February surgery (lap-band) hopeful!

[betty_s 476]

i'm currently on month 10 of 12 for insurance requirements (12 month coaching program, TOPS membership, and all psych eval, medical release, nutrition eval scheduled jan 6.)

i'm frustrated because I call my doctors office and if i'm lucky enough to get through they rush me off the phone and i'm left with the same questions.

will I need to be cleared with insurance before my surgeon sees me again? or should I schedule an appointment after I have the rest of my pre-surgery appointments to find out when (and if) I need to start a pre-surgery diet and stuff?

I started this on February 14, 2013 (actually had orientation in Jan '13) so i'm just getting really antsy at this point. I don't want February 14, 2014 to roll around and my surgery is pushed back because of something I did or didn't do.

Edited December 26, 2013 by betty_s

[2muchfun 8,927]

These are questions only your doctor can answer? But, a 12 month supervised coaching program? That's the most extreme hurdle I've ever heard for a patient to be eligible for WLS? Sounds like it's a filter to weed out the weak and avoid the cost?

[lisacaron 5,075]

Hi Betty,

Don't let the Dr. or his office staff run you off the phone. You are a patient there, you are going through pre-op even if you are not on the diet yet. If you are going to schedule surgery with this Dr. you need to get your relationship with that office staff going! I'm sorry to say that sometimes it takes more then a bit of tenacity on your part to get it going and established on the terms that you are willing to accept.

If you want to see the Dr. he should see you even if it's to answer any additional questions you might about the surgery. I'm sure the office has a medical coordinator that sets up the surgical appointments and knows what data is required prior to setting that appointment. Ask to speak to that person, and if you can get to know a few of the people in the office on a first name basis you will be ahead of the game in your future dealings in that office.

Best of luck to you and I hope it all works out!

[betty_s 476]

yeah, that's what I hear. its been a long journey, so being denied would really be disappointing. I work for an independent state agency in va (state benefits) and they put this in place a few years back to discourage people from employment just to receive the surgery (or so I hear).

These are questions only your doctor can answer? But, a 12 month supervised coaching program? That's the most extreme hurdle I've ever heard for a patient to be eligible for WLS? Sounds like it's a filter to weed out the weak and avoid the cost?

Edited December 26, 2013 by betty_s

[lisacaron 5,075]

These are questions only your doctor can answer? But, a 12 month supervised coaching program? That's the most extreme hurdle I've ever heard for a patient to be eligible for WLS? Sounds like it's a filter to weed out the weak and avoid the cost?

But congratulations for sticking it out through that!!! Don't let this surgeon's office staff stop you now! Start taking names, and call your insurance company yourself and find out if you need anything else to get that date set.

[betty_s 476]

thanks so much, lisa. I think there is only one coordinator and she's hard to get ahold of. I only spoke with the doctor at the orientation, briefly. I see your point on getting relationships going now, since this is a very important event in my life. thanks for the info!

Hi Betty,

Don't let the Dr. or his office staff run you off the phone. You are a patient there, you are going through pre-op even if you are not on the diet yet. If you are going to schedule surgery with this Dr. you need to get your relationship with that office staff going! I'm sorry to say that sometimes it takes more then a bit of tenacity on your part to get it going and established on the terms that you are willing to accept.

If you want to see the Dr. he should see you even if it's to answer any additional questions you might about the surgery. I'm sure the office has a medical coordinator that sets up the surgical appointments and knows what data is required prior to setting that appointment. Ask to speak to that person, and if you can get to know a few of the people in the office on a first name basis you will be ahead of the game in your future dealings in that office.

Best of luck to you and I hope it all works out!