Arnie1269 0 Posted January 10, 2006 Anyone here banded at Hopkins Bayview? I am hoping to be banded by Schweitzer in March or April. I just switched insurance and am trying to get everything together to seek approval. Were you happy with the drs? What were you required to do in terms of a preop diet ?? Share this post Link to post Share on other sites
BarbaraC 0 Posted January 10, 2006 Hello Annie, Are you the fed employee that had BCBS? Juat wondering? I just changed this week have GEHA and will get the band after my 6 month diet. I have a consult set up with Dr S at John Hopkins the end of Feb. Good Luck Barbara Share this post Link to post Share on other sites
stockymd 0 Posted January 10, 2006 Hi Arnie, :welcome2: I'm not yet banded, but have a consult with Dr. Moazzez on 1/23/06 and a consult with Dr. S 2/8/06. Have you met with Dr. S yet? If so, what was your impression? Glad to have you abaord---good luck on you journey :confused: Stocky :cocktail: Share this post Link to post Share on other sites
Arnie1269 0 Posted January 10, 2006 Barbara C - Yes I am. I tried to get approval from BCBS in june and was denied. Then I immediately started the 6 mos supervised weight loss with my doc. Tomarrow is my last appointment (for the 6 mos). I hope what we've done is sufficient. Did they (GEHA) tell you exactly what should be happening during that six months ? I hope the drs notes in my chart are sufficient. I should have all the paperwork together next week... Share this post Link to post Share on other sites
BarbaraC 0 Posted January 10, 2006 I emailed GEHA and was told that I needed a 6 month diet and exercise program supervised by a Dr. I had a 4 month start but it was by a Nutritionist but then could not get another appt. She was always busy. Don't know it that would have counted. I started with a new Dr. yesterday. I will get banded some time this year. Share this post Link to post Share on other sites
Arnie1269 0 Posted January 11, 2006 Do you have the email they sent you ?? What exactly do they expect from the 6 months ? I lost a few lbs and then gained them back I think over the holidays... I am worried that I should have lost more and/or that I should have more than my drs notes... like a personal trainer or curves records for the exercise. I hope I wasn't really supposed to loose a lot during the 6 mos... I thought it was so that you could show that you couldn't loose with traditional weight loss methods... But what if it was so they can see you can committ to something... I don't know..... Share this post Link to post Share on other sites
Arnie1269 0 Posted January 11, 2006 Stocky md - yes I have met dr S - I thought he was great - very straight forward. The only thing was the prescreening his nurse practitioner meets with you first to try to answer as many questions as possible. So my meeting with him was rather short because I had already done a lot of research and his nurse answered a lot of the questions. I then went to the nutritionist and got the psych consult and all that and submitted once already in July but my last insurance wouldn't cover the band. So dr S said now I can just submit and don't need to do another consult. Share this post Link to post Share on other sites
BarbaraC 0 Posted January 12, 2006 Arnie, the emails stated the following: Bariatric surgery is covered if medically necessary. We would need your physician to send us medical records including BMI, history and physical, diagnostic x-ray, lab results, documentation of physical problems exacerbated by the obesity and documentation of 3 years dieting by normal standards without results for review. This does include either bariatric procedure, gastric bypass or lap band if medically necessary. Have you checked that Federal brochure for 2006. IT states: • Surgical treatment of obesity (bariatric surgery) is covered only if: − eligible enrollee is 18 or over, − clinical records support a body mass index of 40 or greater (or 35-40 when there is a co-morbid condition such as life-threatening cardiopulmonary problems or severe diabetes mellitus) for a period of six months,− documentation of failure to lower the body mass index by a medically supervised program of diet and exercise of at least six months duration. I think you will be OK. Hope this helps. Barbara Share this post Link to post Share on other sites
Arnie1269 0 Posted January 12, 2006 Great thanks ! I wonder what the xray is for ? Share this post Link to post Share on other sites