AKessler731

I am scheduled for Nov. 16th :w00t: I start the Pre-op on Nov. 2nd, pre-op labs the same day, pre-op with the surgeon on Nov. 11th. I am so excited. I feel like I wont the lottery since this is 100% paid for by my insurance. I know that I need to be so thankful since this is a surgery some people pay out of pocket for, and trust me, I AM so very thankful!! Good luck to all my fellow November Bandsters!

I am SOO excited!!! I just called to check the status of my insurance approval and was told I was approved and they gave me my approval number! Whoo Hoo! lol I called my surgeons office but they were out to lunch. Now, I just have to get it scheduled. I have a "dummy" date of Nov. 16th which is what they gave my insurance company but the girl at the dr's office said that could change. So I will be calling later on today to find out if I can get a "in stone" date! My paperwork was submitted last thursday, exactly one week ago. So 5 business days and I'm approved. I feel like I've won the lottery because as long as I can get it done before Dec 31st, then I wont have to pay anything for this surgery, it will be covered 100%! Anyways, thanks for listening, I just got so excited!! :wink2:

Thank you!! Good luck with your bands as well :w00t:

How long after they received your paperwork did they approve you? My paperwork was submitted on Thursday...now I'm doing the waiting game and it sucks!

I have United Health Care Choice Plus, my process was fairly easy. But I was so anxious to get my surgery done before the end of the year because my deductible and out of pocket was already met for the year so it will be free. So I wanted to make sure everything was covered. I called the center and asked them what I could go ahead and do and the girl told me the dr requires two support group meetings before surgery. I Did one before the info session. They schedule them like every two weeks or so and I didn't want to have to wait for another one. So I did one of those, then the info session and the other support group before I even got to meet the surgeon. After the support group i went to see my PCP and got a referral, even though it wasn't required, got my letter of medical necessity (even though the ins only required the letter of medical clearance) and I got the letter of medical clearance. My PCP required me to do labs and a sleep study to get the clearance. Then I had to do nutrional counseling and a psych exam (both required by the surgeon) and an information class (also required by surgeon). And I think that was about it. My paperwork was submitted to ins on last Thursday, I called today and they are on step 3 of 5 so he said give it a couple more days. Ins only required: BMI of 40 or 35 w/two comorbidities, letter of medical clearance. And thats about it. No supervised diet, no history. Good luck! I have heard UHC is the easiest to work with! Oh Ya, and the surgeon required an upper GI

You can look up samples on google. I had to have one of these too. Basically its just your dr explaining to the insurance why he thinks you should have this surgery. Any medical problems, how long he has been treating you, different weight loss attempts. I have a bmi of 44 also, I'm sure your dr. would be on board.If not, do you have another dr you could go to to get it?

I called UHC to make sure my dr. submitted my paperwork for approval and it was! They have my date of service for Nov. 16th! I thought "Thats great! They have me down for a date!" So I call my Dr's office to make sure before I schedule my time off from work and I tell her what the insurance lady told me. She said "Oh no, thats just a dummy date. After we get your approval we will call you with a date." Does that happen alot? How likely would it be that I do actually get Nov. 16th? I think they did that so that its more than 30 days incase my ins takes that long but from what I've read, UHC usually doesn't take long at all. Do you think they would schedule it sooner? Either way, I'm very happy to be on the right road

Hi Everyone! I was in the October board but I think I'm looking at a November date now. My surgeon only does his surgeries on Tuesdays. My paperwork will be submitted to insurance tomorrow and i figure to give it a week or so for approval, then I have to do my two week diet. So I'm really hoping for November 2nd! I have United Health Choice Plus and didn't have too many requirements. I didn't have to have any 6 month diet or history to submit so that was nice. I started this process on 8/21 and today I finished everything I was supposed to do (which it was the upper GI today). So, I figured I would join over here since it's most likely going to be November for me. My name is Amanda. I'm married to my husband for a little over 2 years, David. I have two girls. Serenity is 4 and Scarlett is almost 6 months. I'm 25 years old and I'm SO ready to get this done!! I wish you all the best and look forward to sharing our experiences! :tongue2:

Hey! I have the same insurance and my husband also works for Georgia Pacific :biggrin: We are in Rincon, Georgia. My qualifications were just about the same, only I didn't need the 5 years of medical history. Maybe because I have a BMI over 40? I'm just waiting on my Letter of Medical Necessity from my PCP and then they can submit mine for insurance approval. I have my pre-op education and exercise class on tuesday (dr. required) and still have to do an upper gi (dr. required) and then its just a waiting game! Good luck to you! :crying:

Is anyone else a little concerned about this? At my Psych evaluation yesterday my therapist gave me a few photo copied articles out of OH Magazine (obesity help) and it was talking about how when people get wls and lose the addiction to food, the addiction transfers. Some of the women starting having a shopping addiction, one started smoking, one started drinking, ect. I also learned that as a child of BOTH parents having been alcoholics I have a 90% chance of having a drinking problem if I were to ever start. Luckily, as seeing what jerks my parents could be when they were drunk, drinking has never been my thing. But What one of the girls said really caught my eye. She said having been almost 300 lbs when she went out she never wanted to dance or anything but she got down to 135lbs she felt beautiful and wanted to party. I could see that. So I know I will have to pay extra attention to make sure my "addiction" is shifted towards something else. Like working out or doing something with my husband and kids. Anyways, I just thought I would share and see if anyone has an input?

I had my consultation today. We went over my medical history, took my weight, height, measurements. He gave me my check list that I have to get done before submitting for insurance approval which is: Letter of Medical Clearance from PCP, Psych Evaluation, Nutrional Counseling, Upper GI, Pre-Op Education Class and Exercise Class and two support groups.. The good news? I'm almost done! Ive done everything except for the Education Class and Exercise class and Upper GI. Im doing the two classes on the 28th and I just have to get my upper GI done and thats it! I'll be all done and waiting on insurance approval! I will have to do the two week pre-op diet so I'm trying to figure out which one will be the cheapest shake to buy. But anyways, I just thought I'd update you all! :biggrin:

I have my consultation with the surgeon tomorrow. I was told that my surgeon requires me to do 2 support groups (done), attend the seminar (done), psych eval (also doing tomorrow) and the nutrional counseling (also doing tomorrow). My insurance United Healthcare doesn't really require much except to have a BMI of over 40, I do and a letter of medical clearance and of medical necessity (i have a call in to my pcp for both of those.) So, the receptionist said that the appointment usually lasts about 2hours. Can anyone tell me what to expect tomorrow? I'm all jittery but SO excited!!:rolleyes2:

Did Most of you get a "tentative" surgery date the first time you went to see the dr? I'm wondering if that's what they will do for me? All they need to be able to submit for an approval from my ins is the medical clearance and medical necessity letters and hopefully they will have those within the next couple of days.

Personally, I would have the hysterectomy done first. It sounds like that is medically necessary and the band is something that could wait a month or two if need be. Good luck :rolleyes2:

I talked to my insurance coordinator yesterday and she said after I do my Psych visit and my nutritional counseling all I still need to have is my Letter of Medical Necessity and Letter of Medical Clearance from my PCP. I went to them and got a referral so I thought that took care of all that but I guess not. I called and left my dr a message about this and one of his nurses called me back and said she would "get it taken care of". I'm guessing they send that over to the dr? Any advice on this?

Hi Everyone! I'm new to the thread. I have my consultation is Thursday 9/23 @ 8:30am, Psych Eval @ 11:00am and Nutritional Cons. @ 2:30pm all in one day :thumbup: I talked to my insurance coordinator today and she said all I need now is my Letter of Medical Necessity and a Letter of Medical Clearance. I have a call into my PCP already so I'm waiting to hear back now. I have United Healthcare and am so excited. My insurance approval requirements were so easy. I didn't have to do the 6 month diet or anything like that. I'm hoping to have a surgery date of around 10/20. My mother in law watches my girls and she is having surgery on 10/4 and needs at least 10 days down time before I can rely on her to help me. I am SOOO looking forward to this! Good luck everyone!!

I haven't heard anything about that... so I dont know.. Sorry!

Was the 6 month diet required by your insurance or your surgeon? My insurance doesn't require it but I'm afraid that the surgeon might...I'm hoping to get the surgery done before the first of the year since my out of pocket max and deductible have both already been met this year, my surgery wouldn't cost me anything. I have already done 2 support groups, the info session, my 1st meeting with the surgeon is scheduled for next thursday and my psych eval is the same day :thumbup: I'm glad it went good for you though!

Hi everyone. I first called about a consultation a few week ago after I finally made up my mind that I want/need to have this surgery. I was told that the dr requires me to go to an information siminar first. The first one is Sept 1st (this wednesday). I asked if there is anything I need to do in the mean time to get the ball rolling, she said the dr requires me to do atleast 2 support groups before surgery. I did one on 8/21 and I'm doing the second one right after the information session on 9/1. So I will have both of those done. I have already called to get my medical record from my dr (which they want to charge me almost $50 for!). I have already called my insurance and I have UHC Choice Plus and I had just had a baby in April so my $500 deductible and my $2,000 out of pocket max has already been met. If I can get this surgery done before 1/1/11 It will be covered 100%! The only requirements from my insurance was a BMI over 40 of a BMI over 35 with 2 co-moralities. Well my BMI is 44 so thats covered. I asked if I was required to do any lenght of a supervised diet and she said no. I guess my question is what is your opinion on whether I might be able to get this done before the first of the year? I'm so ready to get this done, Ive been fat my whole life and I have never really experianced being slim. I have two daughters and a loving husband who I need to be healthy for. I have PCOS also and that just makes it harder. So what are your opinions?

Thanks everyone. Do you all know does the dr usually require anything that the insurance doesnt? Like the psych consult and the losing a percentage of body weight...are those usually things the insurance makes you do or do just some dr's do it on their own?