diggity

My PCP came through and spoke directly to UHC. They were able to gather the correct documents and I have now been approved! My pre-op is August 23rd and surgery date is August 29th with Dr. Spiegel. :whoo::whoo::whoo:

United Health Care denieds me because of "lack of objective documentation". They cover 35 BMI or more with co-morbidities, so that isn't the issue. I have 35 BMI with Hypertension, high-cholesterol, and tons of bad family history. :help:Can anyone tell me what documentation is really needed so I can get this done ASAP?!?!? Thanks for any help!

Get your Primary Care Physician involved. They can provide the clinical documentation you need to prove that you are severely obese with co-morbidities and medically need Lap Band surgery. I'm not sure what NHI standards are though... explain? Some plans state that you must be 40 BMI or higher while others will state 35 BMI or higher with co-morbidities. Find out what the requirements are exactly. To get a straight answer call teh Care Coordination for United Health Care, 1-866-823-1807. Someone there can explain exactly what your companies stance on WLS. Good Luck!

Good news! It seems my PCP knows exactly what they need for the appeal and is faxing it to UHC on Monday. I an so excited. I really think I could have my band by the end of August. My weight has been such a struggle I can't what to be given this tool. I feel like I will have a new adult life!

Awesome Peggy1011!!! That is such good news. You have really made me feel so much better! Thanks!!!

Hello Everyone! I'm a 31 year old man from Houston looking into getting Lapband WLS sometime soon. I feel like I have tried everything. I'm tired of not feeling like myself. I haven't gotten approval yet, but am looking forward to seeing what my chances are. I have around 36 BMI and was wondering if anyone has had success getting WLS/Lapband at that BMI. I have a lot of the conditions that go with being obese; Hypertension, sleep Apnea, High Cholesterol, and definitely some self-esteem issues. I also have a fatty liver which I am not sure hurts or helps my case. I also wanted to see if there are any men out there that can let me know what the experience was like for them, though I would also love to hear from the women on their experiences as well. Seeing all of the success everyone has achieved gives me great hope this is the tool I need to make my weight loss successful. Any and all feed back is much appreciated!!!

Thank you!

Yes, if insurance denies I will self-pay, but it just wouldn't be as soon as I like. I agree and based on those health conditions my insurance may cover it. I'll just have to see at my consultation. Thanks for your response!

Not to be exclusionary, but I was wondering if there are any guys out there that can provide some feedback on their experiences with Lapband. Thanks!

My bad, I just saw that...

Has anyone experienced any problems due to a fatty liver or elevated ALTs, liver enzymes? I want to make sure I am a good candidate. Thanks!

I am curious how many of you have experienced hair loss. I have not been banded but really would like to know if this is a general problem. Thanks!

Bad news, it looks like my insurance only covers this is you have a BMI of 40 or more. I coudl have sworn when I spoke with someone early last week they said 35 or more with comorbidities...

Great, thanks for the info!

How long does it take from consultation to surgery?

HA! Good luck getting anything from my account after the cost of this surgery! :scalesno:

Hey, 5683 spells love, no? I've used it for years for my pin numbers...

Right, I guess the liver didn't get in the way at all? Good link: Fatty Liver

Maudeispam, 2 years? How have you adjusted? Did your liver issue go away?

I agree. I am going to get this done anyway possible. Thanks for the feedback everybody!

Sweet! That is exactly what I need. I think I really found my answer. Thanks!

I have friends that have said the same thing in the past, "Just stop eating as much". They also have incredible self-control. I'm not sure they understand how difficult it is. Does the band reduce your hunger significantly? That is my problem. I have dieted and worked out and lost weight, but then the hunger hits and I can't stop myself. or I get discouraged because the weight is coming off so slowly.

I have heard so many good things about him and his staff. Thanks for the response!

Awesome! I was wondering what the experience has been like for you, as a guy. Do you feel like the weight is coming off at the pace you want? Did you tell your friends about it?

I still haven't had the consult. i will have it June 27th. I would be having it with Dr. Spivak in Houston Texas. Not sure which facility.