JOURNEY BEGINS NOW 0 Posted February 17, 2006 Okay, I didn't have anyone else to ask but you guys, lap band dr's office closed, ins office closed, and the hospital called wanting to do a pre- registration for my appt on Mon (2/20/06) for an upper gi that Humana is req before they will approve my lap band. However, when I spoke to Humana and my dr's office before each one said it was just a simple x-ray of my esophogus and stomach, not of my colon and rectum and all the things that a barium enema includes. I haven't mentioned the worst part of this situation, the test is around 3200 and my copay due monday before testing is 320.00 I have a 20% ded. I don't know what to do, I need to find out if the test ordered by the cardiologist (not even the lap band dr) are the ones necessary. I don't want to pay for something that is not required. If anyone has anything please, I feel like a big rock feel on me when she called. Share this post Link to post Share on other sites
JANSKI 0 Posted February 17, 2006 Only thing I had to have was blood work and ECG. Janet Share this post Link to post Share on other sites
Alexra 0 Posted February 17, 2006 I only had blood work. But had no other health problems other than my weight. If Ins requires it I would get it done so I wouldn't risk not having my surgery approved. Share this post Link to post Share on other sites
JOURNEY BEGINS NOW 0 Posted February 17, 2006 Okay, actually you know I am so glad you guys mentioned that, b/c now I remember at my first consult w/ins rep she said the upper gi or gastro testing could be done via blood work or upper gi xray. I do not want to give up, I feel like the dr's are taking advantage of my desperation to have the lap band surgery and are doing unnecessary test. When I call the ins company to ask for the checklist for pre cert testing they told me only the dr's office that was ordering the surgery could get that!!!! What is up with that????? I just want to stay focused and keep my eyes on the prize...... Share this post Link to post Share on other sites
DrHekier 0 Posted February 21, 2006 Do you have a history of GERD (reflux)? If so, your doctor may want to get the Upper GI to evaluate if you have a large hiatal hernia that may change his/her approach to surgery. Share this post Link to post Share on other sites
Sorority ChiK 0 Posted February 21, 2006 I was told I was going to have and upper gi also! :phanvan Share this post Link to post Share on other sites
AlyCat 0 Posted February 21, 2006 I had to get the upper gi (drinking stuff) and it wasn't that bad. I also had to get an edg which you get done in a hospital under anestesia. I'm the biggest baby and it was fine. I also had to get a stress test, ekg, and halter monitor and blood work and I'm only 22! but the insurance covered it on the fist letter!!! march 15th is my day:) Share this post Link to post Share on other sites
JOURNEY BEGINS NOW 0 Posted February 22, 2006 Okay, well today is 2/21/06 I was supposed to have those test 2/20/06 (yesterday), change of plans. I spk to Humana rep and she said w/out a 6mth physician monitored diet I would not meet the criteria for approval, so I went and found a pcp in my area instead yesterday. He prescribed Xenical and gave me a diet outline to follow. So, August will be my new goal month to have the surgery. So has anyone tried Xenical is it effective at all???? Share this post Link to post Share on other sites
RoxanneRoll 0 Posted February 22, 2006 OK...just so you know I have to have an Upper GI before my surgery...I am doing it on Thursday...my surgery is on Monday.....I have a history of a hiatal hernia however, so they want to see how that looks now before proceeding, he will repair it as well during my lap band surgery. Ok....I have tried xenical...and all it does is make you poop orange oily runny loose stools, it makes you gassy...and sometimes when you think you have gas....you actually poop on yourself instead of just farting....Yes..I know this sounds gross...but these are the facts you should be aware of. I didnt lose weight while taking it....but I didnt gain any weight either. Good luck!! Share this post Link to post Share on other sites
Tamyrn 0 Posted February 22, 2006 Hey Cyndi, My insurance doesn't cover bariatric...um....ANYTHING, so I went to Mexico. I used Xenical several yrs ago and of course counted fat grams, I lost about 11# and put it all back on a few months later. Roxanne is sooo right about the gas, go to the bathroom for every toot. Also, it only works for the meals you take it with, so take it 3 times a day. Good Luck. Tammy Share this post Link to post Share on other sites
BandsterHopeful 1 Posted February 27, 2006 Many obese people have a hiatal hernia (suspect this and discuss it if you have ANY reflux) and an upper GI will give the surgeon important information, since it will need to be repaired along with the band surgery. the band goes just where the hernias usually are, so they have to be fixed first. An upper GI is not lab work. All this testing is for your own good, and for a sfe and predictable sugery with no unexpected surprises. renee Share this post Link to post Share on other sites
Dody 0 Posted March 2, 2006 An upper GI should be a requirement for all good lap band surgeons. I'm certainly glad it was required in my case, as they found a good sized ulcer that would have caused major problems had I been banded. I've had to wait 3 mo. to get the band and to clear the ulcer up, but I'm so very glad they found it. I'm also glad they required a sleep apnea test, because I had it and am now on C-Pap and feeling so much better. What you think is unnecessary can sometimes be lifesaving in the end. Share this post Link to post Share on other sites
newgirl 0 Posted March 2, 2006 I had blood work, ekg, and chest x ray only. were included in my overall cost. Share this post Link to post Share on other sites