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This! This is what I found when I was trying to 'check off' that I met all the requirements and yet at my appt with my bariatric surgeon yesterday they said CIGNA REQUIRED SIX MONTHS OF BACK TO BACK VISITS WITH A NUTRITIONIST and they MUST be sequential back to back visits or you start over!!!???? I have a year of supervised medical weight loss with my primary dr, a BMI of over 50, pysch eval clearance letter, even letters from other dr's like ortho's who said my knees must be replaced but I need to be at a BMI of 40....and yet I was told that Cigna didn't care about the supervised weight loss. They want me to meet with a nutritionist for SIX MONTHS to do WHAT? I AGREE I need to see a nutritionist although nutrition was always the topic of discussion with primary dr.....but for SIX MONTHS? That's a more rigid requirement than the weight loss and I worked on the weight loss for a year as I wanted to be very sure of things. Why do we get so many different answers..I have Cigna 90/10 plan (I pay extra for higher coverage as I usually am in hospital for 2 weeks every other year...why keep paying a 50K to 100K hospitalization bill for me when we can treat SOME of the underlying reasons and keep me OUT of the hospital?). I'm afraid to even call them. My bariatric surgeon is experienced...not sure about his staff as I just met them and he is building out a new office so they are co-sharing office space with an OB-GYN (like that wasn't uncomfortable)...should I call CIGNA myself or let dr handle? I really am now feeling leery of his staff
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Please Read page 6 of the Cigna Bariatric Surgery cover document. On that page it explains in detail why the office is making us go through a six month nutritional evaluation by a physician or registered dietitian. I know it is frustrating but we must follow the rules, so Cigna can pay for our surgeries.
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A success (6 month check up at 7 months) w/pictures
Meryline posted a topic in POST-Operation Weight Loss Surgery Q&A
So I had my 6 months check up at the hospital on Thursday, 1 day before 7 months. I saw my surgeon who could not be more thrilled with me. I have lost 82% of my excess weight. (which is a little strange as I have lost 91% of what will give me a normal BMI) They don't want me to loose too much more weight as I'll start to look sickly. They don't think I'll need any plastics, as I don't have an over hang and my blood results are great (the doctor at my support group will probably disagree. All my values are within range, but some are in the lower end, and since she is a specialist on supplements for bariatrics, she prefers us in the upper range). They also have a score that they calculate, that I don't remember, but it was very high, and she called me a success case. I don't go back until my 1 year check up. (I'll just have blood drawn in 3 months and show my support group doctor) They were actually fully booked for the BIA test, but the surgeon wanted med to have one, so she called and asked if they could fit me in, and they could. They are done by the nutritionist. She was also very impressed when she saw me, and after the test she could not be happier. I have the values for all 3 tests (1 month pre op, 6 weeks post op and 7 months post op) I managed to gain another 4 lbs before starting my pre op diet, so it wasn't at my very highest. The only negative thing was my phase angle. It has dropped. It's a measurement that shows how well your muscles are getting nutrition. That along with my total protein (from the blood test) she wants me to eat more, and get more protein. Other than that, everything was great and she was so impressed, especially how much muscles I still have. All the working out and walking has helped tremendously. I have included pictures from about 6 months and 7 months post up. It's only like 5 lbs between the pictures, but I see several changes.- 41 replies
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Forest Park Medical Center - Dallas, TX
TexasT replied to Carrie's topic in Weight Loss Surgeons & Hospitals
My situation was different as I was a revision from band to sleeve, but my revision cost was $5000. Plus I had my gall bladder removed at the same time, which my insurance paid for, so the OR and anesthesia costs were covered by insurance. Dr. Barker also did my lap band, and I did NOT have to have a sleep study or psych evaluation before it. I did have to have a cardaic clearance from a cardiologist though before both surgeries. I know you need to get an idea of the cost, but please don't base your decision solely on price. Dr. Barker is an excellent surgeon and VERY experienced with all types of weight loss surgeries. We're lucky in the Dallas area that we have quite a few experienced bariatric surgeons to choose from. There is no reason to go to someone that hasn't done hundreds or even thousands of procedures if you live in our area. Be very choosy and ask lots of questions when making your choice. -
Taking Prescription Pills after surgery
BLERDgirl replied to Remove All Doubt's topic in POST-Operation Weight Loss Surgery Q&A
That's something you need to clear with your bariatric and primary. It will depends on your levels. -
So my journey begins.....
GigiLane replied to qmissy824's topic in PRE-Operation Weight Loss Surgery Q&A
Hi @@qmissy824 i, like you, am also just starting my journey. My appointment is 8/2 I'm in Florida. I'm looking forward to starting the process and seeing what the bariatric surgeon says. Keep me posted on your appointment. Hopefully we will both be on the same timeline. Are you going through insurance? Sent from my iPhone using the BariatricPal App -
How would you have reacted?
Sosewsue61 replied to EsoKev's topic in PRE-Operation Weight Loss Surgery Q&A
It may have been a 'left-handed' compliment of sorts - that you appeared mobile and healthy enough to do weight loss on your own. It wasn't that long ago that bariatric patients needed to be a lot larger than 40 bmi to even be considered. You are not likely to have any more interactions with this nurse. -
This will not be helpful, but I do have my first appointment on Thursday and I've got Aetna POS II so I'll see what they say and try and let you know. I do know that it's either or for the 3/6months plans and the bariatric clinic I will be using does the 90 day program. So I don't know that it's a choice, more so that the office decides the route they take or prefer you take. Sent from my Nexus 6 using the BariatricPal App Just had my appointment today, it's a choice. I chose the 90day which will really be 4mo I guess because of the way the appointments have to be staggered. Sent from my Nexus 6 using the BariatricPal App
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This will not be helpful, but I do have my first appointment on Thursday and I've got Aetna POS II so I'll see what they say and try and let you know. I do know that it's either or for the 3/6months plans and the bariatric clinic I will be using does the 90 day program. So I don't know that it's a choice, more so that the office decides the route they take or prefer you take. Sent from my Nexus 6 using the BariatricPal App
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Anyone in San Diego, California?
The Candidate replied to NinaB's topic in PRE-Operation Weight Loss Surgery Q&A
My program was called Options and is through Kaiser Permanente. It took nearly a year, including 24 weeks of classes and having to lose 10% of my weight. Having waited so long it's kind of surreal that I'm finally so close to my surgery date! I actually live in North County, but Kaiser, in my particular area, contracts out to Pacific Bariatric in SD and all bariatric surgery is done at Scripps. I am only required to do one day of liquids. I think that might be because of already having lost the 10%. But it does make things easier. I feel exactly like I did when I first made the decision to have surgery, in equal parts elated, nervous, hopeful, eager, and above all else, happy. As I've never had surgery I'm, of course, a bit apprehension about the unknown from time to time. But I am 100% certain that this is the right step for me. And as I've overloaded on research this past year, I honestly feel I couldn't be more ready! How about you? What led you here and how are you feeling? ???? -
I have my first appt on Wed. MyChart says it is 30 min with the Bariatric surgeon. It doesn’t seem typical that my first appointment would be with the surgeon and it seems like most of you had longer appointments your first visit. Is this weird? Maybe I’m just getting nervous.
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I was kind of horrified that I had to tell my surgeon’s office this. Seems like something they should know, given how many bariatric patients have thyroid issues and take biotin.
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Unfortunately, it took a serious health scare (my heart stopped in ICU) and my mother and father in-law passing from cancer to take my heath seriously. I had the sleeve done June 2014. High weight 254 day of surgery 234. I’m maintaining in the 130’s. There is no secret to bariatric weight loss. Follow your plan. Learn the basics. log in an app, hydrate, exercise/activity. If you gain call your team. Never be afraid to ask for help.
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Hi everyone. I just want to introduce myself to the group. I am gogogirl....lol I am presleever. This journey is starting and ending with God. I have Kaiser Permanente Insurance. I made the decision to have the sleeve less than a month ago, was able to get a doc appt the next day and was refered to bariatrics that day. I just had my Options orientation session, my body analysis, and my first class over the last couple of days. I am about 3 weeks in and have gone through the first 2 hurdles. As far as I can tell, there are 4 with Kaiser on their part. The next 2 are getting a referral from my Options Instructor and then the O'k from my surgeon who I have not picked yet. I have my choice of 3, one of which received Surgeon of the Year so I think he will be my pick. I dropped about 5 pounds before my initial official weigh in and officially have dropped 2 since my start of Options. I need to lose 10% so let's just say 22 pounds to be considered for the surgery, as well as making all of my classes, doing all of my labs, and whatever else they ask me to do. I got this. To think this is the LAST time I will have to do this without the edge of the sleeve is giving me a great deal of resolve. Anyway, Hello everyone. Please stop by and say hello and introduce yourself. I am not telling too many folks in my circle so I hope to make a new one here.
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Yep, I said it, my life sucks. I had my surgery January 24th, 2011 and the surgery itself was uneventful, the few weeks after, uneventful as far as I can tell. The rest has been DOWNHILL. In a nutshell, I feel like crap, I wanna cry, I have no energy, my sense of taste is disgusting, and I am feeling serious regrets right about now. Yes, I have lost 59 pounds, but if it's at the price of not feeling well and healthy, I really don't know that this was all worth it. I have been to see my general doctor as I had my surgery out of the country, and she has tried to do as much for me as she can. I had a barium swallow and it showed that everything is passing through my system as it should, but also that my stomach is VERY small. I am at the end of my rope as is my doctor so I have been referred to a local bariatric surgeon who deals with people who have had surgery out of country. Sadly, it has only been a week, so I have not heard anything from them. In the meantime, I am now nauseated when I wake up in the morning. Instead of feeling better, I almost feel like things are getting worse. I had a point where I was angry, now I am just heartbroken and just do not know what to do anymore. I pray every night that this will pass because this is no way to live I can tell you that. If there are veteran sleevers who have walked in my shoes, please feel free to respond cause I could use all of the kinship I can handle right now. BTW, I am depressed, I am on meds and this is not depression caused. I wake up each day hoping it will be better than the last, and occassionally it has been a better day, but for the most part, I have not been so lucky. Being that this is irreversable I need answers, being that I have a full-time job, a husband that is having trouble with how I am feeling and a family that is worried sick about me - these issues need to be resolved sooner rather than later. Thanks for listening e
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Esophageal spasms.
Wheeler5051 replied to fredgood's topic in POST-Operation Weight Loss Surgery Q&A
I am so sorry to hear about your troubles. That is no good! Is there any other Bariatric Surgeons in the area that you could possibly see to get a second opinion or at least someone who deals with the lapband on more of aregular basis? It is a shame that you have to deal with people ( although they are healthcare professionals) that do not have a great deal of knowledge about the band. It't almost unfair disadvantage to you. Good Luck, i hope they can help you without loosing your band! -
Anyone going through Kaiser permanente?
msrereb replied to Mel13's topic in General Weight Loss Surgery Discussions
the So Cal Kaiser options class is now 12 weeks, 3 months. i finished it back in early October. hadnt made up my mind to have surgery....until this year. I spoke to my bariatric Dr and asked her to schedule me to see the surgeon. He scheduled me for a month out! and ive been on 1200 cal diet since then. down 12 lbs. i'm 9 days away and trying liquids every other day til then. -
Surgery yesterday, went great! I was very uncomfortable for the first 2 or so hours after, mostly due to morphine drip. Once they switched me to different pain med I started doing much better. Up and walking 4 times yesterday, first thing this morning, no trouble drinking, discharged at 9:00. Dr Hoehn and everyone at KC Bariatric and the surgery center were amazing!! Very attentive and kind. I would recommend them to anyone even close to that area!!
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From Kansas City and hoping to use Dr. Hoehn at KC Bariatric in May.
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Today is my birthday and it has just been the best birthday in a very long time! This time last year, I was beyond miserable. I did not like myself, I was sick and I was probably close to depressed. This year, I have lost 47 pounds since 1/14, I'm starting to fit into my "skinny" clothes, and I'm starting to feel like I'm actually in some kind of shape! I have no regrets. Part of me wishes that I would have started this process last year. By now I would be at my goal! But I realize that I had a journey to go through to come to this decision and if I would have done it too soon, I may have not been successful. In April & May, I worked out 18 hours and 17 hours, respectively. Assuming roughly 4 weeks in the month, that is over four hours a week. I'm feeling pretty good about that! Let's see if I can top both months in June! My favorite achievement so far is that I have made it out of the Morbidly Obese category! I'm now merely Super Obese. Regular Obese...here I come!!! :thumbup: At my current rate, I would be in spitting distance of Overweight! However, I will not be dissatisfied with any result as long as I'm doing the best I can and I'm going in the right direction. As I believe I have mentioned before, I plan to jog a 5K in September. My progress is not as I would hope. I did jog 1.25 miles on Thursday, but I was unable to do so either Saturday or Sunday. I just couldn't seem to go longer than 3 or 4 minutes. Hmmm... Tomorrow I'm getting a fill. I had hoped that I wouldn't need one but I get hungry after about 2-3 hours and I seem to want to eat quite a bit more than the prescribed amount. I feel sure I haven't stretched my pouch or anything, so I probably just need a tweak. I'm always cranky the day of my fill, so I decided to just take the day off. It will be a good day to go get my drivers license renewed. Nothing like being cranky at the DMV! Every 4th of July weekend, I visit my friend's family in Louisiana. Right now, I'm about 25 pounds lighter than I was last year. I would love to lose about 10 pounds in June so I would be about 35 pounds lighter. I think that is quite doable. A. I have my fill tomorrow which always jump starts my progress. B. The last 3 weeks in June I'm scheduled to Jazzercise twice and be with my trainer twice each week. C. After 5 months, I'm still motivated!! I feel quite sure that has never been the case for me. Next Monday it will be time for picture updates and that is always fun!! Hope you all have a great week!
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I have UHC PPO plan. It covered 80%. I had an approval letter in my hand 8 days after my appointment with my surgeon. No other doctors were involved. I was amazed. Coverage depends on your specific plan is. Call them and ask specifically, "is bariatric surgery covered on MY plan?" I did that and they said yes, for my particular policy. I automatically thought it would NOT be covered when I reviewed the UHC web site. So glad I called them. Good luck! Pam banded 3/24 by Dr. Speigel down 15 pounds....
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That's unusual for UHC, they are well known for approving bariatric surgeries. It's entirely possible however, that your employer requested this omission of coverage. It's not unusual of employers to do this to reduce their premiums. Check with your HR department or whoever it is that handles the insurance for your company. I am currently on Medicare myself, due to disability, and I purposefully chose UHC as my HMO because of their positive attitude towards all of the bariatric surgeries. Good luck, hope you can get things turned around in your favor. I wish you all the best. You may also want to check out the Insurance boards on here and see what other people have encountered with UHC and other insurance companies. Cindy
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Please Help Tough Question
bbrecruiter2000 replied to bbrecruiter2000's topic in LAP-BAND Surgery Forums
Hi, Busywoman: I have always had group insurance (through a company) where there are no underwriting guidelines. If you were to lose your job and could not find another before your group insurance expires (which is my case) then in order to have health insurance you would have to buy an individual plan since you were no longer part of a group and no longer had an employer. I am self employed and my husband has always worked for large companies IBM and Motorola. Both companies are self insured and pay the bills but use a network like Humana or CCN PPO to administer the plan and provide the network. My present situation is that my husband is no longer employed, our insurance is running out and I need insurance. COBRA is an option, but the premium is at 102% of the normal premium that the employer formerly paid for my group plan. It means I have to pay it myself. For my family of 4, the monthly premium is $1,400 dollars. The only folks that would want COBRA are people who cant get insurance because they are considered high risk. Having any kind of bariatric surgery within 10 years excludes me from most plans. That is why I am asking for help. Someone here who is self employed or pays for their own insurance may have the answer I am looking for.... Babs in TX -
Sounds like a trip back to the doc is in order and for sure follow up with your bariatrics doc. No need to be in that much pain for that long. Even a really bad UTI should feel better after 3/4 days on meds. Good luck to you, hope you get some relief soon!
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Not about the patients...really
Mikee57 replied to monkeysnana09's topic in Weight Loss Surgeons & Hospitals
My surgeon did the first fill (he operates on Thursdays and Fridays) he has a bariatric clinic that does the rest of them, but they don't do them on Fridays either...only unfills if needed. I think most places are set up like this...the only thing you can do is ask for an exception to the rule...or like you said work around your husbands schedule. So sorry to hear about his health issue...I will keep him in my prayers okay...monkeysnana09!!! Take care!!!
