ShellShock

So I checked my insurance company website and confirmed that my surgeon and the hospital I am going through are both in-network. When I called they explained that according to the paperwork that they received it was listed as my going to the Center for Weight Loss Surgery and that it was out of network. I talked to Kay the billing person at the surgeon’s office and she said they pulled this information from an old record and didn’t bother to change the information to St. Francis Hospital which was written on the form. So they are supposed to change it and send me another letter in the mail. She also straightened out the authorization dates to the correct surgery date. Kay thanked me for keeping such a good eye on my paperwork. I have to say that everyone needs to read the invoices and all letters when it comes to insurance or bills from the doctor. I always pay attention to what I get because there are always mistakes. I have had to call and fix things more than once and the end result meant I didn’t have to pay the amount that I was billed for. Kay has so many people to do this for that I am sure she can’t catch all the mistakes. The out of network percentage that I would have to pay would have been 30% and the out of pocket year maximum is $2000. So I would have had to pay a lot more considering I have already met the in network out of pocket maximum of $500.

So I checked my insurance company website and confirmed that my surgeon and the hospital I am going through are both in-network. When I called they explained that according to the paperwork that they received it was listed as my going to the Center for Weight Loss Surgery and that it was out of network. I talked to Kay the billing person at the surgeon’s office and she said they pulled this information from an old record and didn’t bother to change the information to St. Francis Hospital which was written on the form. So they are supposed to change it and send me another letter in the mail. She also straightened out the authorization dates to the correct surgery date. Kay thanked me for keeping such a good eye on my paperwork. I have to say that everyone needs to read the invoices and all letters when it comes to insurance or bills from the doctor. I always pay attention to what I get because there are always mistakes. I have had to call and fix things more than once and the end result meant I didn’t have to pay the amount that I was billed for. Kay has so many people to do this for that I am sure she can’t catch all the mistakes. The out of network percentage that I would have to pay would have been 30% and the out of pocket year maximum is $2000. So I would have had to pay a lot more considering I have already met the in network out of pocket maximum of $500.

Getting banded September 30th!!!!

Tomorrow is the 1st day of September and that means 30 days till surgery!!! I am a bit worried though. Not because of the surgery but because I got a letter from my insurance yesterday that said that I was approved but through "Out-of Network" since the Center for Weight Loss Surgery was not in Network. This is crazy! The surgeon is one of only three on their list of approved surgeons for bariatric surgery in Washington state and the hospital is on their list. How the heck could the surgeon's office not be on the list??? And why didn't the insurance lady at their office tell me this when she called me. Today is Sunday and tomorrow is a holiday so I have to wait till Tuesday to call anyone. It might be a mistake. I have gotten two letters that said denied but I was warned by the center that I would get those and not to worry about them. I have to check my insurance but Out of Network won't be that bad I suppose. I don't remember what percentage I would have to pay but it will just cost me more. I actually met my In-Network out of pocket already this year so everything is getting paid 100%. I was just hoping I wouldn't have to pay anything. Another thing that was mentioned on the letter was that I was pre-authorized for September 15 and 16th. I don't have surgery till the 30th. What happened is that when my paperwork was submitted the weight loss center put in a surgery date of september 15th so that it would get approved faster but now I have to explain to my insurance that it is not on that date. Hopefully that is just a quick fix of telling them and that is that. I just don't want my surgery to be jepordized because of this.

Tomorrow is the 1st day of September and that means 30 days till surgery!!! I am a bit worried though. Not because of the surgery but because I got a letter from my insurance yesterday that said that I was approved but through "Out-of Network" since the Center for Weight Loss Surgery was not in Network. This is crazy! The surgeon is one of only three on their list of approved surgeons for bariatric surgery in Washington state and the hospital is on their list. How the heck could the surgeon's office not be on the list??? And why didn't the insurance lady at their office tell me this when she called me. Today is Sunday and tomorrow is a holiday so I have to wait till Tuesday to call anyone. It might be a mistake. I have gotten two letters that said denied but I was warned by the center that I would get those and not to worry about them. I have to check my insurance but Out of Network won't be that bad I suppose. I don't remember what percentage I would have to pay but it will just cost me more. I actually met my In-Network out of pocket already this year so everything is getting paid 100%. I was just hoping I wouldn't have to pay anything. Another thing that was mentioned on the letter was that I was pre-authorized for September 15 and 16th. I don't have surgery till the 30th. What happened is that when my paperwork was submitted the weight loss center put in a surgery date of september 15th so that it would get approved faster but now I have to explain to my insurance that it is not on that date. Hopefully that is just a quick fix of telling them and that is that. I just don't want my surgery to be jepordized because of this.

Hello. I just moved out of King County and over to Kitsap County but it really isn't that far with the ferry. I am getting banded on September 30th by Dr. Srikanth in Federal Way. I would love to meet up with some people or keep in touch through e-mail. I have been watching the boards for a while learning everything but until you do it, it just isn't the same.

I am scheduled for September 30th!!! Yay!

My surgeon recommends 90 grams of protein during the liquid stage then down to 60 when you are solids. Though my nutritionist wants me to stay at 90 grams or more. This is supposed to be in addition to anything that we may eat. I was surprised to hear the nurse say to us at the nutrition class I had to attend that she didn't care if we didn't eat anything at all and only did shakes as long as we are getting the 60-90 grams of protein a day.

My surgery is Sept 30th. I just make the cut off to call myself a September Samurai.... (At least all of you will be done by then and I can learn from you) Since it is a Tuesday I plan on taking the rest of the week off then with the weekend I will have 6 days off. If I have to take more I will, but I would have to take LWOP. Besides my co-worker would freak out if she had to do more than four days without me.

I want to be able to ride a gondola at the Venetian in Vegas with my boyfriend and not worry about the boat being lopsided or tip over. Or go horseback riding at the ocean and not be over the weight limit. Also, not have to ask for the seatbelt extension on an airplane.

I have been thinking about my "last supper" now that I have a date (Sept 30th). I don't think I will go all out but I do love pizza. I think I want a slice of pizza and a beer and I will be good. Though... Soda. Everyone says I won't miss it but I will be a little sad to give up diet coke. I just enjoy it once in a while.

I used to come to this forum and read for hours. Things have just gotten so busy. With the last five months of my diet I have gone up and down. Oh the stress… In the middle of it all I had to worry about moving and for some reason I thought we should buy a house. What a silly idea that seems to me now. I am no where near financially stable for that. But we will get there. Anyway… my diet was rocky. I didn’t have a structured… eat this and don’t eat that kind of diet. I was given suggestions by my nutritionist and was supposed to have my protein shakes three times a day. Every time I weighed in at my doctors office I pigged out the next day. Don’t do this! It just made me want to cheat more then soon I gained at the next weigh in and wasn’t able to get back on track. The big thing was that I wasn’t exercising. I can make excuses since I worked an hour away and there really wasn’t enough time in the day, but I could have made time. Eventually I got really tired of the protein shakes. I just really hate making them. I have the magic bullet, tons of shaker cups and a battery operated stir cup. They don’t help me want to do it. I would primarily do it at work and having to wash the dishes immediately afterward just deters me from doing it at all. Yes, I am lazy. July was my 6th month of the diet and didn’t lose any weight. I had my last doctor’s appointment and asked them to submit the paperwork. It took a week and three phone calls for them to actually fax it all in, the same with my nutritionist. Luckily they all got it in and the surgeon’s office faxed it in to the insurance company on August 14, 2008. Exactly one week later on August 21, 2008 I got a call from the surgeon’s office. The lady said I was denied but only because they were missing some paperwork and I should not freak out when I got my letter in the mail. She faxed the missing stuff that day. Then on Monday, August 25, 2008 I called the insurance myself to see if they got everything they needed to make their determination. The lady said I was approved. I was so excited!!! I called the surgeon’s office and scheduled my surgery date for September 30, 2008. I cannot wait even though there is such a big change ahead of me. I have to get back into the right mind frame. I have just been so lazy and gluttonous. Today at the department BBQ, I had two desserts then just a little while ago I went back to the kitchen and stole some cookies. Ugh! I feel so blah…. I know when I shouldn’t eat certain things or at least a lot of it and I do anyway. My boyfriend doesn’t understand this. I have tried to explain it before but he just doesn’t know because he isn’t overweight like me. I know the band is a tool and I really do want to use it properly. I do believe that when I am banded I won’t waste this opportunity. I know I can be serious and lose weight. It will happen. I just believe the band is how I am going to keep the weight off.

I used to come to this forum and read for hours. Things have just gotten so busy. With the last five months of my diet I have gone up and down. Oh the stress… In the middle of it all I had to worry about moving and for some reason I thought we should buy a house. What a silly idea that seems to me now. I am no where near financially stable for that. But we will get there. Anyway… my diet was rocky. I didn’t have a structured… eat this and don’t eat that kind of diet. I was given suggestions by my nutritionist and was supposed to have my protein shakes three times a day. Every time I weighed in at my doctors office I pigged out the next day. Don’t do this! It just made me want to cheat more then soon I gained at the next weigh in and wasn’t able to get back on track. The big thing was that I wasn’t exercising. I can make excuses since I worked an hour away and there really wasn’t enough time in the day, but I could have made time. Eventually I got really tired of the protein shakes. I just really hate making them. I have the magic bullet, tons of shaker cups and a battery operated stir cup. They don’t help me want to do it. I would primarily do it at work and having to wash the dishes immediately afterward just deters me from doing it at all. Yes, I am lazy. July was my 6th month of the diet and didn’t lose any weight. I had my last doctor’s appointment and asked them to submit the paperwork. It took a week and three phone calls for them to actually fax it all in, the same with my nutritionist. Luckily they all got it in and the surgeon’s office faxed it in to the insurance company on August 14, 2008. Exactly one week later on August 21, 2008 I got a call from the surgeon’s office. The lady said I was denied but only because they were missing some paperwork and I should not freak out when I got my letter in the mail. She faxed the missing stuff that day. Then on Monday, August 25, 2008 I called the insurance myself to see if they got everything they needed to make their determination. The lady said I was approved. I was so excited!!! I called the surgeon’s office and scheduled my surgery date for September 30, 2008. I cannot wait even though there is such a big change ahead of me. I have to get back into the right mind frame. I have just been so lazy and gluttonous. Today at the department BBQ, I had two desserts then just a little while ago I went back to the kitchen and stole some cookies. Ugh! I feel so blah…. I know when I shouldn’t eat certain things or at least a lot of it and I do anyway. My boyfriend doesn’t understand this. I have tried to explain it before but he just doesn’t know because he isn’t overweight like me. I know the band is a tool and I really do want to use it properly. I do believe that when I am banded I won’t waste this opportunity. I know I can be serious and lose weight. It will happen. I just believe the band is how I am going to keep the weight off.

How do I get the September Samurai Signature?

My Surgery is September 30th!!!

My surgery date is September 30th!!! I can't wait.

I finished my 6 month diet in July. I lost some weight the first two months then gained in the third went down a little in the fourth then back up again in the fifth and no change in the sixth. In the end I was down 10 pounds total. I know I could have done better but my nutritionist was more concerned with my getting healthy than losing weight. We submitted my paperwork on August 14th and I got my approval today!!! So don't fret! I got an initial denial but only because they were missing some info, so make sure they have everything required and you should be fine.

I am doing a six month diet also, but I have Cigna. Find out from your insurance exactly what they require because everyone is different. You are probably okay with just your doctor but make sure they are writing 6 month physician supervised diet in the notes every month, what you are doing to lose weight and that all vitals are documented.

I really like Champion Whey.

I have a regular blender and I recently purchased the Magic Bullet. Personally I have to recommend the Magic Bullet or at the very least something that will do smaller portions than a regular blender. After you are banded you will be making smaller portions that it will just be a paint to wash the entire blender when you could only be washing a small cup. Besides the Protein powders taste the best with only 4-5 ounces of Water, even if you add other things. What I like about the magic bullet is that you get more than one cup. Sometimes I just don't want to immediately wash it and just put it in the dishwasher and pull out another one for the next shake. As far as the plastic rings that you will need to replace on it, it comes with four or five extras and I have a friend that lost hers and called the company and they sent some for free. If you don't plan on crushing ice or fruit then you don't even need either. You can get stirr cups that mix the powders with water in seconds that cost $12. I got one from the Vitalady. (Vitalady.com - Protein supplements, Vitamins & Minerals, and Safe Snacks!) Those are nice for work and easy to clean.

StacyM, I am like you. I don't eat meat but I do eat seafood. "Amy's" brand is great for Soup. I they have lots of vegetarian ones like I just found one called "No Meat chicken Noodle Soup". I haven't tried it yet but all of the ones I have tried are wonderful. They have it at trader joes and also safeway and fred meyer in the organic section. I am still doing my 6 month diet but will stock up on that one for my pre and post op diets. Don't be scared of telling your surgeon that you don't eat meat. I told mine and was surprised to find out he and his whole family were vegetarians. So it can really benefit you because they will be able to tell you what you should be doing to get all of your Protein in for those first few weeks. You might also try a nutritionist. They can give you a specialized diet just for you. Good Luck!

To be safe, go to your PCP and have them document that you are starting a six month physician supervised diet. Then each month go back and make sure they do all of your vitals, weight and put they it is for the six month diet. That is all my doctor has been doing. I never got a form for them to fill out. I believe you can do anything to lose weight as long as your doctor documents what you are doing. If in the mean time someone calls you from your insurance then great, if not then you already started and you haven't wasted time. Though I would call and ask them again what the details of their program is. If you don't get an answer you like ask for it in writing or call back. I seem to get different answers each time I call because they are too lazy to look it up. Good Luck!

I am currently doing my 6 month physician supervised diet. You need to see your doctor before you start the diet and each month during it for documentation. Make sure they write down that this is why you saw them. The insurance will want to see all vitals and your weight on the paperwork too. At the end you will submit seven visits to your insurance. Cigna paid for my Psych Eval and my Nutritionist visit. The nutritionist is complicated though, they have to bill it a certain way for them to pay for it though. I had a problem at first and when I explained that it was a prerequisit for the surgery they approved it. Don't let the customer service people throw you off track. I have called them a dozen times to verify my insurance to make sure things are covered and that I am doing this right and each time I call I get a different answer. So you need to ask for their policy for bariatric surgery in writing and read it yourself. As far as weight loss during the diet. My surgeon requires us to lose 10% before surgery so that is my goal during this diet. I have asked every person I have spoken to at the sugeon's office and the nutritionists office and they all have said that even if you lose during your diet the insurance will look at your starting weight and BMI from your first surgeon's visit. Some insurances even require you to lose or they won't approve you. I don't think cigna has they rule though. Good Luck all!!!

I went to the Vitalady in Puyallup, WA and tried a bunch of different kinds. If you are in Washington I would recommend that. Or you can go to their website and purchase different samples. I really liked Champion Whey the best. The chocolate was great. I found that only adding 4-5 ounces of water made it taste the best. Sometimes I will add some coffee or SF flavors to change things up.

I approached my doctor a couple years ago with wanting to get a wls, she was against it and convinced me to not do it. At the time it turned out to be a good thing because the place I wanted to go to shortly after went out of business. But now I am going to do it somewhere else and wasn't going to let her opinion change my mind. I really like my doctor and was happy that she said she would support my decision no matter what and would help me with my 6 month physician supervised diet. If I didn't like her as much as I do I would have immediately gotten a different doctor.