I went to the orientation yesterday at WLIA. I have to say I was impressed with Dr DeBarros and I liked that they made it seem as if it was so much easier to go with them because they will work to make sure my claim will be approved and will go the extra mile.

What I didnt like is the fact that the insurance I will be on will most likely cover 100% of the surgery with no co-pays yet I will still have to pay a co-pay and a deductible. This is because one of the doctors (and both will be there during the surgery) is not on the BC/BS plan. This most likely means my totally covered 100% procedure will cost me around $2500 - $3000 when you also take into account the program and other fees.

I have a few things that I am a bit worried about. First of all I dont have a primary care physician and my records are very sketchy over the past 5 years. A couple trips to urgent care for strep throat, a visit here and there for other things but nothing with exclusively one doctor. Other than that I'm pretty much a "healthy" person with a BMI of around 42. No, I dont consider having a 42 BMI to be healthy but I dont have any other problems. My weight has fluctuated a lot over the past 5 years but I've always been around the 40 BMI range.

I am now really regretting not seeing one doctor and having that person have all of my records. (Does urgent care even keep records easily at hand for the person who came there only once three years ago?)

Ok yes, I know this is getting long so I'll cut to the chase. I went to WLIA and they are asking for $2000 in program fees and other incidentals. Is this normal? It's sort of worth it to me if they can get me approved because of my sketchy past where others wont do much to get me approved.

Simply put are these programs fees the norm and how much do the other places do to get you approved for surgery?

Edited May 25, 200818 yr by mariem
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LOL, AZChick..... Yes, they will "arrest" you if you don't follow the rules! I like that.

Thanks for the kind words, BTW. I'm not brave, though-- just trying to get by. I don't know for sure when I'll be going back for my next appointment. Right now I'm in the process of waiting and wondering, waiting, and wondering.... remember that part? :tongue2: I'm just wanting to get through to the next phase of my journey, whatever that may be.

Do you think you might make it to the support group on Saturday?

I was originally going to go to Bridges orientation but they scared me off by telling me I needed to be on a 6 month medically supervised diet.

When I called WLIA they told me that according to BC/BS of Mass. that there was nothing stating about a 6 month medically supervised diet, (though it would be in my best interest to get to a primary care doctor and get started on a relationship with her and talk about the lap band and my goals etc) I just have to have documentation of my weight over the past 5 years. I also asked Bridges when I called when would they actually look into what was needed to be approved and they informed me they would process everything when I was done with the 6 month diet. Maybe I just need to call them again and see if I get a different answer? :ohmy:

That is what I thought about Bridges and 6 months, blah, blah.

When I finally started the process it went so quickly. Bridges did most of the paper work. I let them tell me what I needed for BCBS. Jumped through all the hoops and went to their Seminars. I was approved on the first try as Bridges had all the ducks in a row. I THOUGHT I was ready and knew all I needed to know. When I walked into St.Lukes on surgury morn, I knew I was more ready than I thought I was before the process.

I am 1 year out and and 55 pounds down. In the big picture, the getting ready is not really that long and SO important. I am glad now that I jumped through all the hoops and and have NO regrets.

Good Luck

Edited June 22, 200818 yr by judysue

EZMA,

How were the fees with Banner Gateway ? My partner and I both went today and were "CRUSHED" when we realizd our costs would be well over $5000. So we're4 postponing for 6 months till we get a few things paid down. We just relocated from MAUI so have a few debts.

any if=nfo will help:redface:

Wow that was an old post of mine!! So much has happened since then. I ended up getting Gastric Bypass from Dr Berger in Flagstaff on January 8 of this year and couldnt be happier. I am now down 87 pounds as of this morning!

BC/BS of Mass ended up being a breeze. Most importantly I picked the right surgery for me.

Good luck to everyone here!

EZMA,

How were the fees with Banner Gateway ? My partner and I both went today and were "CRUSHED" when we realizd our costs would be well over $5000. So we're4 postponing for 6 months till we get a few things paid down. We just relocated from MAUI so have a few debts.

any if=nfo will help:redface:

I had NO fees with Banner Gateway... my insurance picked up everything.

Granted, I had my psych evaluation done elsewhere, and that cost me $200 (I never got around to submitting the out-of-network paperwork to my insurance, otherwise they would have covered most of that as well).

But as far as I know, Banner Gateway does not have any "program fees."

Your insurance (or you, if you're self-pay) pays for all the required tests, and the procedure (including hospital facility fees, surgeon fees, anesthesiologist fees, etc).

Their support groups are free.... and they should be able to write you a prescription for the gym... so even if your insurance won't cover it, you can write it off on your taxes as a medical expense.