gatzpup

A little summary of how I got here: March 07 I went to an information seminar. I filled out forms, had required testing done, saw lap band doctor in August 07, and after much frustration with the office staff (took them forever to get my paperwork to insurance), I finally got my denial yesterday, 2/1/08! I have Humana insurance. On the phone, I was told by the dr. office that I was under 40 BMI, and my only problem was hypertension, which is controlled by meds. I also do not have a doctor-supervised weight loss (which I was told early on this was not necessary). I have tried many different programs over the years, but nothing that my doctor has notes on. My hypertension IS controlled by meds, however my dosage has been doubled since I started it and realistically, I'd like to be able to quit taking it! I also have high cholesterol and am beginning to feel pain in my feet and knees. This stuff is only gonna get worse. I honestly feel like having this surgery will cost insurance less in the long run. I will be getting a denial letter in the mail and it will describe the appeals process. My PCP is a personal friend and has been very helpful during this process, so I'm sure that will continue with the appeals process. Do any of you have any advice? It's been a long frustrating experience, but I'm not going to give up. During this year of waiting, I've even gained more little weight! Any advice will be appreciated. Thanks!

I can't remember when, exactly, I started this process. I think it was around Feb/March when I went to the information seminar. In August, after having my sleep study, I finally got to meet my surgeon in a short office visit (the actual visit was nothing compared to the amount of time I spent in the waiting room). During that visit, the nurse gave me a list of required testing that had to be done before my info was sent to insurance. However, my surgeon (Dr. Allen - Louisville) told me that it wasn't necessary - he said I could get all of them done, none of them done, or some of them done. The only thing is that the anesthesiologist could decide he wanted one done and it could hold up my surgery. My primary doc and I decided we wouldn't have them done. Dr. Allen told me to call his office if I hadn't heard from them (on whether or not insurance had approved me) within 30 days. So, around mid-September I called only to find out that they were waiting on me to do the "required testing." I told them what Dr. Allen had told me and they said that was not correct! It sounds like they need to have a staff meeting there! Anyway, my primary doc arranged for me to have lung tests, an ultrasound of the legs, an ultrasound of the heart, and more blood tests. I got them all done in one day. The results were sent a few days later to Dr. Allen's office. After a while, they called to let me know they were missing two things: a letter from my pcp stating that I have been alcohol/tobacco free for 1 year, and my electrocardiogram results. She also wants proof of 6 months doctor supervised weight loss - she said it wasn't absolutely necessary, but would certainly help my case. OMG - - - this is driving me crazy. I do not have notes to support doctor-supv weight loss. I have canceled checks for weight watchers, nutrasystem, and a personal trainer over the past 3 years. I didn't keep any paperwork from these things, because I didn't know I would need them. I'm about to loose my mind. I am right at 35 bmi and was told not to loose any weight since I was so close. That's not been good for me - as I've been eating whatever I want and have probably gained 5-10 pounds. This, combined with the weight I've gained previously, has caused me to continue to feel bad - hips hurt, feet hurt, etc. I am so ready for this process to be over and to start on my lap band journey. I have kept leaving messages for Celeste at Dr. Allen's office to find out where we stand, and I've not heard back yet. If you're still reading, thanks! I know this is a long message, and that I'm probably not the only one who is frustrated during this stage. I only hope that I get approved by insurance after getting this far (and spending the money I have spent so far).

I've been reading this forum for the past several months and thought I'd introduce myself today.<br /> <br /> Early this year, during my physical with my doctor (who is also my personal friend), she suggested I look into the lap band surgery. I was surprised she suggested it, because I never thought I would be a candidate for it. I am 37 and my weight has fluctuated from 210 to 225 during the past few years. <br /> <br /> After her suggestion, I decided to go to an informational seminar (April '07). I've been going thru the process ever since (I barely qualify). After lots of paperwork, a visit with a dietitian, nurse, and counselor, and a sleep study (to confirm what I already knew - I do not have sleep apnea), I finally get to see the surgeon (Louisville - Dr. Jeffry Allen) on July 27.<br /> <br /> Can anyone tell me what to expect from that point? I don't think my insurance has even approved this yet. Hope I've not gone this far for nothing!