oscarel

Hi all. I'm new posting to this forum, but I've been reading for a few months now. I'm 2 months into the required 6 month diet period now. The question I have is AIGB in Richardson is not considered "In Network" by Cigna. I'm being told that AIGB will honor the "negotioated" rates with Cigna but they will not know what that rate will be until after the surgery. I'm told the most I will have to pay is the balance of the "In Network" out of pocket costs. Now I know it's better than having to pay for the whole thing myself, but can someone shed some light as to what they actually had to pay, or what their negotiated rate ended up being? Thanks in advance. Oscar

Thank you!! I jog between 2.5 - 3 miles 3 - 4 times a week. I haven't started weights yet, maybe this week.

Thank you!! And I've done nothing different than most others. Follow the life change in eating habits and exercise. Oscar

I was at 326 when I started pre-op diet on Aug 15, 08 and 309 the day of surgery Aug 29, 08. As of a couple of days ago I'm down to 236. I'm shooting for 230 by the end of the month and then my goal weight of 220 by the end of March.

Yes, it is definately different, you have to change years of bad habits in a short time. The nurses kept stressing to practice slowing down while eating before I had surgery. Every month the first question they asked was how I was doing with it. And so far that's been the key for me to being satisfied while eating. And it's by no means easy. The first couple of weeks I was able to have regular food I had the same thoughts as most, I can eat as much as I want. But the first time I really took the time to slow down 1/2 cup or so was all I could eat. And at that point I had the initial 3.5cc fill in my band. But you will find that as time goes on it gets easier. Just be realistic with your goals. Oscar

Sooverit, it takes time. I know you've gone through a LOT to get your band as I've seen your posts. It's taken me a fill a month since Sept. to get where I am. I normally lose the first 2 weeks and then nothing till the next fill. Hang in there and keep exercising! Isn't it better to say you've lost 15lbs instead of you gained 15lbs?

I think it has to do with the air that's trapped in the stomach underneath the band. I do it all the time while eating and for a good 30mins after.

I'm not sure I agree with this. Prof. Paul O'Brien, who is one of the founders of the lapband, wrote a book that was given to me by the weightloss center I went through stated there is no set caloric intake that one needs to stick with. I've been taking in between 600 - 900 calories a day and with jogging 30 mins 3 days a week I've been averaging about 15lbs a month for the last 5 months. I do stick with high protein meals and haven't had any problems yet. His book has been an excellent source of info for my journey with weightloss. Lap Band Solution Book, Obesity Problem Solutions - Weight Loss Benefits, Eating & Exercises Info NoPBJ, I don't believe I saw where you answered the questions as to what you were eating.. This of course is the biggest part of the band. You have to stick with high protein, low fat foods just as if you were dieting. Another big one for me was slowing down. It now takes me 20 - 30 mins to finish a meal. I may not feel full, but I don't feel hungry either. Also, no drinking for at least 40 mins or so after eating.

Another thing you'll need to remember is which services are in network and out of network as they will have different out of pocket deductibles. Also, submit all your bills, as in psych and nutritional eval, as they may hit towards your OOP.

Most of it depends on what pre-op diet the doctor requires too. My surgery center waited until the day insurance appoved me then they set me up at that point. I also opted push mine out about 6 weeks so that we could make a family vacation and I could wait till the kids went back to school.

Amy, hang in there. As everyone has said we're all different and I'm sure you didn't do this for short term goals. As long as you stick to good eating habits you should start to lose. Also remember that the gym isn't the only place you can get exercise, walking outside is also good for you!! I'd much rather take a 30 - 45 min walk with the dog than sit in the gym on the bike or treadmill.

I also just got a fill on 1/16 that put me at 7cc and at first I thought I was too full. The first week I was PBing daily and had a couple of incidents with vomiting. But I've taken the time to slow down and I'm not having the problems I did at first. Also chicken and milk seem to give me problems, but fish and beef don't.

Lilbit08, I also posted in another thread you had. Check this link too CIGNA - Medical Necessity Definitions When I started the long road to lapband with Cigna my first call to them they were able to tell me whether it was covered or not. You may have to contact your HR dept. to find out if it's included. Cigna also told me they wouldn't even start to look at paperwork until you've met all the requirements, psych, 6 month diet, nutritionist. Also I had just gone for my annual physical and I told my PCP that I was looking into this for obesity. So in the paperwork for the 2 years proof of obesity it was there and I didn't need to get another letter stating it was a necessity. I personally didn't have a lot of problems with Cigna. They approved me on the first submission, within 1 week of submitting, and they paid with no questions asked. I had my surgery done at AIGB in Richardson and I'd recommend them. My surgeon was Dr. Felts, but he's not with them anymore. They took care of all the paperwork, but you will need to double check what they do... Oscar

Cigna does exclude wls by default. Make sure you call and check before starting anything, this will save you time, money and heartache. I also have Open Access and they just paid for mine. Good luck. Here's their doc in case you don't have it. http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

I'm also in Texas and I went to AIGB. Make sure you submit anything the doc says isn't covered by insurance too. For me even though insurance denied the claim it went against my out of pocket and deductibles. I have a $3500 out of pocket and $2000 of that was taken up by the sleep study, I had to do 2. And I wasn't charged anything for them by AIGB!! As for the surgery, so far insurance has payed $25K to surgery center (they submitted $45K) and $1500 to anesthesiologist. I still haven't seen the doctor's charges yet. So once it's done I should be out of pocket about $2500 for everything.

Excellent weight loss bossstar. You know during the final consult with the surgeon he also said they would unfill for "special" occasions like Thanksgiving and trips. And I actually thought that was funny because I wanted this so that I couldn't eat as much during those occassion. Don't get me wrong, I did think about it, but that's what got me into this situation. Maybe once I get to my goal weight I may think differently but now I'm wanting to get there first as quickly as I can!!

Until you start getting filled you really aren't suppose to be losing weight. The post-op diet is mainly to heal, the fills are to lose weight. Hang in there.

Are you drinking Protein shakes? My wife said I had a "smell" too and that's what it was. Oscar

Yes, farting and burping.

I was ok. I did the barium swallow before I went home. I slept in a recliner as I was not able to lay on my side. The pain medication worked great. I was also able to walk around pretty good. Everytime I woke up I made sure I walked around.

They put the IV in while I was in the pre-surgery room. As they were wheeling me into the ER they knocked me out. I woke up in recovery in what seemed like mins later, but it was like 1 1/2 hrs. It wasn't that bad. They gave me pain medication shortly after waking up and some Water to sip on. I was put under last year to have wisdom teeth removed and it was nothing like this. Oscar

Walmart sells liquid Tylenol. My doc said it was OK to alternate between ibuprofen and acetaminophen if there was pain after my surgery. And actually the nurse had to reverify and she also said it was ok. They are apparently changing their view so I would call and ask yours to make sure.

I just wanted to let everyone know that I was banded this morning by Dr. Felts and he is the BEST doctor I've had to date. I was a little worried since you only get to meet the Dr. the day before surgery but I felt very comfortable with him and his staff. Dr. Felts is a very personable guy and he has a since of humor!! They truly have a first class operation there. Also the staff at AIGB/TrueResults did a wonderful job too. They will definately get my thumbs up for referrals. Thanks AIGB and Dr. Felts!! Oscar