got home from doing the esophagram test, nasty tasting but fast, my next appointment will be for sep 15 and I'm missing the schedule date for my psychological one. I don't have to do a diet plan or loose any amount of weight but we have to do the two weeks liquid diet before surgery. I'm getting the bypass so I was ask to also get a stool sample. And last month I had my ekg, blood work and X-rays done. My doc I have not had much conv with him except the date he gave me my surgery date which was on my second visit .. can't say much there.

Best of luck on your appointment and tell me how it goes.
  • Author
1 hour ago, Luisajfc said:


The process is fast with my insurance and this hospital, I just got home from doing the esophagram test, nasty tasting but fast, my next appointment will be for sep 15 and I'm missing the schedule date for my psychological one. I don't have to do a diet plan or loose any amount of weight but we have to do the two weeks liquid diet before surgery. I'm getting the bypass so I was ask to also get a stool sample. And last month I had my ekg, blood work and X-rays done. My doc I have not had much conv with him except the date he gave me my surgery date which was on my second visit .. can't say much there.

Best of luck on your appointment and tell me how it goes.

Can I ask you a question So you didn't have to do the 3 or 6 month diet? Why Bypass? Do you have co-morbidities? What insurance do you have? Sorry not trying to be FBI lol just new to this. I have chosen VSG yet to see what the doctors do say though. They can be like no you need bypass.... you know what I mean we never know until you are there from what I have read.

Edited by Maryvsg87

Can I ask you a question So you didn't have to do the 3 or 6 month diet? Why Bypass? Do you have co-morbidities? What insurance do you have? Sorry not trying to be FBI lol just new to this. I have chosen VSG yet to see what the doctors do say though. They can be like no you need bypass.... you know what I mean we never know until you are there from what I have read.

No i didn't, I guess every insurance may work differently on hospitals .. so no diet at all. I chose bypass cuz my bmi is above 40 and I feel that if I chose sleeve I wouldn't loose enough .. I weight 280 I'm 5'7 with a dislocated knee cap, I need the weight out of me cuz the last thing I need is a knee surgery, [emoji848] I don't have GERD but I do get heartburn like two weeks of a month .. I don't know if it is related but with the test I did today maybe I'll find out which Is why chose bypass since I read VSG makes it worse .. can't have that. Forgot to tell ya, my insurance is affiliated to this hospital. ( metroplus) which at the seminar they mention it would be easier for some, I heard of others who had it in 3 months. ( lucky maybe)


“There will be obstacles. There will be doubters. There will be mistakes. But with hard work, there are no limits.” —Michael Phelps
Congrats..... that is an amazing drop!!! If you don't mind me asking why do you say that (chicken factory)?

Typical NYC hospital that works like a slaughterhouse. You're just a number. I had to wait in recovery like 10 hours because there was no bed available :-(

SW:305

CW:212

Sleeved 01.30.17

On ‎08‎/‎18‎/‎2017 at 10:49 AM, LadyT17 said:


I have emblem, I'm seeing Dr Park, so far everything is going good with all these appointments

On ‎08‎/‎18‎/‎2017 at 10:49 AM, LadyT17 said:


I have emblem, I'm seeing Dr Park, so far everything is going good with all these appointments

I have ghi / emblem . you have to wait 6 months at mount Sinai?

3 hours ago, LadyT17 said:


*ghi

I read that is was only 3 months if using a multidisciplinary program. I also have ghi emblem through my job with the city . my first appointment date was 7/25. I'm expecting a surgery date sometime in October.

"Active participation within the last 2 years in a physician-directed weight-management program for ≥ 6 months without significant gaps (or 3 months if provided through a multidisciplinary bariatric surgery program). The program must include monthly documentation of all of the....... "

https://www.emblemhealth.com/~/media/Files/PDF/_med_guidelines/MG_Bariatric_SX_c.pdf

Edited by danybx
addition

I read that is was only 3 months if using a multidisciplinary program. I also have ghi emblem through my job with the city . my first appointment date was 7/25. I'm expecting a surgery date sometime in October.
"Active participation within the last 2 years in a physician-directed weight-management program for ≥ 6 months without significant gaps (or 3 months if provided through a multidisciplinary bariatric surgery program). The program must include monthly documentation of all of the....... "
https://www.emblemhealth.com/~/media/Files/PDF/_med_guidelines/MG_Bariatric_SX_c.pdf

Ok thats great, I'm good with the 6 months being as I just had knee surgery, so I can wait


Hi just wanted to welcome you im from the bronx and im having mines done in montifore of new rochelle today was my last weight in i did all test so crissing my finger good luck

On 8/18/2017 at 3:04 PM, Maryvsg87 said:


Ask yourself why did you want the GBS vs VSG and then what made you choose VSG and then why now you want GBS again if whatever you answer makes sense to you gen go with that. I always say go with your gut feeling and ask if you can change surgery cause then you might then later on go get a revision and that's another surgery.

I mean theres usually a clear cut better choice. If you have diabetes, are severely obese (I mean super high BMI like 55-60s) , or have GERD the bypass is "probably" the better choice. For people with lower BMIs without GERD I would definitely want a sleeve.

The bypass is the more complicated surgery with more risks, but there are times when its more appropriate. If a surgeon recommends something I would heed their words carefully

  • Author

I'm so excited one to my first appointment and everything went well and hopefully getting it done in October with Dr. Kini but only thing I'm trying to find a psychologist that does the evaluation with Fidelis because the one he recommended I will have to pay out of pocket ? Anyone knows of a psych that does it with insurance?


I'm so excited one to my first appointment and everything went well and hopefully getting it done in October with Dr. Kini but only thing I'm trying to find a psychologist that does the evaluation with Fidelis because the one he recommended I will have to pay out of pocket ? Anyone knows of a psych that does it with insurance?




Hi, i had the same situation. I found one in Brooklyn, park slope area his name is Dr fried

Sent from my SM-N920T using BariatricPal mobile app

  • Author

Hey do you remember either his first or last name I'm looking them up but don't get the exact match?


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