Persuing the lap band...just starting out

[Jamie83 0]

Hello,

My name is Jamie and I live in Spokane, WA. I am just starting out in this process to get the lab band. My husband may also do this too. Either way, I am researching and watching you tube videos. I called my insurance and they said that it is covered but will need to go through a pre-authorization process. I called the surgeon's office and they said to start out by going to the info seminar. That seminar is coming up this tuesday the 8th. I am hoping to leave with a better idea of what things need to be done first and then hopefully will be able to get a consulation with the surgeon soon after the seminar. I have no clue how many people usually attend those seminars or how far out the surgeons are booked. Of course I would like it to be sooner than later, but I know it can often take 6 months or so to get everything in place. My insurance company didn't say that there was a required waiting period but she did say that by the time people usually get everything done for the authorization process and pre-op testing that it is usually 3-6 months. Anyways, I am looking forward to getting to know some people who have been through it already and hopefully meet some buddies that are going through the same stage I am.

Jamie

[CindyBklyn 4]

Hi Jamie - welcome and congrats on starting your journey. My husband and I went through this process together just recently and would be happy to answer any questions you may have. He started the process by scheduling the seminar appointment and I went along to listen. In the end, we both came to our own decision that it was the right thing for each of us. Again - good luck! Cindy

[MelindaH 3]

Hi and welcome to our forum

I am still pre-op hoping for a December surgery. I started by attending a seminar in late April, filled out a twenty page questionaire, and then my surgeon visit was the end of May. So it is almost six months for me and will probably end up being close to seven.

I had to do three months of nutritional counseling, write a letter stating weight loss attempts over the last year, provide two years proof of obesity for the insurance part of it. My surgeon required that I lose five percent of my weight, get cardiac clearance, sleep specialist clearance, hematology clearance because of a previous pulmonary embolism, an endoscopy and manometry test, a referal letter from my PCP supporting the surgery and stating that she would follow me after the surgery, have lab work,.and lastly, I think, I had to have psychological issues which was not given until she had talked with my mental heallth providers. I have lost weight very slowly as I am restricted on exercise due to back and joint problems. I gained weight the first month and was mortified but they were very understanding. All I have left are two pre and post op classes and lose about three more pounds. Then my case can be sent to the insurance for approval and after that it can be scheduled. I am very nervous about the approval process but the insurance co-ordinator says not to worry about it.

That workup may be a little over the top for most people. I have several issues (co-morbidities) and I believe my insurance requires two. I won't bore you with the details but am hoping that I can cure some of them and reduce the medication list I have significantly. The lap band is the only weight loss surgery that I am comfortable with. My surgeon has one and has been successful at losing seventy pounds over a two year period. I have about eighty five pounds to lose

I really recommend that you use a Center of Excellence if at all possible. My pre-op care has been outstanding and am so grateful that we have one here in Eugene and I didn''t have to travel. Start drinking lots of Water, learn to sip, working on eating less and chewing everything at least thirty times. Walk as much as you can. Try to get a brief walk in everyday. I know it rains a lot up there like it does here but I broke down and bought a raincoat this year after surviving seventeen years without one. Obviously didn't walk much, lol.

Feel free to message me if I can help answer questions and concerns. Lastly, I will say that I am glad it has taken this long as I have received some invaluable information along the way. All the best to you and your husband as you begin your journey to good heath.

Melinda

[bluebird663 0]

Hey Jamie,

I am new to this site too but just got my surgery date today which will be dec 9. My first surgeon appt was October 11. Every insurance is different but from all the research I have done it seems to me that they all require at least 2 years medical records, psych eval, nutrition consult, clearance from regular md and goes on from there. I really recommend writing your own personal letter of medical necessity to your insurance company and you can even find examples online to help you. That is why I think I got approval without a lot of hassle. My regular md even told me that my insurance required the 6 month supervised diet and then I got the approval letter from insurance about a week and a half after I started the 6 month diet! Good luck!

[Jamie83 0]

Hey Jamie,

I am new to this site too but just got my surgery date today which will be dec 9. My first surgeon appt was October 11. Every insurance is different but from all the research I have done it seems to me that they all require at least 2 years medical records, psych eval, nutrition consult, clearance from regular md and goes on from there. I really recommend writing your own personal letter of medical necessity to your insurance company and you can even find examples online to help you. That is why I think I got approval without a lot of hassle. My regular md even told me that my insurance required the 6 month supervised diet and then I got the approval letter from insurance about a week and a half after I started the 6 month diet! Good luck!

Wow, how did you manage to get around the 6 month period? I guess mine requires that. The insurance didn't tell me that, but the bariatric nurse coordinator told me that. I guess she's pretty familiar with alll the insurance companies.

[Phranp 46]

Wow, how did you manage to get around the 6 month period? I guess mine requires that. The insurance didn't tell me that, but the bariatric nurse coordinator told me that. I guess she's pretty familiar with alll the insurance companies.

You should be able to go to the website for your insurance and it will tell you all the prerequisites for the surgery. Admittedly, it was not easy to find the actual info on my insurance's website, so if you have a problem finding the info either call your benefits department or your insurance directly and they will tell you how to find it online. It is very helpful to have the info in black and white. It also helps you determine what your insurance requires vs. what your doc requires. Some docs are very strict. One of the programs on my insurance was through Cedars Sinai here in L.A. I did NOT use that program. Cedars included extra fees and a very strict program before surgery.

Knowledge is power, and you are able to make better choices when you have more information.

All the best to you on your journey.

~Fran

[Miller.ted 3]

DON'T WAIT! JUST DO IT> Best luck if you have any questions, please let me know! Ted

[Taynaydosmom 1]

I am currently enrolled in the Cedar Sinai program and I wouldn't go anywhere else! There are no program fees or hidden costs. They do require an extensive multidisciplinary approach. Nutrition, pschy, extensive pelts lap work up...but do you want to go somewhere where they put the band in on your first appt. The whole point of all the different appt. Is to make sure you will be safe during and after the procedure. I am extremely happy with Cedars.

[Phranp 46]

I am currently enrolled in the Cedar Sinai program and I wouldn't go anywhere else! There are no program fees or hidden costs. They do require an extensive multidisciplinary approach. Nutrition, pschy, extensive pelts lap work up...but do you want to go somewhere where they put the band in on your first appt. The whole point of all the different appt. Is to make sure you will be safe during and after the procedure. I am extremely happy with Cedars.

I am happy that the Cedars program is working for you. Congratulations on starting this journey.

Whether or not there are fees depends on the particular insurance plan your employer purchases and the agreement between that plan and the hospital. Mine plan would have cost me extra.

Since I have been banded more than two years now and I have no regrets, my choice of surgeon/hospital turned out to be safe. My insurance (as most do) required nut, psych, labs, etc. Different strokes for different folks. I was not saying that the Cedars program was bad, just that it was not the right one for me.

All the best to you on your journey.

~Fran

[loretta\ Baconton Georgia 10]

hey jamie. I am also just getting started. My appt with the surgeon's office is tommorrow. can not wait!

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quote name=Jamie83' timestamp='1320384163' post='1681755]

Hello,

My name is Jamie and I live in Spokane, WA. I am just starting out in this process to get the lab band. My husband may also do this too. Either way, I am researching and watching you tube videos. I called my insurance and they said that it is covered but will need to go through a pre-authorization process. I called the surgeon's office and they said to start out by going to the info seminar. That seminar is coming up this tuesday the 8th. I am hoping to leave with a better idea of what things need to be done first and then hopefully will be able to get a consulation with the surgeon soon after the seminar. I have no clue how many people usually attend those seminars or how far out the surgeons are booked. Of course I would like it to be sooner than later, but I know it can often take 6 months or so to get everything in place. My insurance company didn't say that there was a required waiting period but she did say that by the time people usually get everything done for the authorization process and pre-op testing that it is usually 3-6 months. Anyways, I am looking forward to getting to know some people who have been through it already and hopefully meet some buddies that are going through the same stage I am.

Jamie