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

Seeing family Doc Tue. to start the ball...



Recommended Posts

Seeing family Doc Tue. to start the ball rolling. I know I can get lap-band I have a 61.5 BMI! My Ins. (I called last week) will pay if Doc deems it medically necessary. Do you have any advice that may push this along. Information I may need to help it go faster, like a list of diets I have tried (and failed). Doc knows my medical issues. I have decided I want this and I want it now! I need to save my own life and this is the first step! :(

Share this post


Link to post
Share on other sites

Seeing family Doc Tue. to start the ball rolling. I know I can get lap-band I have a 61.5 BMI! My Ins. (I called last week) will pay if Doc deems it medically necessary. Do you have any advice that may push this along. Information I may need to help it go faster, like a list of diets I have tried (and failed). Doc knows my medical issues. I have decided I want this and I want it now! I need to save my own life and this is the first step! :(

In my opinion you should draft your letter prior to your visit and ask your pcp to place it on their letterhead. Of course tell them you are doing this for bariatric clearance/surgery..I had no problems. This is what I did and it benefitted me greatly. Here is a link to a sample...I included diets such as Atkins, sugar free, low caloric intake, raw foods, etc and was approved no problem

http://www.drwizman.com/PDFs/med_letter.pdf

Share this post


Link to post
Share on other sites

IF I had to give you advice it would be to go to a seminar and keep track of every single paper. I started a folder specifically for my lapband papers. At the seminar they gave me a specific paper to give my pcp for every visit during the six month supervised diet. They also bring the 2 different lapbands so you can feel them touch them and maybe decide which you want. I think that you wont have any problem, but the seminar will educate you to the little details that can get you approved by the insurance comp or denied and if you want to get this done fast, then go to the seminar and schedule your psych consult. You will be surprised the amount of respect the surgical doc's office will give you when they see that this is important enough to keep on top of every step of the way!!

Share this post


Link to post
Share on other sites

Thank you so much for the words of wisdom. I will do anything it takes.

Share this post


Link to post
Share on other sites

document EVERYTHING!!! Tell your doc to write down everything that you can think of. If you have back pain from the weight, your feet hurt, sleep apnea, anything at all. Do you get rashes from a hanging belly? Anything like that. The more you document the better off you are.

Share this post


Link to post
Share on other sites

yep - ditto!

I made up a chart of my weights, dates and diets and outcomes --- showing how I'd lose 50 and then gain 60. I think that helped my 5-year history thing cuz duh, when I lost 50 pounds my BMI wasn't over 35 anymore.

list anything and everything you can. My PCP wrote a letter based on my insurance requirements, showing how I met each and every one of them. Then it was sent to my surgeon with my chart included with my medical file (I gave it to PCP) and my surgeon wrote a letter. I'm not exactly sure what he wrote (I would love to see it myself actually) but they faxed it to BCBS on a Friday and BCBS sent out a letter the next Wed of approval.

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

    ×