some questions

[CoolBrze198 0]

Hi Everyone,

I have been doing research on LB.. I would love to have it done. I have not went to an orientation. I will attend on Jan 23rd.

I am really excited to get more info. I did get a brochure in the mail from Dr. Rehnke's office. I have it all filled out. Will take it with me to the meeting. What all happens at the orientation/informational meetings?

After the initial meeting is that when you schedule your 1st meeting with the Dr. to discuss the surgery & ins. and the whole shabang?

I called my ins. co and they told me they cover 80% of surgery. And I think she said I had a $1,000 deductible. I am having them send me a copy of our benefits booklet. Want to get it in writing...

One of my biggest things I am concerned about. What if my PCP doesn't agree with this surgery. I am sure there are many Dr's out there that will not approve having LB done.... ?!?!?!

I haven't talked to him yet. But will soon. I have a followup on my bloodwork on tues. Have to get it done every year because I have an underactive thyroid..

Have any of you had a PCP not approve surgery? If so, how did you handle it? Did you get another Dr? :nervous

Also tell me about the Optifast? Is that a drink? What is the taste?

Thanks in advance....

:wave:

[Wheetsin 714]

What all happens at the orientation/informational meetings? That's going to vary by surgeon. At mine it was a combination of introducing everyone in the program (nurses, coordinators, surgeons, psychologist, dietician, etc.), then going through a PPT of the procedure & statistics, information/paperwork is distributed, then Q&A, then the surgeon has past patients come up and share their experience and opens up to Q&A with them, etc.

After the initial meeting is that when you schedule your 1st meeting with the Dr. to discuss the surgery & ins. and the whole shabang? What happened in my case was that the initial meeting is ONLY for information & getting the paperwork. You then do your paperwork and submit it to the coordinator who processes with your insurance. Once you're pre-approved they schedule your consultation. Keep in mind this process can be very different depending on insured/self-pay, insurance co, etc. It's generally during the consultation with the surgeon that a surgery date is set. I never discussed insurance with my surgeon, that was completely handled by hos coordinator.

I called my ins. co and they told me they cover 80% of surgery. And I think she said I had a $1,000 deductible. I am having them send me a copy of our benefits booklet. Want to get it in writing...

Make sure they send you an "SPD" (summary plan description).

One of my biggest things I am concerned about. What if my PCP doesn't agree with this surgery. I am sure there are many Dr's out there that will not approve having LB done.... ?!?!?!

Is your PCP's consent required for insurance approval per their conditions? If not, then it doesn't much matter. There are some doctors that don't approve, but I only have experience with two. My PCP was thrilled and told me I was the perfect candidate, and is very eager to see how I'm doing whenever I come in. The other is my mother's PCP - very old-fashioned and generally goes with "diet and exercise, maybe WW" as the only way to lose weight. She mentioned to him my surgery and how I had done, and she said his reponse was, "Well then sign up."

Have any of you had a PCP not approve surgery? If so, how did you handle it? Did you get another Dr? :nervous

No but again - is PCP's approval a requirement from your insurance company? In my case, I didn't need a referral (I don't have a true PCP, but she is my doctor). Try talking to your doctor - you seem pretty "sure" s/he is going to say no, you might be surprised. See if it's even required. If it is required and you get a no, then whether or not you seek out another doctor is up to you.

Also tell me about the Optifast? Is that a drink? What is the taste?

Never had to do it so I don't know what it tastes like. Yes it's a liquid formula.

[buffy5220 0]

My pcp is not really thrilled about me wanting the surgery and has tried to talk me out of it. (She probably weighs 300 lbs herself.) I don't know if that has anything to do with it or not??? She said that one of her patients that has had LBS is doing great, one has lost too much weight, and one lost weight and is gaining it back. She is cooperating though. She sent a referral letter to Dr. Woodman, my surgeon, and needs to send another letter directed to the ins. company. I talked to the office about that today.

Dr. Woodman said during the seminar if your pcp won't write you a letter, find one that will!

[soniacan 0]

i got to my orientation meeting late so i missed the video of the operation - thank goodness! then the dr talked about the stats and the risks and passed a lapband arond for us to see and touch.

i think i scheduled my meet with the doc that day too.

i dont really have a PCP so i didnt deal with that. I did tell my obgyn since my apointment was the day before my surgery and she was suportive. cant wait to see her next october!

[CoolBrze198 0]

Thanks for the replies everyone.

I did mention it to him. And he said "it's not for you" Then he went on to ask who was diabetic in my family.. Well of course, my mom & all my aunts...Because my sugar is borderline high.Then he proceeded to tell me I need to cut every thing I eat in 1/2... I don't think I eat a whole heck of a bunch. And have tried several appetite supressants. He prescribed me more. Will try, tried last time with no help. I did see on some website that there were Dr's that believed in the surgery.anyone know where this list is located?

And if my Dr won't send me a referral I guess I will have to find another new Dr. or to self pay. Trying not to do that don't have that much $$ I can't just give up. I would have to pull some strings and do a lot of work to make it...Look out credit cards here I come. For the ones not already maxed out. hehehe

Help? Any other things you can think of for me to try?

[anonemouse 1]

Does your insurance even require a referral? Mine didn't, so I think you should check your policy to be sure. Of course, you will need him to write a letter for you if you decide to try to have insurance pay for it, so I would sit down with him and tell him that you are going through with this with or without his approval, but it would make things a lot easier if he would write you an approval letter.