Lapband in the DC Area

[stefgray 0]

Hi everyone. I was looking for stuff on Optifast and came across your thread. I live in Bowie, MD and my surgeon is Dr. Steele at Johns Hopkins Bayview. She's great, her office staff is wonderful and I'm very excited! I have now completed all of my pre-op stuff and it's been submitted to my insurance (also BC/BS federal). So, based on your messages above, I guess I've got a pretty good shot at being approved quickly - my BMI is 42.

A few years ago, before BC started covering the band, I had met with and talked to Dr. Pinnar in Reston. He was very nice and his staff really had their stuff together. But, I couldn't afford it, so I had to wait.

Now, I'm very happy! Nice to see fellow Marylanders.

Stephanie

[Pamela Yvonne 0]

Hello Stephanie,

I just wanted to say congratulations and did Dr. Steele put on a diet or drink Protein shakes before your surgery. Do you have to lose 30lbs because that is what they told me?

Pamela

[stefgray 0]

Nope. No diet or Protein Shakes yet. But, I haven't been approved, so I don't have the pre-op stuff yet. I would think she'd want me to follow some sort of plan before surgery, but don't know what. I don't have to lose any weight before....if I could do that, I would have already done it! Dr. Steele's office told you that?

[Pamela Yvonne 0]

I know that's right. I should have driven up there to B-more. Well, my doctor told me that I would have to lose 30lbs before my surgery date. So, I said that is why people are coming to you to help them lose the weight. They don't look at it that way, so she said if I come close to it is great but I need to try to lose some weight.

I will keep Dr. Steele in mind if I cannot lose the desired weight they want me to.

Pamela

[stefgray 0]

Best of luck, Pamela. I hope that all goes well for you.

Stephanie

[Pamela Yvonne 0]

Thank you Stephanie, please keep me posted on the outcome.

Pamela

[mumof2boys 71]

Hi, Stephanie. So...you're from Bowie? I just got back home from there. I had to go to David's Bridal to order a bridesmaid's dress. Oh, what fun. Anyway...about Optifast...I HATE IT!!! The taste isn't that bad, but I just want something else. I would kill for a salad right about now. I started the Optifast diet on Monday (4/16/07) and I am down 8 pounds. My doctor (Dr. Brody) didn't tell me that I had to lose weight, the purpose behind the Optifast is to shrink your liver. Anyway...good luck on the approval process...you should be alright. I heard that BCBS isn't that difficult. I wish you the best and if you have to do Optifast, I'll be thinking about you. It has kind of gotten me depressed. Especially on a day like today, it's so beautiful outside...a nice day to throw some hot dogs and hamburgers on the grill...but NONE FOR ME!!! :think

Let us know how it works out for you!!

Tina

[stefgray 0]

Thanks, Tina. I actually don't mind some of the Protein shakes, but I'm having a hard time imagining going from eating like normal to that. My husband and I talked last night about starting to phase in some of the changes I'll need to make. I'm a HUGE soda drinker. I start my day with one cup of coffee and then it's almost exclusively sodas from then on. So, I'm really going to have to work on that. I like other stuff, but it's my go-to drink!

I know where David's is. I go to that AC Moore all the time and we get dinner from California Tortilla about once a week (well, we did............).

stephanie

[ja9va 0]

Pronetus,

I to have BCBS Federal and have my surgery scheduled for June 7. Are you saying you have a 5,000-7,000 out of pocket expenses not paid by the insurance? When they approve you I thought that meant they covered it! I realize there may be some expenses, which I was thinking under 1K? Please confirm. I know for some who are paying out of pocket, think this is nothing, but for one that is hoping it is covered it is a different position. I may have to call my surgeon's office on Monday.

Pamela, I have my surgery scheduled with Dr. Batista at Commonwealth Surgeons in Richmond, VA. I know several people who have gone to this group for BP but not band. But the feedback is great. He is a young doctor as well and the group has been a certified weight loss group for a long time. My surgery date is June 7 due to their credibility, I think many use them.

the insurance process is different for everyone. As you can see in this post, I am asking for clarification and may need to explore more, for I would like to know ahead of time if I am going to be faced with that amount of a bill!

Good luck on your journey and keep in touch.

Janine

[bhabydoll 0]

<p>Don't Worry Everyone, I will not be going to Southern Maryland Hospital. I met with Dr. Kalan and he was very nice. I really liked him and he made me feel comfortable. BC/BS said that I don't have any pre op requirments except to have the BMI. But when I went to the Doctor today I was told BC/BS would want everything before she submitted it. Everything I am okay with (all 6 tests) except the 6 month physician supervised diet. I didn't do that even though I have been thinking about lapband for sometime because my insurance said I wouldn't need it. I called Dr. Kalan's office and told her BC/BS said to just submit it but she said the doctor would make me do those things no matter what for liability reasons even if insurance says I don't need it. Is that normal? or has anyone ever heard of this before? <img src="http://www.LapBandTalk.com/images/smilies/help.gif" border="0" alt="" title="Help" smilieid="256" class="inlineimg" /></p>

Oh and Janine When I to BC/BS they told me if you went with a preferred provider they would cover 90% of the cost. So 5-7Kseems a little steep. I was only estimating 3K at the most. If you go with a non preferred surgeon they only cover 80% so maybe that was the case.

[mumof2boys 71]

What a relief that you are not going to Southern Maryland for this procedure. I would be very scared for you. As far as the tests...I think that every doctor is different in what they require prior to the surgery. For instance...my insurance does not require a psych evaluation, but my doctor did. So...don't worry...it's for your own safety. You should be good to go and you will get your surgery soon. I only have 4 days left. :high5:

Tina

[bhabydoll 0]

Pamela,

Hi Pamela I decided to make an appointment with Dr. Rickford. I thought it wouldn't hurt to talk to another doctor. Is Dr. Rickford the one who told you to lose the weight? Did he say why and if you don't mind me asking what is your BMI and/or weight. Thanks

Danielle

[Pamela Yvonne 0]

Hello Danielle,

Dr. Rickford didn't tell me that I had to lose 30lbs, but his assistant doctor did; her name is Dr. Tapscott. I feel if I could lose the 30lbs why in the heck would I need the Lapband. I told her I have tried to lose weight on my own but I keep gaining and gaining. I will talk to him about it because she is not doing the surgery and other people on the forum even said they didn't have to lose weight before their surgery.

Let me give you Dr. Rickford number 202-448-4080. Please keep let me know how you are doing and what's going on with you.

Pamela

[bjlang68 1]

I have BCBS Federal. I just had my surgery on 3/23, so the info is fresh!

There was a $200 "Program participation fee", the dietician didn't accept insurance, so I paid her $150. The surgery co-pay was $100, and is paid the day of surgery. Regular visits are the normal $15 co-pay. Other than that, the insurance covered 100%. I just got a bill for $142 from the surgeons. Not sure what it was for, but I'll check into it!

Also, the insurance requires no psych eval and NO WAITING PERIOD!

Hope this info helps! BJ :clap2:

[Pamela Yvonne 0]

Hello BJ,

Did you have to lose any weight before your surgery? I guess every doctor is different because they wanted me to get a Physc evaluation which was $150, dietician was $15 co-pay, cardiologist $15.00 co-pay and sleep study $15 and then I'm done. However, I need to lose 30lbs before my surgery date.

Pamela