Jump to content
×
Are you looking for the BariatricPal Store? Go now!

6 Freaking Months!??!



Recommended Posts

I just got off the phone with Dr. Storeys office (Houston) and they told me that after 6 months with them and being monitored by a dietician and exercise they will submit it to the insurance company. I am not willing to wait 6 more months. I told the girl I would be dead by then.

Did anyone have to wait like that? Is that the norm?

How absurd for them to even say that! If people could get the weight off by just watching what they eat then they could just waive their magic wand and it would be done now wouldn't it!!??!!

It's not like getting fat has happened to me overnight, I have been battling weight all my life and with hypothyroidism thrown in there to mix it all up.

Its not like lap band surgery is a quick fix for goodness sake its still major surgery and I don't think anyone out there thinks its an easy solution. But how freaking fat do you have to get before enough is enough?

Sorry to rant an rave but this is frustrating!

Share this post


Link to post
Share on other sites

Most of the time I think this is an insurance requirement. It's not about whether anyone thinks we can lose the weight with diet and exercise, it's about whether the insurance company can avoid paying for the surgery for as long as human creativity can devise.

If you have any way of paying for this yourself or financing it there are options to get all the way to band-land in a couple months or less. And there are some relatively affordable options to get there, in the 10,000 dollar range for self-payers. If you able to consider this there is a lot of information in this forum you can search for, and if you post questions you will get lots of info.

Good luck.

Share this post


Link to post
Share on other sites

Dear Margo, I started with my first meeting in 4-26-06. This did not include my appointent with my own Dr. I just met the Dr. who will do the surgery 12-21-06. He said about 8 weeks to surgery.:notagree I thought about throwing in the towel but it finally is coming to the day

Share this post


Link to post
Share on other sites

Margo, My band Quest started with my first initial visit in January of 2006. My insurance company had requirements (many) that had to be met before they would consider paying for my surgery. Once i met all the requirements my surgery was approved in TWO DAYS!! The down side was it took from 1/07 till my surgery day of 9-13-06. I had my 3rd fill yesterday and was down a WHOPPING 66 lbs !! The 66 lb loss includes my two week pre-surgery diet. Hang in there it is totally worth the wait.

Share this post


Link to post
Share on other sites

Why don't you make sure you are covered then attend one of Dr. Spiegel's or Dr. Spivak's seminars. It doesn't take that long to get processed. Make sure in your history you list all the diets you have been on and the results. I didn't have any problems and it was quite fast.

Share this post


Link to post
Share on other sites

Margo -

If you have EVER been on a doctor supervised diet - that will usually fill the requirement for the insurance company.

Just get the medical records. I have heard people that have used weight watchers membership and other things as well.

I used old history of weight loss.

That being said, I had to fight the insurance company for four months to get approved - but not because of that.

You can always submit for pre-approval yourself - but that is a lot of work.

You can also try another doctor who isn't going to Baa like a sheep when the insurance company calls. If your doc won't be more assertive, you will have to be.

Sorry!!

Share this post


Link to post
Share on other sites

Margo, six months in the long term doesn't mean anything. Really, if this is something you are determined to do, there's no harm that will be done by a six month wait.

So many insurance carriers have some kind of pre-op management requirement that I guess your doctor's office decided to make it mandatory. I know a lot of people complain about it, but I honestly think it makes sense. Weight loss surgery is a big, huge step and MANY people who think they need it or who medically qualify just aren't ready for it mentally. And that's the worst way to go into surgery; it leads to frustration and failure later on.

Bite the bullet and start the process. Six months is nothing when compared to a lifetime of feeling and being healthier.

Share this post


Link to post
Share on other sites

I am sorry that you have to wait 6 months with this Dr. I think you should try Spiegel or Spivak too. I agree with Kelin, it will be 100% worth the wait, don't give up!

Share this post


Link to post
Share on other sites

Believe me, the actual procedure is the surgeon's bread and butter. So, it's highly unlikely you would be held up from having the lapband surgery by their office. What is more likely is the surgeon's office is now offering the supervised diet and exercise program to meet your insurance carrier's requirement and to ensure their office retains you as a client.

Call your insurance carrier and ask specifically what the requirements are for CPT Code 43770. I think you'll find that is where the official word of the six-month supervised diet and exercise program came from. The surgeon's office is just the messenger of your insurance benefits and entitlements.

You'll also find that should you decide to self-pay for the procedure and have all your pe-operative requirements completed, you'll have a surgery date so quick it will make your head spin.

Share this post


Link to post
Share on other sites

I was able to submit years of medical records from my OBGYN which documented my being over weight for more than 5 years. I also submitted logs from weight watchers. And having started seeing a nutritionist right away when I started my inquiry of the band, knowing that would be an eventual plus in getting approval.

I started my journey in June doing serious research, joined this board in September, and here I am, just 3 weeks away from my surgery date. I know you're mad, upset or disappointed - we've all been there at some point. Trust me, you'll need 6 months just to get yourself well enough educated to make this huge change in your life.

Good luck.

Sheri lynn

Share this post


Link to post
Share on other sites

i had to do the 6 month thing. It goes fast and having insurance pay is well worth the wait! Total, I 'll have to drop less than 3k for the whole thing. I think it's worth it and I love my band - less than 3 weeks out of surgery!

Share this post


Link to post
Share on other sites

In Canada, specifically Montreal, to get the operation, you're on a waiting list that is now up to 7 years, unless you're super super super super obese, which is 3-5 years, so count yourself lucky that you've only got 6 months. I waited 2 years for mine and the only reason I waited 2 years is because I heard from an insider that a new clinic was opening up and the list was short. Short = 2 years.

Share this post


Link to post
Share on other sites

Margo....My insurance company doesn't pay for the surgery at all. If you are getting it payed for and only have to wait 6 months count your blessings. Every thing in life doesn't always happen at our pace and some times exspecially when someone else is paying for it we have to go at their pace. I had my surgery within 2 months but it came with the hefty price tag of $17,500. I am sure if you are willing to self pay there are alot of surgeons who will get you in alot faster. You have to decide which is more important to you your time or money. Good Luck to you and I hope the frustration of having to wait doesn't discourage you from going forward.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      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:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×