chsricha 0 Posted September 28, 2011 First of all this is an amazing forum with so much information to read. I've just joined this and this is my question/dilemma and I hope someone can help me understand. I have a BMI of 36 and I have sleep apnea. I'm in the bay area and have already attended a seminar and met with a surgeon at Palo Alto Medical Foundation. I'm getting married in February and I wanted to get banded asap so I can lose some weight and also heal in time. However the earliest PAMF will operate on me is 3-4 months - and that's because of the mandatory 3-4 dietician sessions which are spread a month apart. Is the requirement of a dietician driven by insurance? I have Cigna PPO and I am trying to figure what are my options - if I lose some weight naturally by Dec or Jan (which is when they'll schedule me for surgery), i would have gone below the 35 BMI limit and not qualify for insurance. I've seen a lot of folks on this forum who only waited a month between their first surgeon visit and the actual surgery - are all those self pay options? Even when i enquired for self pay - PAMF tells me that I still would require the dietician session. Can anyone suggest what I can do to get a surgery sooner than that? Thanks and very much appreciated! Share this post Link to post Share on other sites
CrisM 0 Posted September 28, 2011 Hello, Have you called your insurance and verified the requirements? I have Blue Cross and I went I went to my originally chosen dr. for the surgery, they told me I had to talk to a dietician for 6 months. Well, it turns out that it was completely false. I only had to see the dietician once and now I am schedule for surgery in two weeks with a different surgeon. That's why I suggest you call you your insurance. I know that there are some insurance companies that do require 3-6 months of speaking with a dietician. Have you tried other weight loss through other means? Such as Jenny Craig, Weight Watchers, etc? If so, do you have it documented? Because then you can appeal it and show proof that you have tried loosing weight, and sometimes they will accept that and won't require you to see the dietician. Best of luck to you and congrats on your wedding!! Share this post Link to post Share on other sites
chsricha 0 Posted September 28, 2011 Hi CrisM, Thanks for your response - as it turns out - the insurance doesnt even say anything abt having to meet with a dietician. It seems to be a requirement of the hospital that I am working with - even when I asked them about the self pay option - they tell me I still need to see the dietician. I've tried HMR - which a dietician supervised diet and I do have that documented. The surgeon that you chose for your banding - was he/she part of an outpatient facility - such as a hospital? Thanks! Hello, Have you called your insurance and verified the requirements? I have Blue Cross and I went I went to my originally chosen dr. for the surgery, they told me I had to talk to a dietician for 6 months. Well, it turns out that it was completely false. I only had to see the dietician once and now I am schedule for surgery in two weeks with a different surgeon. That's why I suggest you call you your insurance. I know that there are some insurance companies that do require 3-6 months of speaking with a dietician. Have you tried other weight loss through other means? Such as Jenny Craig, Weight Watchers, etc? If so, do you have it documented? Because then you can appeal it and show proof that you have tried loosing weight, and sometimes they will accept that and won't require you to see the dietician. Best of luck to you and congrats on your wedding!! Share this post Link to post Share on other sites
CrisM 0 Posted September 28, 2011 Yes, because I live 10 minutes away from the hospital it will be an outpatient. Sorry you are having such trouble with this. Have you tried looking at other hospitals? You may have to drive far. The place where I am going they have patients from other states come and have the surgery. Because they come from so far they stay a day or two at the hospital. I hate to incovenience you, but this may be an option for you. As far as I know they only speak with the dietician once. Hi CrisM, Thanks for your response - as it turns out - the insurance doesnt even say anything abt having to meet with a dietician. It seems to be a requirement of the hospital that I am working with - even when I asked them about the self pay option - they tell me I still need to see the dietician. I've tried HMR - which a dietician supervised diet and I do have that documented. The surgeon that you chose for your banding - was he/she part of an outpatient facility - such as a hospital? Thanks! Share this post Link to post Share on other sites
chsricha 0 Posted September 28, 2011 CrisM, Do you mind sharing the name of the hospital/surgeon? Thanks again! Yes, because I live 10 minutes away from the hospital it will be an outpatient. Sorry you are having such trouble with this. Have you tried looking at other hospitals? You may have to drive far. The place where I am going they have patients from other states come and have the surgery. Because they come from so far they stay a day or two at the hospital. I hate to incovenience you, but this may be an option for you. As far as I know they only speak with the dietician once. Share this post Link to post Share on other sites
CrisM 0 Posted September 28, 2011 I just sent you a message with the info, you should see it somewhere in your profile. CrisM, Do you mind sharing the name of the hospital/surgeon? Thanks again! Share this post Link to post Share on other sites
kristenaz 0 Posted September 28, 2011 Since I did self pay I was able to have surgery within 3 weeks of my first visit with the surgeon. I was told that self-pay patients go to the front of the line. My doc required me to see the dietician once and the psychologist once. Good luck! Share this post Link to post Share on other sites