cjose 0 Posted February 20, 2008 I started my journey to get banded back in Sept 07 and have not been successful yet. I did have some health issues that required further testing and completed all the testing on Jan.18 and still do not have an appt for surgery. The frustrating part is I am self pay. Share this post Link to post Share on other sites
hinger 0 Posted February 20, 2008 Hello everyone. New to this message board but have read through all the posts. I became a bandit on Dec 26, 2007 with the assistance of Dr. Choban. I can relate to alot of things that are being said about Charlene, but I also stayed in touch with my insurance company on an every-other-day basis. Checking in with them to get the latest instead of relying on over-worked (and probably under-paid) Charlene. There were times I had a more up to date response than she did and would call her to tell her. Anyhow ~ I started my journey in June 2006! I was looking into having it completed at the Barix in Groveport but quickly found out they weren't a covered provider on my insurance plan and Mt Carmel West was. So I contacted them, signed up for the seminar and got the ball rolling with them. One of my biggest snags was with my (old) PCP and I had to switch insurance companies. (The surgery wasn't going to be a covered benefit under my old plan, Aetna, but it would be a covered benefit under the other plan my employer covered, BC/BS of Illinois). So I switched insurance plans and submitted everything to them that they requested. By Jan 2007, I had finished my 6 months requirement of meeting with my PCP to discuss diet & exercise and had my pysch evulation. I submitted everything to BC/BS along with a few additional small documentation ( 5 yr weight history, etc) and was quickly denied. They said my PCP didn't put much in his notes and they needed to be more detailed. Whatever. BC/BS suggested I start over with another 6 months worth of PCP visits. So I switched PCP's and went to one that has helped other patients get approved for the surgery. Met with him once a month, discussed what I was doing and I would hear him dictating a letter after the visit ~ he was very detailed in his reports. At the end of my 6 months, it became a waiting game for the insurance to approve it. From Sept 7th (my last dr visit) through late Oct - early Nov was tough. Insurance denied my request (I had to be grandfathered in for this to be a covered benefit and the people who approves the pre-determinations didn't know that. They just knew it wasn't a covered benefit for 2007.) So after MANY phone calls to BC/BS and an appeal to them, outlining how I specifically met their requirements, I was approved! I cried! And then I called everyone I knew to tell them My surgery went off without a hitch (in fact, Dr. Choban told my family the surgery was a boring one. And in the field of medicine, a boring surgery is a good thing!) Recovery went well and I have lost 16 pounds so far. Not as much as others have lost for having their surgery on the same date as mine, but I also don't exercise like I should be and they are. So it's my own fault. I had my first fill yesterday and it wasn't as bad as I was expecting. I have band that will hold 10 cc's and they filled it to 4 cc's. I go back on April 17th unless they call and say I need to be seen before that for whatever reason. Okay ~ now that I've told my life story (at least the last year and a half of it), I should get off here and get some things done. :biggrin2: Thanks for listening, Becky Newark, Oh Share this post Link to post Share on other sites
SpecialK 22 Posted February 20, 2008 I'm APPROVED FOR SURE!!!!! I called Aetna and they said yes, their records show that the surgeon's office provided the missing information on Feb 18 and that Aetna approved my surgery that day!! That I will be getting a letter saying it is approved. I feel so blessed. Share this post Link to post Share on other sites
SpecialK 22 Posted February 20, 2008 Becky (hinger) I can relate to the feeling of being so happy you wanted to cry when you knew you were approved. Congratulations. Looks like there are several of us lining up to be Banded Buddies in March. Share this post Link to post Share on other sites
hinger 0 Posted February 20, 2008 CONGRATS Special K! I am thrilled for you! Share this post Link to post Share on other sites
suecasb 0 Posted February 21, 2008 Charlene called today with my surgery date...March 17th. Whooo!! Can someone who had Dr.Choban please give me a step by step of what to expect? You checked in and then what? Niki..you will be 5 days ahead of me...good luck! and keep us posted please. Are you scared? I am. SpecialK..maybe we will have the same date! Share this post Link to post Share on other sites
debbiek1 0 Posted February 21, 2008 so many people, so many stories!! this thread is popular!! it is great to read everyone story of wondering, hoping, stressing and finally receiving a new lease on life. March is going to be very exciting as so many members will finally get banded. This is going to be so much fun to watch. Share this post Link to post Share on other sites
nurse niki 0 Posted February 21, 2008 Alrighty then ladies...I will start March off on the 12th and you guys quickly follow me. We WILL do this!!! Sue, I am not really scared yet. I don't know if it is bc we are leaving for Disney in 4 days and I still can't find our suitcases, or if it is I have been wanting this for soooo long that I feel relieved it is going to happen. I know the other ladies I did my pre-op testing with last week said they were starting to get nervous. I think the only thing I am worried about it getting "put out" with a general. I have not done well with it in the past, and I have a terrible family history with it, so it make me nervous. I think Mt carmel is a great hospital and I have complete faith in our doctors/nurses and other staff (Michelle, Melissa, ect) that I believe we ALL will do just fine. Welcome cjose and hinger! We are always looking for new friends and stories, so glad you came! _niki Share this post Link to post Share on other sites
Thinner me 1 Posted February 21, 2008 Hello and Welcome to all the new ladies. I am so happy for you guys getting dates in March. It's just around the corner now. Share this post Link to post Share on other sites
SpecialK 22 Posted February 21, 2008 Wow! Its so positive to see people getting their surgery dates in March! They said Dr. Price will be reviewing my paperwork tomorrow and I should know something maybe by Monday. Second, I had a really great conversation with 2 different people related to Mt. Carmel's Bariatric program. Here's the scoop. I'm encouraged they cared to call me and talk. Melissa is the Bariatric Coordinator for the hospital and I told her that several of us felt Mt. Carmel could step up more on improving having patient advocates that help people get through all the clearances, scheduling and insurance process, not just the person who submits the insurance paperwork. She said she appreciated the feedback and said she'd have the office manager of Mid Ohio Surgical Associates call me to talk since the doctors in that practice are the sole group of bariatric surgeons at Mt. Carmel for now, and that ultimately how many people they have staffed to handle their bariatric patients is their call but that Mt. Carmel certainly has a stake in how successful and how positive the whole process is. The office manager, I think he said his name was David, also called me back and we had a great conversation. He said yes, they realize that there is a need for someone to help patients get through the whole process, that they had proposed adding a position called patient adviser or patient advocate (something like that title) that would be the person who handles helping the patients who are trying to get approved for coverage or who have to complete various clearances to have surgery are getting done. I mentioned the other bariatric programs having a 1 day process of bringing people in and getting their cardiac, psych and nutrition clearance appointments all nailed down in a single day and that it was a tough process scheduling them all individually ourselves. He said he'd definitely consider that. He wants to expedite and improve it as much as they can. He also mentioned that he'll bring this up at the Mt. Carmel bariatric program committee meeting and also with the three doctors who ultimately own the Mid Ohio Surgical Assoc practice. So, it would be wonderful for the newbies coming into the process to have some more help than some of us have had in the past. I mentioned that you have to be tough and determined to get through all the hoops and they really shouldn't make it so hard on folks who really need this help. He agreed and was very very nice about listening to the feedback on improving the Mt. Carmel program. Hope that brings encouragement to others and we'll keep you posted if we hear they've added to the staff to help bariatric patients get through the first six months especially. Share this post Link to post Share on other sites
nurse niki 0 Posted February 21, 2008 Melissa said they were working on the process...I guess this is proof positive! Great Job Special K...you speek what so many of us feel! Share this post Link to post Share on other sites
nurse niki 0 Posted February 21, 2008 Thinner Me...I was thinking that you should be about done hoop jumping, and guess of a surgery approval/surgery date? Share this post Link to post Share on other sites
Thinner me 1 Posted February 21, 2008 Hey Niki~ everything is submitted, just waiting now on insurance approval. They said its taking about a month once you get approved, so looks like the end of March or April. I would love to join you girls and be a Marchie too. (fingers crossed) Share this post Link to post Share on other sites
SpecialK 22 Posted February 22, 2008 There is a cute thread under General Discussion about what nickname to come up with for us March 2008 bandsters. Check it out. I created a sample graphic to use on my signature once I know for sure I get to be a March surgery date...still waiting. http://www.lapbandtalk.com/f17/what-march-bandster-s-official-name-year-53071/ Share this post Link to post Share on other sites
palarin 1 Posted February 22, 2008 I am so happy for you, Special-K, Suecasb, and any others who have been waiting through the process to receive that one special phone call telling them that they are approved and here is your surgery date. How exciting everyone must be. I remember that feeling not too long ago. I had my first fill on Tuesday, Feb. 19 along with Becky (hinger) and a few others. I didn't think it was too bad either. Although I still have a small piece of my incision above my port that is not healed all the way but almost there. When they did the X-ray, the insertion point for the port was actually right below my incision line, so everything worked out. I have a morphine pump right below where my lap band port is located and it too has a port that I have refilled on a monthly basis. Dr. Choban was teasing me when she told Melissa to make sure that she gets the right port. This is one of the reasons I like Dr. Choban so much is because she is so down to earth. However, when your health takes a turn in the wrong direction, she is very dedicated to taking the best possible care of you. Those are qualities that you don't find in very many doctors. I told Dr. Choban that I had saw her on TV and asked for her autograph. She laughed and said it must be on in the morning because the only thing on her TV in the morning is the Sports Center. Hi Becky, I noticed that they gave you April 17 for the next fill as well. Kathleen told me that it is actually 8.5 weeks out even though Dr. Choban told us 6 weeks. She did mention though that Dr. Choban's schedule is really, really busy so if things changed someone would call me. Have a good weekend everyone......Marie :smile2: Share this post Link to post Share on other sites