The story of an impatient chick in Kansas City

[jencomenz 3]

Hello all! I am also in KC. Will be having my surgery at KU Med this summer.

[kalfin13 4]

I'm definitely interested as I will be having surgery out of state.

What part of the city are you guys? I'm southern KC, actually live 30 min south of Overland Park.

I bet we might get a local library to let us use one of their rooms. Just a thought.

I am in north KCMO.

[jencomenz 3]

I live out by the speedway but work up north. KU Med has support groups but they are only monthly and they are not sleeve specific.

[kansas1973 1]

Hi there!

I am about 7 months post-op sleeve, and I just want you to know I felt the same way going the process. However, I think divine intervention came your way in the shape of going to the Kansas City Bariatric program. Dr. Stan Hoehn did my surgery, and he is the best of the best. THe program is fantastic, and they are professional and fantastic. If you have any questions about the process I went through, don't hesitate to ask.

Keep your chin up!

Hello all.

I finally made the decision and started the process.

2/14/11: Verified with Saint Luke's Center for Surgical Weight Loss that my insurance would cover their program

2/15/11: Attended St. Luke's Seminar

2/23/11: Attended first pre-op Dr. appointment. Sandy explained that I would need a 1) sleep study, 2) appointment with their nutrionist and exercise specialist to begin a three month supervised diet/exercise program, 3) psych eval, 4) letter of medical clearance from my GP, and 5) copies of notes from any doctor I saw in 2009 and 2010 showing my current weight. I would also need to attend at least one support group meeting. My appointments for the psych eval and diet/exercise specialists were set. I briefly met Dr. Price.

2/24/11: I received a call from the St. Luke's sleep Lab to schedule my sleep study.

2/27/11: Completed sleep study.

2/28/11: Received call from UHC. They explained that my policy does not cover Saint Luke's Center for Surgical Weight Loss . In addition, my policy requires a 6 month medically supervised diet.

You might imagine my reaction to this news. I was devestated and furious at St. Luke's for assuring me that my insurance would cover everything when they clearly had NO IDEA.

2/28/11: Reserved a spot in the upcoming seminar (3/7/11) at the only local program my insurance does cover, The Bariatric Center of Kansas City at Shawnee Mission Medical Center. All I can do now is wait to see what my earlier mistakes will cost me and try to move forward despite them.

[Mystee 2]

Hello everyone, I am so glad I found this site and especially this post. I am getting ready to get "sleeved" on 4/11/11 in KC with Malley Surgical & New Hope Bariatrics. You must have GM Blue Cross & Blue Shield I went through the same thing as you and since my BMI is a little over 39 I just made the decision to pay out of pocket. I was told over the phone they accepted my insurance but when I showed up for my appointment I found out differently. I think they hope to get you in there and talk you in to paying out of pocket. But even then Weight Loss Surgical center was about $1,400 more then Malley Surgical/New Hope but even expensive I believe will be well worth it.

I believe my surgery will be at Menorah and I live up North Of the River in MO. So far my experience has been great with them and my Doctor (Nichole Fearing) she has been very kind and fully explained everything to me. I am very excited and listening to everyone experiences, advice and success stories makes me even more excited the the day. Eeeekkk 1 more month, never thought I would wish away my life to be in pain for a while lol.

[Cmsumom 5]

Hello everyone, I am so glad I found this site and especially this post. I am getting ready to get "sleeved" on 4/11/11 in KC with Malley Surgical & New Hope Bariatrics. You must have GM Blue Cross & Blue Shield I went through the same thing as you and since my BMI is a little over 39 I just made the decision to pay out of pocket. I was told over the phone they accepted my insurance but when I showed up for my appointment I found out differently. I think they hope to get you in there and talk you in to paying out of pocket. But even then Weight Loss Surgical center was about $1,400 more then Malley Surgical/New Hope but even expensive I believe will be well worth it.

I believe my surgery will be at Menorah and I live up North Of the River in MO. So far my experience has been great with them and my Doctor (Nichole Fearing) she has been very kind and fully explained everything to me. I am very excited and listening to everyone experiences, advice and success stories makes me even more excited the the day. Eeeekkk 1 more month, never thought I would wish away my life to be in pain for a while lol.

Hey- You are the first person I have met to have this done there- I went in and saw Dr. Malley- but is Dr. Fearing the one that actually does these? I was told they do them at Menorah on the 2nd and 4th Thursdays of the month- so I guess we will see- my insurance does pay- but I am right now waiting to see if they approve it- I called yesterday and even tho they had it Friday- they can't find it now- so that is frustrating- what are their pre op diet requirements? I would be very interested in knowing your story since we have the same doctor! I am nervous and excited and all in the same time want to just get it over with. But would love to hear any info you have from them- as their website is all about the lap=band.

[Mystee 2]

Hey- You are the first person I have met to have this done there- I went in and saw Dr. Malley- but is Dr. Fearing the one that actually does these? I was told they do them at Menorah on the 2nd and 4th Thursdays of the month- so I guess we will see- my insurance does pay- but I am right now waiting to see if they approve it- I called yesterday and even tho they had it Friday- they can't find it now- so that is frustrating- what are their pre op diet requirements? I would be very interested in knowing your story since we have the same doctor! I am nervous and excited and all in the same time want to just get it over with. But would love to hear any info you have from them- as their website is all about the lap=band.

Typing from a cell so it may not look great an may have a few typos. Since its Malley & New Hope now I think an this is my own opinion is that Nicole has done a lot of Gastric Bypass surgeries an Dr Malley mostly lap band. So she may do one an he the other, I am not sure. But you are correct in that they are only 1 or 2 days they do them a month unlike the lap band where I think they do them 2 days a week. I have not received my pre-op diest yet but should get it soon I would think since I am only a month out. I did just go in for a pre op test. Other then they were really behind an I had a girl who was digging my vein to get the IV in everyone was great an very kind whith a nice big room for me to relax in.

So far I have only been to the seminar which is mostly on lap band but on my appointment date she gave a little more info on the Sleeve. I then got more info off the web an I liked that you didn't have so many appointments with the sleeve since it is really hard for me to get off work. After finding this site an seeing some people that already had the band are opting for this procedure and all the great sucess stories here it sealed the deal for me. I am very anxious for the surgery since I have Fibro pretty bad along with very bad back pain from a car wreck an pain in my left foot along with acid refux bad fatigue but mostly pain. I will post any updates as they happen.. Yeah, 1 month.

[former_vbg 198]

Hey- You are the first person I have met to have this done there- I went in and saw Dr. Malley- but is Dr. Fearing the one that actually does these? I was told they do them at Menorah on the 2nd and 4th Thursdays of the month- so I guess we will see- my insurance does pay- but I am right now waiting to see if they approve it- I called yesterday and even tho they had it Friday- they can't find it now- so that is frustrating- what are their pre op diet requirements? I would be very interested in knowing your story since we have the same doctor! I am nervous and excited and all in the same time want to just get it over with. But would love to hear any info you have from them- as their website is all about the lap=band.

You should be able to find this out directly from your insurance carrier either on their website or calling their customer service. Also, your Dr.'s office should be able to help you with this too. I recommend that you find this out before you submit for a pre-certification, otherwise you will likely have to go through a lengthy appeal process if you haven't met all of their requirements ahead of time. Appeals can work, but it usually delays things.

Just a couple of suggestions.

[Cmsumom 5]

You should be able to find this out directly from your insurance carrier either on their website or calling their customer service. Also, your Dr.'s office should be able to help you with this too. I recommend that you find this out before you submit for a pre-certification, otherwise you will likely have to go through a lengthy appeal process if you haven't met all of their requirements ahead of time. Appeals can work, but it usually delays things.

Just a couple of suggestions.

Yep- My I did all my homework - my insurance only requires a psych and nutrition evaluation and thats it- well besides the bmi and weight related conditions. BUT found out today- even tho I had told them every time I spoke with them that I wanted the sleeve- they turned it in for the band - so pretty frustrated with that- but it will either work out or it won't- I am not going to fret to much about it.

[kalfin13 4]

Just got a call from Dr. Hoehn's office and my date is April 13. Can't wait!!

[Holiday 18]

Just got a call from Dr. Hoehn's office and my date is April 13. Can't wait!!

Congratulations!! I can't wait for the day I can post this news.

[Holiday 18]

Hi there!

I am about 7 months post-op sleeve, and I just want you to know I felt the same way going the process. However, I think divine intervention came your way in the shape of going to the Kansas City Bariatric program. Dr. Stan Hoehn did my surgery, and he is the best of the best. THe program is fantastic, and they are professional and fantastic. If you have any questions about the process I went through, don't hesitate to ask.

Keep your chin up!

I really appreciate the encouragement! And I need it. The last few days ahve been uber frustrating.

I'm blogging the experience, mostly for my personal venting and keeping track of info, but I also want to share my recent frustrations here.

3/7/11: After an overnight fast, I went to DO's office for pre-supervised diet/exercise program blood work.

Later that morning, I partipated in scheduled meeting via phone with my UHC case manager, Jill. She instructed me to 1) tell the folks at SM that she is my case manager, 2) called her with any questions at (866) 534-7209 x65559, and 3) check in with her in June to let her know my progress.

In the evening, I attended the seminar at the Bariatric Center of Kansas City at Shawnee Mission Medical Center. Delivered my paperwork and insurance and ID copies to the staff. I also met Connie - what a sweetheart!

3/10/11: I was excited about starting my supervising diet at the appointment with my DO that evening. I called Jill, my case manager, in the morning to check that the 6 months worth of dates I meant to schedule with the DO will work within the parameters of the requirements. I had to leave a message and wait for a return call.

About 2:00 pm I received a phone call from Jan at The Bariatric Center. She called to tell me that my insurance only pays for a maximum benefit of $10,000 of weight loss surgery expenses, not nearly enough to cover even just the expense of surgery, let along the additional office visits and evaluations required. We decided not to set my appointment with Dr. Hoehn until I sort out if/how I should proceed with this new information. She explained that Dr. Hoehn's surgeon fees alone are $5000, and that to get the cost of the hospital stay, I should call Shawnee Mission Medical.

Of course I flipped - and it only got worse.

Next, I called and left another, frantic message with Jill. My first appointment was scheduled in just a few hours with my DO to begin my supervised diet. At this point, I couldn't be sure it was even possible to pay for the surgery and all of the appointments associated. After waiting a few minutes, I decided to call the member phone number on my insurance card to check if the $10,000 was accurate. The lady I spoke with assured me that the cap existed and was not subject to my yearly out of pocket max of $1000, so all excess costs are mine to bear. I started to ask which office visits would be billed against the maximum benefit, knowing that if the supervised diet, the psych eval, etc, etc were all debited from that bucket, there would be no money at all to pay the surgery. She wasn't sure of the answers, so she transferred me to the UHC bariatric specialists’ location where Jill is located so that I could ask more detailed questions. By this time, it was 15 minutes until I was leaving for my appointment. I tried to explain my problem to the operator. She wanted to know "what my question was" and I tried to explain that I had many questions, all relating to how my benefits work, and that I really needed answers before I left for my appointment. She insisted on knowing what my appointment was, and assured me that if I told her what appointment I was going to, maybe she could get my question answered. I told her the appointment had nothing to do with my questions. The operator (who had been extremely rude and could barely be heard over the constant, furious clicking of her plastic fingernails typing as she spoke) told me that elective procedures are not considered urgent by UHC and I would have to leave a message and await a phone call.

Waiting for my work phone to ring (oh, yeah - all of this is happening on my work phone, where nosy co-workers can easily overhear, my bosses keep coming by for one reason or another and find me still on the phone, red-faced and frantic...it wasn't pretty or good for my career), I took out my cell phone and called Shawnee Mission Medical. I was directed to Patty at (913) 676-7736. Patty explained that the actual cost for the hospital stay in considered outpatient, though I would be observed overnight, for a average total of $39,000. However, UHC's contract allows them to bill about $7500 ($5735 + observation hours). Then she dropped the bomb - this did not include the fee for anesthesiology. My heart sank. Even with a sizeable chunk in my flex account, there was no way I could afford this surgery. $10,000 isn't coverage, it's a tease. My stress level and psychological health would have been better served if my policy didn't claim to have any benefit for weight loss surgery. I said as much to Patty, who cheerily replied, "At least you don't have to pay $39,000!" Some consolation. Patty was kind and helpful, even if she did not understand my predicament. She gave me the billing code all of the docs will use for the surgery expenses (43843) and the name and number of the anesthesiologists’ office so I could call them to see how much they would charge. (Anesthesiologist Midwest Anesthesiology Group (913) 234-1600). In the meantime, it was time to leave and I didn't receive a call back from UHC or Jill.

I did begin my 6 month supervised diet, despite the turmoil. After all, a supervised diet that included accountability with my doctor was better than taking no action for my health at all, right? She prescribed daily caloric intake under 2400 calories and to resume my training with Bethanie at the gym where I currently belong.

3/11/11: Received a phone call from Jill fist this in the morning. I explained what happened. She assured me (numerous times, at my insistence) that there is no $10,000 cap on my weight loss surgery benefit. There is a $10,000 cap on travel and lodging expenses, if I were over 100 miles from the nearest approved Center of Excellence, but that is not the case. The promised she would call Jan at the Bariatric Center to clarify the insurance terms and she would ask Jan to call me to set up my appointments.

*cue sappy soap opera type music*

At this point, I'd like to ask for something in writing. But first, I am waiting to see what happens if/when Jan from the Bariatric Center calls me. After so many dark moments in this process that has only barely begun, dare I hope it will all work out?

[former_vbg 198]

I really appreciate the encouragement! And I need it. The last few days ahve been uber frustrating.

I'm blogging the experience, mostly for my personal venting and keeping track of info, but I also want to share my recent frustrations here.

3/7/11: After an overnight fast, I went to DO's office for pre-supervised diet/exercise program blood work.

Later that morning, I partipated in scheduled meeting via phone with my UHC case manager, Jill. She instructed me to 1) tell the folks at SM that she is my case manager, 2) called her with any questions at (866) 534-7209 x65559, and 3) check in with her in June to let her know my progress.

In the evening, I attended the seminar at the Bariatric Center of Kansas City at Shawnee Mission Medical Center. Delivered my paperwork and insurance and ID copies to the staff. I also met Connie - what a sweetheart!

3/10/11: I was excited about starting my supervising diet at the appointment with my DO that evening. I called Jill, my case manager, in the morning to check that the 6 months worth of dates I meant to schedule with the DO will work within the parameters of the requirements. I had to leave a message and wait for a return call.

About 2:00 pm I received a phone call from Jan at The Bariatric Center. She called to tell me that my insurance only pays for a maximum benefit of $10,000 of weight loss surgery expenses, not nearly enough to cover even just the expense of surgery, let along the additional office visits and evaluations required. We decided not to set my appointment with Dr. Hoehn until I sort out if/how I should proceed with this new information. She explained that Dr. Hoehn's surgeon fees alone are $5000, and that to get the cost of the hospital stay, I should call Shawnee Mission Medical.

Of course I flipped - and it only got worse.

Next, I called and left another, frantic message with Jill. My first appointment was scheduled in just a few hours with my DO to begin my supervised diet. At this point, I couldn't be sure it was even possible to pay for the surgery and all of the appointments associated. After waiting a few minutes, I decided to call the member phone number on my insurance card to check if the $10,000 was accurate. The lady I spoke with assured me that the cap existed and was not subject to my yearly out of pocket max of $1000, so all excess costs are mine to bear. I started to ask which office visits would be billed against the maximum benefit, knowing that if the supervised diet, the psych eval, etc, etc were all debited from that bucket, there would be no money at all to pay the surgery. She wasn't sure of the answers, so she transferred me to the UHC bariatric specialists’ location where Jill is located so that I could ask more detailed questions. By this time, it was 15 minutes until I was leaving for my appointment. I tried to explain my problem to the operator. She wanted to know "what my question was" and I tried to explain that I had many questions, all relating to how my benefits work, and that I really needed answers before I left for my appointment. She insisted on knowing what my appointment was, and assured me that if I told her what appointment I was going to, maybe she could get my question answered. I told her the appointment had nothing to do with my questions. The operator (who had been extremely rude and could barely be heard over the constant, furious clicking of her plastic fingernails typing as she spoke) told me that elective procedures are not considered urgent by UHC and I would have to leave a message and await a phone call.

Waiting for my work phone to ring (oh, yeah - all of this is happening on my work phone, where nosy co-workers can easily overhear, my bosses keep coming by for one reason or another and find me still on the phone, red-faced and frantic...it wasn't pretty or good for my career), I took out my cell phone and called Shawnee Mission Medical. I was directed to Patty at (913) 676-7736. Patty explained that the actual cost for the hospital stay in considered outpatient, though I would be observed overnight, for a average total of $39,000. However, UHC's contract allows them to bill about $7500 ($5735 + observation hours). Then she dropped the bomb - this did not include the fee for anesthesiology. My heart sank. Even with a sizeable chunk in my flex account, there was no way I could afford this surgery. $10,000 isn't coverage, it's a tease. My stress level and psychological health would have been better served if my policy didn't claim to have any benefit for weight loss surgery. I said as much to Patty, who cheerily replied, "At least you don't have to pay $39,000!" Some consolation. Patty was kind and helpful, even if she did not understand my predicament. She gave me the billing code all of the docs will use for the surgery expenses (43843) and the name and number of the anesthesiologists’ office so I could call them to see how much they would charge. (Anesthesiologist Midwest Anesthesiology Group (913) 234-1600). In the meantime, it was time to leave and I didn't receive a call back from UHC or Jill.

I did begin my 6 month supervised diet, despite the turmoil. After all, a supervised diet that included accountability with my doctor was better than taking no action for my health at all, right? She prescribed daily caloric intake under 2400 calories and to resume my training with Bethanie at the gym where I currently belong.

3/11/11: Received a phone call from Jill fist this in the morning. I explained what happened. She assured me (numerous times, at my insistence) that there is no $10,000 cap on my weight loss surgery benefit. There is a $10,000 cap on travel and lodging expenses, if I were over 100 miles from the nearest approved Center of Excellence, but that is not the case. The promised she would call Jan at the Bariatric Center to clarify the insurance terms and she would ask Jan to call me to set up my appointments.

*cue sappy soap opera type music*

At this point, I'd like to ask for something in writing. But first, I am waiting to see what happens if/when Jan from the Bariatric Center calls me. After so many dark moments in this process that has only barely begun, dare I hope it will all work out?

Wow.... that is an intense couple of days. It sounds like it is going to work out, but I hear ya, like you are supposed to be happy you wouldn't have to pay the full $xxxx.... whatever....

I am a little surprised to hear your insurance has any benefit for travel for out of town. I kind of doubt Aetna has that, but heck its worth asking as my surgery will be out of state.

Keep the faith!

[Mystee 2]

I really appreciate the encouragement! And I need it. The last few days ahve been uber frustrating.

I'm blogging the experience, mostly for my personal venting and keeping track of info, but I also want to share my recent frustrations here.

3/7/11: After an overnight fast, I went to DO's office for pre-supervised diet/exercise program blood work.

Later that morning, I partipated in scheduled meeting via phone with my UHC case manager, Jill. She instructed me to 1) tell the folks at SM that she is my case manager, 2) called her with any questions at (866) 534-7209 x65559, and 3) check in with her in June to let her know my progress.

In the evening, I attended the seminar at the Bariatric Center of Kansas City at Shawnee Mission Medical Center. Delivered my paperwork and insurance and ID copies to the staff. I also met Connie - what a sweetheart!

3/10/11: I was excited about starting my supervising diet at the appointment with my DO that evening. I called Jill, my case manager, in the morning to check that the 6 months worth of dates I meant to schedule with the DO will work within the parameters of the requirements. I had to leave a message and wait for a return call.

About 2:00 pm I received a phone call from Jan at The Bariatric Center. She called to tell me that my insurance only pays for a maximum benefit of $10,000 of weight loss surgery expenses, not nearly enough to cover even just the expense of surgery, let along the additional office visits and evaluations required. We decided not to set my appointment with Dr. Hoehn until I sort out if/how I should proceed with this new information. She explained that Dr. Hoehn's surgeon fees alone are $5000, and that to get the cost of the hospital stay, I should call Shawnee Mission Medical.

Of course I flipped - and it only got worse.

Next, I called and left another, frantic message with Jill. My first appointment was scheduled in just a few hours with my DO to begin my supervised diet. At this point, I couldn't be sure it was even possible to pay for the surgery and all of the appointments associated. After waiting a few minutes, I decided to call the member phone number on my insurance card to check if the $10,000 was accurate. The lady I spoke with assured me that the cap existed and was not subject to my yearly out of pocket max of $1000, so all excess costs are mine to bear. I started to ask which office visits would be billed against the maximum benefit, knowing that if the supervised diet, the psych eval, etc, etc were all debited from that bucket, there would be no money at all to pay the surgery. She wasn't sure of the answers, so she transferred me to the UHC bariatric specialists’ location where Jill is located so that I could ask more detailed questions. By this time, it was 15 minutes until I was leaving for my appointment. I tried to explain my problem to the operator. She wanted to know "what my question was" and I tried to explain that I had many questions, all relating to how my benefits work, and that I really needed answers before I left for my appointment. She insisted on knowing what my appointment was, and assured me that if I told her what appointment I was going to, maybe she could get my question answered. I told her the appointment had nothing to do with my questions. The operator (who had been extremely rude and could barely be heard over the constant, furious clicking of her plastic fingernails typing as she spoke) told me that elective procedures are not considered urgent by UHC and I would have to leave a message and await a phone call.

Waiting for my work phone to ring (oh, yeah - all of this is happening on my work phone, where nosy co-workers can easily overhear, my bosses keep coming by for one reason or another and find me still on the phone, red-faced and frantic...it wasn't pretty or good for my career), I took out my cell phone and called Shawnee Mission Medical. I was directed to Patty at (913) 676-7736. Patty explained that the actual cost for the hospital stay in considered outpatient, though I would be observed overnight, for a average total of $39,000. However, UHC's contract allows them to bill about $7500 ($5735 + observation hours). Then she dropped the bomb - this did not include the fee for anesthesiology. My heart sank. Even with a sizeable chunk in my flex account, there was no way I could afford this surgery. $10,000 isn't coverage, it's a tease. My stress level and psychological health would have been better served if my policy didn't claim to have any benefit for weight loss surgery. I said as much to Patty, who cheerily replied, "At least you don't have to pay $39,000!" Some consolation. Patty was kind and helpful, even if she did not understand my predicament. She gave me the billing code all of the docs will use for the surgery expenses (43843) and the name and number of the anesthesiologists’ office so I could call them to see how much they would charge. (Anesthesiologist Midwest Anesthesiology Group (913) 234-1600). In the meantime, it was time to leave and I didn't receive a call back from UHC or Jill.

I did begin my 6 month supervised diet, despite the turmoil. After all, a supervised diet that included accountability with my doctor was better than taking no action for my health at all, right? She prescribed daily caloric intake under 2400 calories and to resume my training with Bethanie at the gym where I currently belong.

3/11/11: Received a phone call from Jill fist this in the morning. I explained what happened. She assured me (numerous times, at my insistence) that there is no $10,000 cap on my weight loss surgery benefit. There is a $10,000 cap on travel and lodging expenses, if I were over 100 miles from the nearest approved Center of Excellence, but that is not the case. The promised she would call Jan at the Bariatric Center to clarify the insurance terms and she would ask Jan to call me to set up my appointments.

*cue sappy soap opera type music*

At this point, I'd like to ask for something in writing. But first, I am waiting to see what happens if/when Jan from the Bariatric Center calls me. After so many dark moments in this process that has only barely begun, dare I hope it will all work out?

If all goes south with them you really sould check into New Hope/Malley Surgical. If you have to end up paying for it, it's $16,500 and includes everything even office visits for the first year. It sounds like you would fair better with that option then even with insurance paying if you do find they have a cap at $10,000. Keep us posted how it goes.

Don't let my hubby hear this,but glad I didn't have to go through insurance since I would have to wait out the 6 month Dr. Diet. Pay out of pocket and I get it NOW! LoL, I can't wait.

[kalfin13 4]

Wow! Hope you are able to work something out. After reading a lot of stories on here I realize how blessed I am to have such great insurance. i can't believe all the price quotes they gave you. What happened to all that "$11,999 sleeve special" they have posted on their website?