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Subaru

Gastric Bypass Patients
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Everything posted by Subaru

  1. Subaru

    BCBS RI requirements?

    How far apart were your NUT visits scheduled? I’m going to seriously lose my **** if this adds two months. 😳 Also, yes, I would call your insurance company once you know the drs office has submitted for approval.
  2. Subaru

    BCBS RI requirements?

    Congrats!!
  3. Subaru

    BCBS RI requirements?

    The *** were for “H M O.” For some reason the site masked that.
  4. Subaru

    BCBS RI requirements?

    Briae13, is your bcbs a PPO or an ***? I’m asking In hopes that you have an *** and that’s why you had to go to the nutritionist several times. I’m hoping I only have to do the one visit. Nobody said anything about a class, but that would make sense. What time of the day is that class on the 20th? If I have to go to one of those classes and I can squeeze getting in on the 20th, I will certainly do it! In terms of how long insurance approval takes, I have heard that it can take up to three weeks. However, I suspect that if you are proactive in following up with Blue Cross it may push things through more quickly. I’ve certainly read plenty of posts were people said it took a week or even less. I think the three weeks is their outside timeline.
  5. Subaru

    BCBS RI requirements?

    I can't think of the name of it. However, the newsletters are available on the Miriam Bariatric page and they usually list the Facebook group. I think (?) I joined or requested to join but I don't know as I've read that page or posted to it yet. Good luck!
  6. Subaru

    BCBS RI requirements?

    That's great info! In terms of required meetings, do you mean the group meetings? I don't have to do a sleep study since I've had one in the last year. According to the woman in Dr. Stafford's office, once I get NUT clearance (which I am hoping is just this one visit this week), they will submit to BCBS. Once they get approval they will schedule me for my pre-op with the surgeon (often within the same week as approval). At that visit we will schedule surgery and discuss any other questions/outstanding stuff. Between then and surgery will be the pre-op testing that you referenced, and I have to go to the several hour long pre-op seminar. (Held on Thursdays at 3:30 btw.) From the sound of things, I'm, 6-8 weeks out from surgery. Dr. Stafford also told me that the process typically takes 6 months. And then he flipped through all of the test results I'd already had sent to him and told me that since it seems I'm on top of things it would like be faster. I told him I was targeting early January and he thought that was very reasonable. When do you have your NUT appointment? It sounds like we're on a very similar track!
  7. Subaru

    BCBS RI requirements?

    Psych clearance today. NUT next week. Onward and upward!
  8. Subaru

    BCBS RI requirements?

    I did meet with him already. It's not clear to me with my program if I will see him again until just shortly before surgery. I guess I'll find out!
  9. Subaru

    BCBS RI requirements?

    That's fantastic! It's moving along smoothly so far! I see the NUT in two weeks and also go back to the psych to go over that report. Then I don't really know what happens!
  10. Subaru

    BCBS RI requirements?

    The two that I most follow are "Gastric bypass support Group" and "Gastric Sleeve Support Group." I find they can be good places to help you think through your decision, get motivation, and be part of your overall research. That said, remember that everyone's experience is different. Some people do post their horror stories. Only you can decide what is best for you. Here is what led me to the decision to go with bariatric surgery: I've struggled with my weight on and off my whole life. I have had successful weight loss attempts before. However, I am now 52 and have high blood pressure, sleep apnea, severe (though well medicated) GERD, and high cholesterol. I need another tool to aid me in this journey and I can't wait any longer for me to "get motivated." This will help force me into motivation and, hopefully, be a tool to help me stay on track.
  11. Subaru

    BCBS RI requirements?

    I've just done tons of research and made the decision before I ever went to one of the groups. (I was at the September group as well.) There are also a couple of good facebook groups where you can get decent feedback. A bit of drama in them, but overall I've found them to be helpful in solidifying my decision. Dr. V. is supposed to be very good. I have a friend going to him for a revision. I'm also trying to find out how much extra $ it would cost to have a private room at the Miriam. My ex had a private room after a kidney surgery, and that was the standard on that floor for the kinds of surgeries that folks have. I think the bariatric surgeries tend to all recover on the same floor in double rooms. But I don't want to deal with someone else's whining in the midst of my own so if it's something I can afford to do I'm looking at it.
  12. Subaru

    BCBS RI requirements?

    I'm going through The Miriam Hospital's Bariatric program. My surgeon will be Dr. Todd Stafford. I didn't choose him. When you do the online orientation and request a consult they schedule you with someone. He seems very nice! As near as I can tell, the program and Miriam and at Roger Williams are both pretty good but I have an old hatred for Roger Williams. The Miriam has monthly support groups for pre-op patients (that go toward the required visits) so you might want to check that out. It's a touch decision for sure. Good luck!
  13. Subaru

    BCBS RI requirements?

    Nothing in particular, but I'll be interested to hear how it goes. Best of luck!
  14. Subaru

    BCBS RI requirements?

    Have they given you any sense of other requirements or how long you'll have to visit the NUT? I was able to complete my psych eval in two back-to-back sessions (allowed by this insurance plan but not all I gather). I also had some homework that I dropped off the next day. The Dr. is writing my report and I'll meet with him in 2 weeks to review but then I'm done with him. At the time of my in-person visit he didn't see anything to that point to stop me from being approved. My NUT visit is in two weeks. My surgeon said after they have both signed off they submit to my insurance and then after that approval it's about a month to surgery date, with other assorted tests in between. I'm hoping for a January-ish surgery date. The surgeon told me it's usually a 6 month process but given how motivated I seemed to be (based on all the documentation I already had sent to him prior to my appointment) he thought January was a reasonable goal.
  15. Subaru

    BCBS RI requirements?

    I have BCBS PPO. When I've called they've said that my only requirement is the doctor to send over the pre-authorization request. I've called twice and spoken with 2 different people. I suspect that they have requirements for the drs office to include specific information and I'm being sent for a psych eval and to the NUT. The surgeon's office said they've never dealt with an insurance company that doesn't have any requirements. (I'm also going through the Miriam program.) As near as I can tell there is no 6 month nut requirement though. The Miriam program does require attendance at two pre-op support group meetings (minimum). I'm guessing they also require the psych and the NUT because I'm scheduled for those. And then they do additional testing after they get approval. (In my case I will not need a sleep study because I sent them results of one from last year. No endo because they have results from one and seem to prefer upper GI/barium swallow test.) Not all of Miriam's surgeons do things exactly the same way though. Dr. Ryder requires you to attend an in person orientation where all the other surgeons accept the online orientation.
  16. Subaru

    Upper gi

    Most insurances don't require co-morbidities if your BMI is 40 or over. If your reflux has been diagnosed as GERD, I believe that is a co-morbidity, as is hypertension and sleep apnea and a few others. I do not think a hiatal hernia is a co-morbidity. Best of luck!
  17. Subaru

    3 weeks away

    Two friends who have had WLS suggested I not buy or prepare too much of anything beforehand because, they said, one's tastes change after surgery and you might not be able to stomach the thought of what you have prepared. As a fellow planner that was quite disappointing!
  18. I had put off being tested for sleep apnea for years because I slept well. Others had pointed to my snoring, etc and advised I get checked out, but like you, I was adamant about not wearing a CPAP and that I slept well. Two things changed my mind: -I dated a guy with sleep apnea and got used to seeing the CPAP. It's been great for him. (And for my siblings.) -I started suffering from anxiety attacks throughout the night that would wake me up and keep me awake. They started happening during the day as well. Racing heart, sweating, everything. I'd always had low level and not frequent anxiety, but this was bad. At some point my stupid brain connected my "anxiety attacks" with sleep apnea. I suspected what was waking me up in such a state was not breathing. So I did the study at home and started with the cpap when it was confirmed I have sleep apnea. I also use the nasal pillows and they work well. The thing that holds them on your head is very loose. I did try other types of masks and determined that I could live with the nasal only if the pillows didn't work. I have read of lots of folks whose sleep apnea resolves (or improves to the point of not needing a cpap any longer) after WLS. It's one of the reasons (co-morbidities) I'm going for surgery. Best of luck!
  19. Subaru

    Optifast Flavour Samples

    I have no experience with Optifast. I would just suggest that vanilla flavor is easier to add flavors to if you don't like the taste. It's more difficult to cover up chocolate.
  20. Subaru

    RI

    Resurrecting this thread in case there are any current RI WLS patients. My first appt with my surgeon is in early October. I hope to do the VSG (or bypass depending on Drs recommendation) through the Miriam Hospital program. I'm curious to know the process with them for those whose insurance company has no pre-requirements other than doctor's approval/authorization. Hopefully someone here has experienced that and will share. Thank you!
  21. Subaru

    Anyone in RI?

    Resurrecting this thread in case there are any current RI WLS patients. My first appt with my surgeon is in early October. I hope to do the VSG (or bypass depending on Drs recommendation) through the Miriam Hospital program. I'm curious to know the process with them for those whose insurance company has no pre-requirements other than doctor's approval/authorization. Hopefully someone here has experienced that and will share. Thank you!
  22. Subaru

    GERD

    That makes perfect sense. It may well be the direction I end up going as I continue to research. The challenge for me is all this time before even meeting the dr means I just keep researching and thinking.
  23. Subaru

    GERD

    Thanks for that feedback, especially your surgeon's feedback on hiatal hernias and GI guys. Very helpful! Is your GERD well managed now, and on what medication if you don't mind sharing? Thanks again!
  24. Subaru

    GERD

    Just starting this process myself (surgeon visit in October). I have GERD which is quite well controlled with rabeprazole with limited break through episodes which are typically triggered by specific food or drink/late eating/weight gain. I don' know about hiatal hernia, except that at my last endo in 2010 I did not have one. I formerly had an esophageal ulcer which has healed. I'd prefer to do the sleeve but will, of course, consult with my surgeon and ultimately go with what he suggests. Has anyone with well controlled GERD noticed an increase in symptoms after VSG? Decrease? I've read a lot from people with GERD who, it seems, did not have it well controlled prior to surgery. Just wondering if that might make a difference. (I know we are all different. Anecdotes are helpful at this point in my research.) Thanks all! (First post!)

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