erp 2,016 Posted December 21, 2012 I have read the horrors other have had with their insurance. I am lucky, my insurance doesn't require a six month diet or anything else. In fact, you just have to have a two year weight history and a BMI of over 40. Great right?! No because my stupid medical group, Mercy medical has created their own made up rules!! I've been to two different nutritionists four separate times and I have more visits to go. One nutritionist assigned by my PCP, one required by my surgeon. In addition, I was required to attend a dietician class last night. I have to have a "family" visit appointment with my surgeon's office still. Literally, they require my family to attend- I'm single and own my own home but apparently need my parent's approval!! I've explained that they live in another state and the surgeon started talking like I need to fly them out. Uh, no! We agreed that they can attend by phone. Same with the guy I'm with, he lives two hours away and he needs to be on the phone too. WTF? I'm 40 not 14! I've had 3 months of physical testing, really dumb stuff like how many sit up can you do in two minutes, how fast can you walk a mile kind of tests. The psych. eval is ok- sounds like everyone has to do that. Same with the EKG and chest xray. Everyone has to do that and I've completed mine. My surgeon requires an endoscopy. So I called my PCP and they ordered an upper GI. After a couple of weeks delay over that confusion, they ordered the endoscopy but now I must first have a consult with the gastroenterologist before I can get the EGD. So this intermediary step creates another delay. My surgeon's office is ready to schedule me in Feb and the earliest I can even got the consult for the EGD is mid-January and they don't know how soon they can book the EGD after the consult, that's up to the dr! I am So Annoyed!! Now I know why people hop on a plane to Mexico!! If this drags out past February without a surgery date, Adios Mercy medical group (middle fingers up) and Hola Dr. Aceves!!!! Share this post Link to post Share on other sites
chitowngirl 886 Posted December 21, 2012 My doctor did require a support person to go with me to the preop meeting. I would just take a support person and call it a day. I'm sure a person here locally that is not family can do more for you than family that is not easily accessible because they live far. If they keep pushing I would say ok this is my cousin, it shouldn't matter that they're related what matters is that you have a support system. Best of luck to you... 1 erp reacted to this Share this post Link to post Share on other sites
abridgie 73 Posted December 21, 2012 My doctor also required a family member to be at my appointment and i had to have my husbands consent before surgery Share this post Link to post Share on other sites
Butterthebean 8,146 Posted December 21, 2012 My doctor also required a family member to be at my appointment and i had to have my husbands consent before surgery What kind of world is this? I'm all for getting family support but if you have none, or the family isn't behind you that should prevent you from getting life saving surgery. 1 erp reacted to this Share this post Link to post Share on other sites
Spatters3 315 Posted December 22, 2012 Weird. The center of excellence I went to in Georgetown, KY encouraged family participation but it certainly wasn't required. I thought they had me jump through too many testing hoops too, but not even close to all that you seem to be going through. 1 erp reacted to this Share this post Link to post Share on other sites
NurseGrace 509 Posted December 22, 2012 this is the type of bureaucracy that is sucking the system dry. I would recommend looking for a different group. Explore private hospitals in your area. 2 katieboo and erp reacted to this Share this post Link to post Share on other sites
erp 2,016 Posted December 22, 2012 this is the type of bureaucracy that is sucking the system dry. I would recommend looking for a different group. Explore private hospitals in your area. I may NurseGrace, though, I feel like I have so much time and co-pays invested at the moment that I'm stuck. I did inquire about switching to Sutter, but my insurance said it would set me back even longer and I'd have repeat a bunch of the tests. We have open enrollment in June and I will definately be weighing all of my options. Share this post Link to post Share on other sites
NurseGrace 509 Posted December 22, 2012 I may NurseGrace, though, I feel like I have so much time and co-pays invested at the moment that I'm stuck. I did inquire about switching to Sutter, but my insurance said it would set me back even longer and I'd have repeat a bunch of the tests. We have open enrollment in June and I will definately be weighing all of my options. I here you, but let me just tell you, private hospitals that dont have you jump though all those damn hoops can have you approved and scheduled in a week. I got approval in three days, and scheduled for next month after one appointment. 1 erp reacted to this Share this post Link to post Share on other sites
AlbanyDan 32 Posted January 6, 2013 The pre-op procedures are required more by insurance than the Hospital. VSG just started being fully covered because of the weight rate compared to the bypass. My pre-open tests included Psyche evaluation, mandatory group sessions as well as the physical tests. All those tests and evaluations are packaged and sent when they seek pre-approval for the surgery. Just 4 years ago only the gastric bypass was covered in Nys since it was the only procedure with some proven success. Now there are options with VSG and the gastric band. Share this post Link to post Share on other sites
RickyDee 5 Posted January 22, 2013 The biggest mistake I made was alienating my surgeon's group and then leaving. Later, when it was time for maintenance assistance, they refused to see me, and no other Dr would touch me. Many things that people dislike before surgery are so important, even though yours sounds a bit excessive. Listen, EVERYBODY needs to slow down before surgery. Take into account that everything you do before surgery will benefit or harm yourself after surgery. 2 Truckerchic_M and Butterthebean reacted to this Share this post Link to post Share on other sites
Truckerchic_M 92 Posted January 22, 2013 The biggest mistake I made was alienating my surgeon's group and then leaving. Later' date=' when it was time for maintenance assistance, they refused to see me, and no other Dr would touch me. Many things that people dislike before surgery are so important, even though yours sounds a bit excessive. Listen, EVERYBODY needs to slow down before surgery. Take into account that everything you do before surgery will benefit or harm yourself after surgery.[/quote'] Agreed..I have wanted this for a few years been obese 36 yrs, I was disappointed when I found out I had to do the 6 months but with my first month out of the way im actually glad because im getting better prepared ....this however seems a bit much Share this post Link to post Share on other sites
NurseGrace 509 Posted January 25, 2013 The biggest mistake I made was alienating my surgeon's group and then leaving. Later' date=' when it was time for maintenance assistance, they refused to see me, and no other Dr would touch me. Many things that people dislike before surgery are so important, even though yours sounds a bit excessive. Listen, EVERYBODY needs to slow down before surgery. Take into account that everything you do before surgery will benefit or harm yourself after surgery.[/quote'] Can I ask how you alienated them and how they justified not seeing you? Share this post Link to post Share on other sites
RickyDee 5 Posted January 27, 2013 Long story. They had poor support groups for RnY and Band, but nada for VSG. He is the local expert for sleeve so it seemed unusual. I was told in RnY meeting by leader, that if I "wanted to have my stomach pulled out through a whole in my belly, go ahead!" Long struggle to establish Sleeve support went unheard. Share this post Link to post Share on other sites
AlbanyDan 32 Posted January 29, 2013 Long story. They had poor support groups for RnY and Band' date=' but nada for VSG. He is the local expert for sleeve so it seemed unusual. I was told in RnY meeting by leader, that if I "wanted to have my stomach pulled out through a whole in my belly, go ahead!" Long struggle to establish Sleeve support went unheard.[/quote']I dropped out of my first program in 2009 because they only considered the gastric bypass. VSG was not covered by many insurance and they did not like the amount and success rate of the band. By 2010 they also did the band and insurance started covering vsg in 2011. It's nice to have options. It took me 2 years to talk myself into it. Share this post Link to post Share on other sites
Ms.AntiBand 2,984 Posted January 29, 2013 How do y'all find the time and days away from work to attend all the bs insurance companies require? It's crazy! Share this post Link to post Share on other sites