Jaidah000

HI I joined forum today. In November 2012 I started my journey...my insurance required 9 months with a medical doctor for weight loss efforts. I completed it and all other test and clearances by August 2013. I didn't hear anything for about 2 months. I tried to contact the clinic and all they kept telling me was the person over the department had to review my file and send it to insurance. Called my insurance and they said it only take maybe a week for approval BUT no one sent then anything. Frustrated, it seemed when I called the clinic to get some direction people avoided my calls and began not being as friendly as they had been before. Now, I wasn't calling a lot and I even told the redeptionist I understand workers are busy and things take time I just wanted to know a time limit..1mth...3...6..before my paper work is submitted to insurance? Everyone who has been through the process knows for insurance it is time sensitive because after a certain amt of time I would have to start my 9mths all over again. Then one day the receptionist said well you need to speak with the coordinator she has some questions...ok 2 mth later and you are just telling me this? At this time I had postponed starting a new position because I couldn't miss any days during my 6 week training. Left a message for coordinator to contact me..stil nothing I had to start my training. In my 3rd week of training she finally called me at 8am in the morning and she wasn't friendly at all. I was told that since I had gained weight during the 9 mths that they need me to do another psych eval which I was cleared before. They all knew I was seeing one of their doctors for weight loss using phentermine which I lost 22lbs in 3 mths 20 in the first 2 mths. I had gained 10 of those back during the last 7mths being off the meds and by law you can't be on for more than 3mths at a time. This has been my weight loss struggle for over 20 yrs I would do well on some meds until the effect wore off and although still trying weight over the years would creep back on plus some. We all know that story. I was very upset that it took them 3 mths to get in touch with me to tell me they wanted another psych eval and my insurance company was stunned as well they even said "It is proven that usually people who take meds for weight loss regain some if not all and more weight back after the dosage has stopped". I was not happy...I am ok with the waiting process as long as things are moving forward but it was the disregard I felt that made me uncomfortable. So I thought if it is this hard to get and answer and the feeling I was bothering those who are suppose to help...how will my after care be? How will the surgery go? One lady in one of my nutrition classes said her April 2013 surgery was postponed due to sergeon not being available and it was July and she was still waiting for a new date. So I called another hospital OSU Medical Center. They scheduled me for intake. I met the coordinator first who was very nice and gave me a lot of information on what she will be doing for me during the process (she will handle paper work for insurance) and same day met the nurse who went over all my options because they do all 3 surgeries at OSU (I stuck with lapband) and after her met with the nutritionist. They received my paper work from the other clinic and if all goes well all I would need to do is 4 weeks of nutrition with OSU (once per week) and meeting with the surgeon because everything else hopefully is done. They did their own lab work on me but will accept all my other clearances. I felt comfortable and at home at OSU. Crossing fingers that I can get approved and maybe surgery before the summer. I will finishing up my degree in April this year as well! woot woot lol Looking forward to the support this forum offers & future banding friendships. ~Blessings

Hello All, I am new to this forum and wanted to comment on this topic. I would suggest contacting your insurance to find out what their requirements are. When I spoke with my insurance contact person she was very nice and informed me of what their requirements were for submission to get approval for the surgery. She also told me that if medically needed skin surgery after bariatric surgery was covered too. The hospital I am with had a form with questions for the insurance I needed to fill out with my insurance reps answers which was very helpful. She also told me the time it would take for them to review the information. A lot of what you are going to go through depends on what your insurance requires. There are lab test you will have to have as well as medical clearance from Pulmonary and Cardiac Specialist as well as a Psych Evaluation all of these your chosen hospital for the surgery will go over with you. If anything shows up that is a concern believe me they will make sure you have follow up appointments. You will also meet with their nutritionist to go over dietary things with you. Some places require you to go to support group meeting which I had to. As most said ask questions and research the surgery yourself to make sure you have all the information needed. A lot of stories I have read or videos I have seen where the person had issues with their band or wasn't as successful as others was due to the fact they weren't following the guidelines. However, to be fair there are some who follow but for whatever reason had a issue. Don't become overwhelmed with the test and appointments, classes, support groups etc needed to fulfill what your clinic requires because it is all set up to help you be as successful as you can be after surgery. The more informed you are the better. I am looking forward to the support from this forum ~Be Well~