I am in Rogersville, TN (Hawkins Co.) and wanting/needing to be banded. My doctor admitted that the nurses usually know more than him as to who is good. The nurses at my doctor's office suggested Dr. Kapplan in Kingsport. I haven't heard anything about him. The only local doctors I have heard anything about on this forum are Drs. Watson and Hodge in Johnson City, TN. My doctor also mentioned a surgeon in Chattanooga, but didn't give a name yet. That is a little far for me, but I'll go wherever I need to get the best care. (Heck, some folks go to Mexico from what I'm reading.) If anyone has any advice to offer, please let me know.

Thanks in advance!

Have you started your 6 month Dr. supervised diet yet? I know that my insurance requires it and my Dr. told me that she believes he also requires it before surgery. I just started mine last week so a long way to go I guess. What are you taking with you to your first appointment? I am taking a list of the high blood pressure medications Ive been on from my pharmacist and copy of my bank statements for the past year showing that I've been enrolled in Weight Watchers. Do you have any other suggestions? I just want to go in as informed as possible and I want to do and say the right things to insure that I get accepted. Are you a self pay or will your insurance cover it?

Hi Jessica,

I'm also a patient of Dr. Kramer. I had my first appt. with him on 9/12. You will need to take all of your medications in original bottles. Also, you will need your driver's license (proof of ID) or other photo ID, and of course, your insurance card (unless you are self pay). And they require a $150 program fee which is due at the first visit.

Dr. Kramer didn't mention anything about requiring a 6-months pre-op diet. (My insurance company does require this). I'm reading through the manual they gave me when I attended the Lap Banding class last week. I'll let you know if they mention this as a requirement.

Bottom line, research what your insurance company requires. I would suggest doing this before your first appointment with Dr. Kramer.

Good luck, and let me know how you like Dr. Kramer and his practice.

Dee

Edited September 28, 200817 yr by excarolinagirl
deleted reference to online questionnaire - see subsequent post

I should have mentioned this before:

Once you have your appointment with Dr. Kramer, his office staff will send you a packet of information including a link to an online website. You will be required to fill out an extensive online questionnaire about your diet history, medical history including family medical history, etc. Also included in the packet is a "sleepiness evaluation" form that you will complete and fax back to the office. The paperwork took me about 45 minutes to complete.

I have UHC, and I believe mine will be covered. I called and all the insurance lady would tell me over the phone is that my policy does cover bariatric surgery when deemed medically necessary and that I would need a letter stating the medical necessity from my physician. She wouldn't tell me any other requirements. I'm not assuming that there aren't any other requirements just because she didn't mention them. She may have just not mentioned them to me specifically. I'd say the requirements may vary from person to person.

Excarolinagirl, do you still have to pay the $150 if your insurance covers it? I'm taking it that you do since you mentioned that you have insurance. That is something that I didn't expect. My insurance is really good, and I've never had to pay anything more than $50 to go to the ER. Even when I had my gallbladder removed, I only had to pay $50 for the whole surgery and hospital stay and everything. I'm in grad. school so money is tight right now, but I'll do what I have to do. I am ready to get on with this.

Aivey,

The $150 program fee is NOT covered by insurance.

Other charges are $39 for the nutritional eval if you pay same day. If you choose to be billed, the nutritional eval fee is around $60. A lot of insurance companies don't pay for the nutritional evals.

The psych eval is covered by my insurance so that won't be out of pocket.

Check your insurance policy to see if the nutritional and psych evals are covered.

Dee

Thanks for all the info. espeically the "hidden cost" that we should expect. I am just trying to be as informed as possible before I actually walk into his office. I have one other question that you all may not be able to answer. My bmi is between 36-37. If I drop below 35 during my pre-op diet will that make me inelligible for the surgery? I am willing to start working hard now to start the process of getting the weight off if I think it will help but I don't want to do anything to risk being told no to the surgery. Any advice about this? Can I be upfront about this question with Dr. Kramer?

Jessica,

I have a relatively low BMI also (38-39) and in addition to the 6-month pre-op diet, my insurance company requires 10% weight loss (although someone from Dr. Kramer's office said they don't always hold fast to that requirement.) Losing 10% will put me in a "borderline" BMI for WLS, probably around where you are starting.

Dee

I would definitely address this question with Dr. Kramer.

Edited September 29, 200817 yr by excarolinagirl

Just wanted to say that I had the lapband surgery by Dr. Watson on Jan. 14, 2008 and have been very pleased with Dr. Watson, the staff and surgery results. He did not try to talk me into having the gastric bypass. I have had 3 fills and Dr. Watson answered all my questions at each visit. I am scheduled for another fill in Nov., but I feel I have reached my sweet spot so I will just wait and see if Or when I need another fill. Good luck to everyone in the Tri-Cities area.

Jessica,

I just re-read your posts and saw where you have a 5-year medical history of "uncontrollable" hypertension. Be sure and mention this to Dr. Kramer. This might be considered a co-morbidity factor that would qualify you for the surgery despite your low BMI.

I have osteoarthritis which is listed as a co-morbidity factor by my insurance company.

Again, be sure and check your insurance policy before your appointment with Dr. Kramer.

Dee

Do you ever drink liquids at meals? This has been the hardest thing for me to stop doing. Just wondering if anyone has had success with weight loss and am still able to drink some liquids at meals.

Lotstolose,

Congrats on your success!

Dee

Lotstolose,

You might try posting this in also in one of the other forums "Post-Op Questions." I am not banded yet so I can't answer the question.

Good luck.

Dee

Thanks. I'll try that.

Just wanted to say that I had the lapband surgery by Dr. Watson on Jan. 14, 2008 and have been very pleased with Dr. Watson, the staff and surgery results. He did not try to talk me into having the gastric bypass. I have had 3 fills and Dr. Watson answered all my questions at each visit. I am scheduled for another fill in Nov., but I feel I have reached my sweet spot so I will just wait and see if Or when I need another fill. Good luck to everyone in the Tri-Cities area.

How did you feel about Dr. Watson's bedside manner? What I have heard about this is why I didn't opt to see him. How was his staff? Did it take you long to get an appointment with him? What is his program fee? I'd like any information you're willing to provide.

I was very pleased with Dr. Watson's bedside manner and his staff. I have heard several people say that he is much more friendly and has a better bedside manner than Dr. Hodge, although Dr. Hodge is also an excellent Dr. I have BC/BS of TN insurance and I had to pay I believe it was $400.00 initially because BCBS had not approved the surgery. After the surgery was approved, I got a $300.00 check back from Dr. Watson's office. I payed $12.00 to the Psych Dr. that insurance did not pay and that was ALL I had to pay. My insurance payed for everything else, hospital bill, being put to sleep, everything. I was very fortunate. It did take a while to meet all the insurance requirements, like going to my PCP monthly to be weighed, showing that I could lose 10% of my body weight in 3 months but could not keep it off.... so I had to lose some weight and then gain it back. Anyway, after I had met all the insurance requirements which took about 8 months from my first office visit, it took another 3 months to get a surgery date with Dr. Watson. If Dr. Hodge had been my Dr., I could have had it done in about 3-4 weeks. Does this say anthing about Dr. Watson's caseload and bedside manner. I think so. I had the surgery on a Monday morning at JCMC, came home Tuesday evening and went back to work in 3 weeks. I could have probably gone back to work in 2 weeks, but enjoyed being home. Have had no problems with the band, no problems with vomiting and have been able to eat all foods. I do have to eat slow, or it feels like it is stuck in my chest, but goes away soon. You do learn to eat slowly and chew, chew, chew. My weight loss has been slow, but I have always heard you keep it off better when you lose slowly. Good luck.