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Are the requirements the same for self-pay?



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I've decided to have lap band surgery. I am 5'2 181 lbs (today) with a BMI of 33.1. I doubt my insurance will cover the surgery so I don't want to waste time going thru the process of trying to get approved. Currently there is a doctor in town offering the surgery for $9,999. I can pay out of pocket now. I've done everything to lose weight and as soon as i lose I gain it right back...if i lose at all. I'm never successful for more than a few pounds then it comes right back which is so discouraging. I have some health issues as well. My gall bladder attacked me and put me in the hospital for a week, i have high testoterone levels which has made it difficult for me to lose weight. With all that said..........Will I need to go thru all of the testing and psychological exams as someone trying to get approved thru their insurance company? Will I need to go on the 6 month diet I've read some people have had to do?

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If you are self pay, find out what the surgeons requirements are. They are all different. He may still want you to do the 6 month diet.

I've decided to have lap band surgery. I am 5'2 181 lbs (today) with a BMI of 33.1. I doubt my insurance will cover the surgery so I don't want to waste time going thru the process of trying to get approved. Currently there is a doctor in town offering the surgery for $9,999. I can pay out of pocket now. I've done everything to lose weight and as soon as i lose I gain it right back...if i lose at all. I'm never successful for more than a few pounds then it comes right back which is so discouraging. I have some health issues as well. My gall bladder attacked me and put me in the hospital for a week, i have high testoterone levels which has made it difficult for me to lose weight. With all that said..........Will I need to go thru all of the testing and psychological exams as someone trying to get approved thru their insurance company? Will I need to go on the 6 month diet I've read some people have had to do?

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If you are self pay, find out what the surgeons requirements are. They are all different. He may still want you to do the 6 month diet.

Thanks! I'm going to the doctor's weight loss seminar on Tuesday. He requires everyone to attend before making an appointment with him. He has a fast track to surgery program. I should have read that before i asked....sorry :blush5: Thanks for answering. These are the Dr's requirements.

Patients who may qualify for the FAST TRACK program will generally need to meet these criteria:

  • PREAPPROVED. If you are already approved through your health insurance provider and have a written preapproval (after a workup from another practice). Note: do not try to send a letter to your insurance company without our assistance.
  • CASH PAY OPTION. If you are going to pay for surgery ‘out of pocket’ or planning on having the procedure financed, we can help guide and expedite you through the process.
  • Complete preoperative workup as specified by our office (or completed elsewhere) and be determined by our office to be an appropriate candidate
  • The well qualified patient meets the criteria for surgery set forth by the American Society for Bariatric Surgery (ASBS)
  • The well qualified patient is one who has done significant research into their weight loss options, has tried and failed other ‘non-surgical’ weight loss programs, and is ready to make significant lifestyle changes to ‘help themselves’ reach their weight loss goals. The decision to proceed with surgery is not one that is taken lightly.
  • Patients who are not qualified to pursue bariatric surgery are those who have not made significant efforts to learn about their weight loss options, have not faithfully tried ‘non-surgical’ weight loss programs, and those individuals who are not ready to make lifestyle changes.
  • Patients should discuss any possible surgery with their primary care physicians.
  • The 30 day FAST TRACK process starts after your initial office visit.

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I was self-pay and the only thing I had to do pre-op was 2 weeks of Atkins diet for liver shrinking. I'm sure every surgeon has their own pre-op requirements and they may be different for patients depending on health situations. See if the surgeon you are thinking about has a website. He/she should fill you in on everything when you go in for a consult.

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I was self-pay and the only thing I had to do pre-op was 2 weeks of Atkins diet for liver shrinking. I'm sure every surgeon has their own pre-op requirements and they may be different for patients depending on health situations. See if the surgeon you are thinking about has a website. He/she should fill you in on everything when you go in for a consult.

I can do 2 weeks of Atkins :) Thanks for the info!!!!

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As a self payer I have to do two weeks of a low glycimic diet b4 surgery and had to fill out a 12 page questionairre. DONE!! Booked for November 30th and can't wait/

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As a self payer I have to do two weeks of a low glycimic diet b4 surgery and had to fill out a 12 page questionairre. DONE!! Booked for November 30th and can't wait/

:blink: sounds like my sort of plan :bananajump:

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Almost all self pay programs are just the seminar to learn about the band (as required by the band manufacturer), a couple labs to cover the surgeons butt in the event of a malpractice lawsuit, and a pre op diet to shrink the liver down due to it being an abdominal surgery. But its a usually a 2 week process to be banded depending on when their first openings are! All about the benjamins.;) I did it that way too. But still do your homework!

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:blink: sounds like my sort of plan :bananajump:

Yeah, I forgot. one month b4 surgery I have to do some blood work but one needle no biggie.

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Almost all self pay programs are just the seminar to learn about the band (as required by the band manufacturer), a couple labs to cover the surgeons butt in the event of a malpractice lawsuit, and a pre op diet to shrink the liver down due to it being an abdominal surgery. But its a usually a 2 week process to be banded depending on when their first openings are! All about the benjamins.;) I did it that way too. But still do your homework!

Thanks for the info!!!! I'm looking forward to being banded!!! i have the seminar on Tuesday and I would love to have the surgery by the end of the month or early Novemeber if he has the availability.

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I was a self pay. I had my first meeting with him May 30th and was banded June 27th.:)

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I was a self pay. I had my first meeting with him May 30th and was banded June 27th.:)

Your post has given my all kinds of hope :laugh:

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      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
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