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I am so happy :-)

Cigna approved my lap band surgery Hip Hip Hooray! I am going to meet Dr. Spaw at Baptist Hospital on February 26. I cannot wait :smile:

By the way, I have to be on liquid Protein diet + one lean cuisine meal for 2 weeks then 4 liquids diet (no solid) for the week before surgery.

Any advice on which Protein Drink will not make you hungry that much? What I need to prepare before I see the surgeon and the dietitian?

Any recommendations is greatly appreciated.

Thank you,

Alisa

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Well I do not have any answers for you.....but congrats!!! I live in Knoxville as well, I am just starting this process with Foothills Weight Loss Clinic in Maryville. I really only knoew of two places that did it, there, and Parkwest. Who is Dr. Shaw? I would love to chat with you along the way! Good luck, post of your progress! Jodi

  • Author

waynes6,

Dr. Spaw is at Baptist and I just had a chance to meet him last Thursday. He seems really nice and down to earth. He went over the surgery with me and show me the picture (inside the stomach). He went through all my question and was not in a hurray at all. I also met the dietitian and also got my surgery date. They wanna do it on March 17th but since i need to rearrange babysitter for my 3 kids, I chose March 31st.

I also have to do some pre op testing too. I have to swollow barium and they wil x-ray and see if my stomach is leaking and if the barium passes through ok or not. I need to have blood work done all before the sugery day.

Has the insurance approve you yet?

I will definitly keep in touch with you. :party:

Alisa

Wow! You only have a month to wait!! I am not approved yet, still gathering records and stuff, we have Aetna. My first visit with the doc is 3/10. I am curious, how did you choose your doc? Mine was $$ pretty much. They seem to want the least upfront fees, times are tight around our house! 26 days and counting for you!! Jodi

  • Author

Jodi,

My surgery has moved to April 7th now since i have no one to help my husband with my 3 little monkeys :)

The reason why I picked him was because I have 2 co worker that went through him, they loved him and he has been doing lap band the longest in the group. I work closed to Baptist Hospital too so that is a plus.

I started my journey since June and just got approved last month. I been through all the requirements and the only reason that I got it is because I have sleep apnea. I just found out I have sleep apnea in Jan 2009. if the insurance did not approve me, I would not be able to have it done. I have 3 little boys (ages 4, 3 and 15 months) at home to take care of too. I thought about Mexico since it cost half of what they charge in the US and Dr. Ortiz suppose to be the best; however, I still have to come up with $8,100 that I don't have :tongue2:

Do you know what Aetna's requirement is? If I can help you in anyway, please let me know.

Alisa

:tt2:WOW, three kids, I have one girl, age 8, she is enough for us! Aetna's requirements are a BMI over 40, no co-morbitities, or 35+ with. I am unfortunately at around 44. So I just need a phych eval, supervised weight loss for 3 or 6 months, not sure what determines that, and a 2 year history of obesity. That is where I am struggling, as with a lot of overweight people, I rarely go to the doc., frankly, I am very healthy except the weight. I think I have 2007 covered, but not 08. Got any suggestions? Maybe I have 06 too.

Looks like you can start spring off right with the surgery! Thats a lot of $$ out of pocket!! I am hoping for less than three. Maybe I am way off base! There is the 750.00 program fee, then our ins has a 2000 max out of pocket. Are there other costs I need to know about!? My hubby will croak! :) Jodi

  • Author

Jodi,

I don't mean that I have to pay $8,100 out of pocket. Cigna approves me and I only have to pay co pay for the surgery and co pay for each fills. The $8,100 is the cost in Mexico, which is half the cost in the US.

About your weight history, did you get your physical check up last year? I mean female check up, if so, you can use the weight there too. What about weight loss center like Weight Watch, Jenny Craig, LA Weight Loss, if you attends there at one point in time, you can use the weight there. If you have the 2006 one is great, just gather all the info as much as you can, if you miss out one year, there should not be any problem. If you go to the doctor this year for something, don't forget to let them weigh you so you can have 2009 weight.

If you want to know what your requirements are, call Aetna and asked for the requirements and don't forget to ask the name of the person you talk to.

BTW, my psych evaluation cost me $225 , yep, my insurance does not cover at all. Does your pcp supports you? If not ask the weight loss center to recommend you the doctor that has been doing it for a long time. For me, my pcp does not support me, so Baptist reccomend me to see Dr. scales, i went to see him for 6 month and he wrote me a reccomendation letter.

What is the program fees?

Talk to you later,

Anissa

Thanks for the info, I really did not get weighed period in 2008, guess its a by product of my embarrassment over letting myself get to this point! I will try and figure something out between now and then I guess.

About the program fees, they are for pre-op appointments, nutrition counciling, maybe some Vitamins, basically a money maker for them I think. I checked with Parkwest, they said their fees are around $3000, so I figured I was getting off way easy at $750. Do you have any of these fees? Maybe I should check with your doc. Both Foothills and Parkwest said that all of those "fees" were not covered by insurance, ...ever. Hmmm, maybe I should check on that. :unsure:

We are not required by our insurance to pick a PCP or have a letter of recommendation or or referral from one, so I just never have gone to any one doc for a long period. Thanks for all your help, in retrospect, I guess I should have!

Talk soon, Jodi

  • Author

Jodi,

Here are the fees that I’ve paid so far.

1) Co Pay to see the pcp for 6 months total $120 (I have to do the 6 months weight management thing per Cigna)

2) Psyche Evaluation $225

3) Pre Op co pay $30 (specialist), I got to meet the surgeon, talk to the nutritionist and it cover the pre op testing and all.

4) For Vitamin, per the surgeon, I bought the over the counter one and that is it.

Try to call Baptist one and see what they said. Here is the number 284-2400.

Let me know what they say.

Alisa

Dumb question.....that is Baptist in Knoxville? I called the number and it said I needed an area code.

  • Author

Jodi,

If you want me to call and get info for you (since it is a long distance), please feel free to let me know.

Alisa

Ya know, that would be great, I am stuck at work until 6:00 where I cant make long distance calls. I am assuming they close at around 5:00, then its the weekend. Do they have weekend hours in the ofice by chance, if so I could call tomorrow, if not I would really appreciate you doing that, thanks again! Jodi

  • Author

I am leaving in about 2 mins. Leave me the info and I'll try to reach them, if not, i will do it monday.

Thank you so much!! We have specifically Aetna POS II.

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