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I'm hopefully being banded by Dr. Terry Simpson this summer. Still jumping through insurance hoops so keeping fingers crossed. To a previous poster - Dr. Simpson takes on already banded patients but you have to pay a one time program fee. Not sure how much it is. So cool to see others near me in Bandland! :scared2:

Hello everyone! I'm in the 4th month of my supervised diet and I'm confused. My husband called our insurance at the beginning of all this and they said you have to have a BMI over 35 with 1 comorbidity. Then the insurance coordinator verified coverage and it was 35 with 1 or 40 with none. Not sure which one to believe. :thumbup: My issue is I have a BMI of 40 with none but from what my husband heard, I wouldn't get approved with this. Has anyone heard of the insurance requiring a comorbidity regardless of BMI? Thanks in advance!

GavynsMum - It did make me pause. I looked at 3 different centers in my area. All had programs fees but I admit this was the highest. However, my insurance doesn't cover the nutritionist or the psychological consult so those two would run at least $500 by themselves. The program fees for the other two centers were less but didn't include these appointments. Also, all my appointments with my 6 month supervised diet is included and I get to see the doctor every time I go...not one of these meet the doc 2 weeks before surgery type places so I'm comfortable with it at this point. Access to the doc is very important to me and if I email him (had to ask a question about my husband's liquid diet), I get a response within a couple hours. Worth it to me.

I looked into them. Dr. Robin Blackstone was the #1 Bariatric surgeon in Phoenix Top Docs 2009. I know several people who went there and had very good results. I decided not to go with them just because I wanted to meet my surgeon prior to surgery (I guess you don't meet her again after the seminar until a couple weeks before) and develop somewhat of a rapport. I also didn't feel that they would "hold my hand" through the process with the insurance and everything (and yes, I need my hand held). Also, I read some recent reviews that claimed it was taking longer and longer to get in for fills and aftercare (which in my opinion, is the most important part). I think she's a great surgeon...I just need more support. That's my opinion, hope it helps.

Just echoing what others have said. My surgeon has $1000 program fee :eek:that is due in the fifth month of my 6 month supervised diet. This includes the psych eval, nutritional consult and dietician advice for life. I would be curious as to why they require it at the first appointment...are you sure you're going with this surgeon? If you're still deciding on a surgeon, I wouldn't pay anything until you've confirmed you're going through them.

I'm doing this as well. I'm should be on Week 3 but I'm repeating Week 2 as I just don't have the stamina to move up yet. I like it so far and I'd love to be a runner! I'm also hoping this will jumpstart some weight loss (still in preband land - hoping to be banded in July). I'm hoping to RUN a 5K and then do the 3 Day Walk for the Cure in November. Here's to us JOGGERS! :thumbup:

I've heard some people on this site use the excuse of hernia repair since the surgery incisions, recovery time, post op diet, etc. are similar. Hope this helps. :thumbup:

I'm in preband land too! I'll check yours out! Mine is listed in my signature.

Hello Everyone! I hope to be banded by July...I'm in month 3 of my 6 month supervised diet. I have registered to walk in the Susan G Komen 3 Day here in Phoenix in November. For those unfamiliar, you walk 60 miles over 3 days! I have one person walking with me and we're forming a team. We are stuck on a team name. I'd appreciate any and all suggestions for a catchy team name. Thanks everybody!

I started a blog because I was inspired by other lapband bloggers. I'm also not telling many people in real life and the people who blog and read blogs seem so supportive and caring. It really makes you feel good about what you're doing for yourself. I'm still in preband land but if anyone's interested... Candyland to Bandland

Just wanted to let you know I'm keeping my fingers crossed for you. :smile2:Keep us posted!

Actually, that program fee seems about right. I checked out 3 surgeons in my area. One had a $500 program fee that basically didn't really buy me anything. :thumbup: Another didn't have a program fee but said that usually the psych consult and nutritionist appointments were covered by insurance and that would probably run me about $500. :w00t: The surgeon I'm going with (hopefully w/insurance approval) has a $1000 program fee :woot: but it includes the psych consult, nutritionist, first 3 months of fills (not sure if insurance covers those yet) and lifelong dietician help and support groups. I feel it's worth every penny if I can get this weight off. Hope this helps.

I went to my first seminar in October 2008...left feeling that it was too extreme and I could do it myself. Now, here I am in my second month of my required six month diet. :blushing:Had I just gone for it the first time, I'd (hopefully) be banded by now. But I wasn't ready then. Now, I realize I can't do it on my own and that this is the best thing I can do for myself. I've done a lot of research in the past year, so I know I'm ready for the changes the Band requires of its owner. I hope this helps. Good luck in your decision! I know it isn't an easy one...

I had a similar experience as one of the previous posters. I had an individual consultation and it was like a sales pitch. A lot of pressure to go through with it but on top of that, a lot of pressure to self pay (which was definitely not an option for us) :thumbdown:. However, if you're already approved through insurance, then that may not be a problem for you. Their doctor is listed in "Top Docs" in Phoenix, so he his credentials must be pretty good. I just didn't feel like I got a real personalized appointment there. I am on my six month diet for insurance and hope to be banded by Dr. Simpson in Phoenix. His office staff and insurance coordinator are fantastic and most of your appointements are actually with the doctor, as opposed to Scottsdale Bariatric. :eek:(To be fair, Dr. Blackstone was ranked the best bariatric surgeon in Phoenix). Hope this helps.

Hi everyone! OK...so I've done the whole seminar thing and I've got my initial consultation set for today. What happens at this appointment? When I called, they said it only takes 15-20 minutes. That seems pretty short? Any input would be greatly appreciated. Thanks!

Thank you for the info. Does your surgeon have a program fee? The one I'm meeting today does and I was hoping that included the 6 months of dieting I need for the insurance as opposed to having to pay the co-pay to my pcp. Hmmm...seems like a lot of hoops doesn't? :huh2:Of course, NOW it dawns on me that I forgot my 5 years of medical history at home! :confused: Hope they don't need it today.

A few things here. I haven't been banded yet but I can tell you I probably wouldn't be if I only had 60-70 pounds to lose. They recommend you be about 100 lbs overweight. Also, by your stats, your BMI is 36.3. Most insurance companies require a BMI great than 40 or greater than 38 w/at least one comorbidity (high blood pressure, cholesterol, sleep apnea, etc.). Some companies also require a 6 month supervised diet, psychological consult, nutritional consult, ekg, etc. Also, this is not the "easy" way to lose weight. It involves a MAJOR lifestyle shift in how you eat. If I were you, busy or not, I'd do A LOT of research before you commit to anything. Not to be mean but it sounds like you don't really know much about this procedure or the type of commitment required to make it work. Good luck to you!

So sorry you're having a hard time. :thumbup: I'm still in preband land but after reading many of the posts on this site, it seems you may out of luck. If your insurance actually has a policy exclusion saying it does not cover WLS, then an appeal probably won't help. If they're denying based on the criteria, then your doctor can probably get the decision overturned. From my understanding, it isn't the insurance company that determines the policy exclusions, it's the employer. I've heard some say their companies have an employee advocate that can sometimtes help in these situations. I'm glad your surgeon isn't giving up. Not all of them are so helpful. Good luck to you and please keep us posted!

Congratulations on your success so far! I'm hearing great things about this doctor but the program fee seems a little steep. Thanks for the info!

Hi all! I'm trying to find a surgeon in the Phoenix area and Dr. Simpson is highly recommended. However, all of the "highly recommended" docs I have found so far have pretty high program fees too. Would any of you mind telling me what kind of program fee Dr. Simpson's office charges? And what was included in that? I checked his website but it doesn't mention it. Thanks for your help!

Hello everyone! I'm calling the insurance company next week but wanted to see if anyone here has some experience with the United Health Care coverage for AZ State employees? When I looked into LapBand in 2008, they required 5 years med history, 6 month supervised diet, BMI over 40 or over 35 w/2 comorbidities. They just changed coverage this year and was just wondering if anyone knows if this is has changed? :thumbdown: I appreciate your help! Thanks!

Congratulations!! :thumbdown: I'm still preband but from everything I've read on here, the key to getting rid of the gas is walk, walk, walk! You'll be feeling better before you know it! :thumbup:

Great info! Thanks for posting!

Thanks for the clarification GraciesMom. :smile2:That was just confusing the heck out of me! LOL!

Love this list!!! - Sitting in a booth at a restaurant without worrying I won't fit! :wink2: - Not wanting to crawl under a rock when I wear a bathing suit - Not buying an extra seat on an airplane so I don't offend who's sitting next to me :redface: - Being able to chase my kids around without getting out of breath Thanks!