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Doctor Requirements - Stuck in Approval



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I started my bariatric's journey back around August of 2012 with a conversation with my insurance company. They advised they would pay for my surgery in full after I completed the requirements of 6mth nutritionist and physiatrics appointment. They then set me up with a direct counselor. My counselor was a bum one and everyone I spoke to said I had to talk to her before I did anything else. Before you knew, almost six months went by and I called back they said, they would get me a new person. I instead got the same bum counselor. Finally, I called a fifth time and got a new person who said I didn't need her at all it was only for reporting purposes. HEAD BANG!


Finally, I started checking around and getting setup with a nutritionist and got that done and my psychiatric appointment. I think it makes me sad it was delayed so long over a mis-communication. The insurance company, doctors, and counselor do not communicate very well. The one big benefit is that I have had all this time to discuss it with my family, research, and read everything I could on the subject.


I had finally completed all my requirements and was approved by the insurance company for moving forward. Geesh that took forever!


When I saw my surgeon for the first time, we discussed my options he learned or tried to convince me to do an RYN because my metabolism is so slow. I said I would consider a sleeve but knew without a doubt, not an RYN. I initially went in wanting a lap band. However, he's a teacher, so he did lots of surgeries and went over the complications of lap bands.


We agreed that my metabolism was bad in our session. I eat really well these days. Rarely do I eat anything processed or packaged. I cook everything from scratch, and I have spent my time with nutritionist customizing that and listening to my body. I now stop when I am full I don't keep eating. Which was a big deal for me. My surgeon required 50lbs before surgery. I've lost a bit and gained a bit but nothing near what he required. I spoke to the nurse at his office, and she said without a doubt I had to loose at least that to setup a follow-up for blood test etc.


It's kind of discouraging being stuck at this point I feel like I have to starve myself to get past this last hurdle to continue on with my life.


Some people have recommended doing just shakes for awhile though I have thought of that and said it might work others have stated I would be worn out on a liquid diet for so long.


I understand the surgeon requires two weeks of liquid diet pre operation, and I believe almost 6weeks after surgery. I know all doctors are different. I think he's a stickler for making sure the new stomach doesn't leak.


It took me a long time to convince my girlfriend to compromise and allow me to have this surgery. She loves the surgeon I have now because he's so meticulous and through.


Not sure how to proceed... I'm stuck in approved status for a resolution to my problems, and my problem is preventing me from being free!

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Wow! Yeah, he sounds meticulous alright. Does he also have OCD? Why so stringent? You are meeting requirements for *insurance* purposes. I would like to see you go to a different very good

surgeon who won't put up any B.S. roadblocks.

Also, since when does a girlfriend "allow" you to have surgery?!

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I wondered if he was just overly strict compared to others. I saw one person say that they saw their surgeon on a Tuesday approved by Thursday via Medicare and having surgery on Tuesday of the next week with only a one day liquid diet preop.


My girlfriend and I have been together for over 9yrs. She's a spouse in all likes of the word, but we haven't taken a big step. I am making a life changing event it is not one I would do without her. It took a lot of positioning on my part to convince her it would be okay. Though it is my body and my life, we share a life together. I did yes have to have her approval first.


I wonder if I start the liquid diet and document it since it would be before someone telling me too do it and look at other surgeon options in the meantime. Maybe they will give me credit for the liquid diet days I've already done? That's way out there but who knows I suppose.

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I dunno.. Honestly, I would shop around for another surgeon. Requiring 50 pounds after he agreed you had a slow metabolism? Something doesn't seem right about that. While it's true that all surgeons are different and require different things, that really just sounds excessive. I wonder what his "requirements" would have been if you had agreed to the surgery of his choice.

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I tried to get some additonal providers today and the insurance company failed! I will try again tomorrow and make some calls see if I can't get a quicker turn around time.

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I actually changed surgeons. I started this journey September 2013, and just got approval 6/6 and am scheduled for 7/1. the new DR got everything handled as of 4/28, that was my first visit with him. I would honestly look for a new DR.

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My doc doesn't require a weight loss unless you are over a 50 bmi or higher. Then he wants you to lose 5-10% of that

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