Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

What were the first steps anyone took to start the process, both of getting approval from insurance company and how to get started with a bariatric surgeon ? Also how & who decides exactly what type of bariatric procedure you get? Also I have Maryland medical assistance, and my mco is priority partners , has anyone who has the same type of insurance as me, had any issues with getting approval to cover the costs of the surgery and any other things that are required bloodwork & tests , dietitian services , etc

Share this post


Link to post
Share on other sites

I had surgery at a Center of Excellence for Bariatric Surgery. These Centers of Excellence are available in many states. The Centers of Excellence provide a complete support for the surgery. There are many components that require a range of specialist beyond just a surgeon who specializes in Bariatric Surgery. They include nutritionist, psychologists, a hospital that specializes in bariatric surgery, staff that work insurance issues, pre-op testing, weight loss and exercise programs, bariatric surgery support group meetings, five years of post-op follow-ups. It is like a "full meal deal", no pun intended. Many have an free introductory meeting that describes the various surgery options.

Generally the decision of the type of surgery is made by you and the surgeon. There are medical reasons to chose one type over another. Such as if you have severe acid reflux (GERD) you would want to chose RNY gastric bypass over the sleeve because the sleeve will only make the condition worse.

Share this post


Link to post
Share on other sites

5 hours ago, Christina pletzer said:

What were the first steps anyone took to start the process, both of getting approval from insurance company and how to get started with a bariatric surgeon ? Also how & who decides exactly what type of bariatric procedure you get? Also I have Maryland medical assistance, and my mco is priority partners , has anyone who has the same type of insurance as me, had any issues with getting approval to cover the costs of the surgery and any other things that are required bloodwork & tests , dietitian services , etc

As they say......... do your homework! Attend those free seminars! You can actually talk to surgeons, ask questions & learn a lot! That is what we did! I say "we" because my husband is my support team & always is with me for everything. Reviews about surgeons are important also.... just more help in your decision. Of course, there are many Labs to do & all kinds of specialists to see & be tested. The worst for me was the 2 day stress test.....that was no fun! I started this journey in Oct. 2016, so almost a year, however, Dr's have different requirements....mine just happens to cover every single base & leaves nothing to chance. We just last week changed mine from the Sleeve to the By~Pass, which will be on 9.25.17, not far off. Not looking forward to the liquid diet, but, we do what we have to, right?

If, you have any questions that I might be able to help you will, just ask! I think my email somewhere around here, too. Take care! ............... Thinking of you!......................

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • 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. 
       
      · 0 replies
      1. This update has no replies.
    • 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
      1. This update has no replies.
    • 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
      1. This update has no replies.
    • 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 
      · 0 replies
      1. This update has no replies.
    • 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!
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×