Waiting sucks!

[Crich36108 1]

Im currently going thru the process of doing my pre-op testing and I hate that once its completed I have to wait 6 months per my insurance. I'm so ready for a change and now I'm feeling depressed! Especially if i don't know if they are going to approve or not. Any advice?

[Lacey Elliseal 21]

Im currently going thru the process of doing my pre-op testing and I hate that once its completed I have to wait 6 months per my insurance. I'm so ready for a change and now I'm feeling depressed! Especially if i don't know if they are going to approve or not. Any advice?

I wanted to give up too! But don't, it will go by faster than you think. I know it sucks but you'll be glad you did. I'm 2 weeks post op and I had to wait the 6 months too. You've probably already done research but do more, try to change your eating habits, (have more than a couple of "last meals") lol! And from what I've seen most insurances come through, after you jump through some hoops. Mantra time! Everything will be okay, everything will be okay!

[Big Opie 32]

I have to do the 6 months monitored diet for my insurance then a psych evaluation and a dietician. I'm currently going in for my 3 month on April 9th. It's gone faster then I thought it would, and I understand about how the waiting sucks. I'm going nuts waiting for these 6 months to go by! It'll go by quicker then you think. ???????? chin up

[Crich36108 1]

Question? When does the Dr. Submit your claim to the insurance to start the 6 month waiting period? After all your test is complete? Or on your first visit? My Bmi is over 40 so I shouldn't need another co mobility but I think they are sending one just in case.

[brmbrown 15]

How it works is the Drs office will verify pretty early on with your insurance information that it's (Bariatric surgery) is available under plan. If it is they can according to your carrier determine requirements. Once it is confirmed that your insurance covers provided requirements are met, they will continue to see you. Your initial consultation will be included as your first visit with dietician etc. My husband and I are together to be sleeved on 4/23. We recvd our surgery dates on our initial visit -- after they confirmed our eligibility-- while my hubby and I watched video to determine which procedure we were interested in.

[brmbrown 15]

After the video, we talked with dietician, she gave us the binders which guided us with requirement from our insurer. They even scheduled next appt which occurred a few days later since our first appt was at the end of the mth.

[brmbrown 15]

Time went fast

[coleenrenee 66]

Don't give up my insurance fell thru twice and it's been 5 years of waiting and jumping thru many many hoops.. First insurance wanted the laundry list 6 months of diet blah blah etc. I had HMO and a big fight between providers and medical group caused a hold on surgery. Year later new medical group new provider after the 6 month of diets again etc insurance denied me, said I didn't prove any "failed attempts" the diet I was on was successful.. ???????? a year long of appeals... so for about 2 years I said I'll just stick to the diet which was working until I ran into some "stressors" and the weight started to come back.. ???? just November I decided to try again. Dr. Couldn't get me in until December 21... I cxld rescheduled Jan 9th nurse calls Dr had emergency and reschedules me(My Dr is in high demand appts are hard to come by) Feb 9th 2nd consult.. Turns out I didn't have to start over.. They approved me right then and there.. Set up Psych evaluation, dietitian and pre-op appts. All finished and surgery is on 23rd of April ... But can I say that it's killing me to wait even another week! Keep going if you really want it don't stop until you have it.

[Crich36108 1]

What insurance company if you don't mind me asking? And I'm glad you didn't give up!

[coleenrenee 66]

Blue Cross Ca. ✋

[Crich36108 1]

Can you be my support buddy? If so can you please inbox your number. I would love to have communication with someone in the same boat.

[coleenrenee 66]

Yes absolutely...

[burneyatchley101213 7]

My husband and I are saving a lot of time doing this together so our appointments are together but man is it taking forever. We started this process in December. We are about 95% of the way done by April 15th...hopefully. Since we are doing this together and we are each others support person, we have to have our surgeries a month apart. I won't have mine til JULY. Jumping through the insurance hoops and waiting is the worst

[Less of Jess 28]

Waiting has been tough!

I first decided to start this journey Jan 2014 when I found out the new insurance my work started carrying would cover WLS. I needed to get a referral from my PCP first, but first I needed an in-plan PCP! Took three months to get into an in-plan PCP, then the insurance required a 6 month "i can change" program, which consisted of talking to a life-couch once a month for 6 months. I started that program 4/2014. My first appt with a surgeon was 7/2014. At that point the surgeon's office required psych and nut consults before submitting for insurance approval, then the rest of the pre-op testing; sleep, ecg, upper gi, bloodwork. I completed my Nut consult and began psych consults in 9/2014, as well as my first sleep study.

I completed the i can change program in 10/2014. Once I submitted the proof of program completion and Nut and psych consults to the surgeon's office I asked them to call me if they needed anything further to complete my pre-approval. I didn't hear anything for a few weeks, so I called the surgeon's office and asked if they'd heard back from my insurance, they said that they hadn't heard back yet. So I contacted my insurance to see what the hold up was, the hold up was that nothing had been submitted! So I called the surgeon's office and was told someone would call me back. Nothing... Called again a few days later, again told someone would call me back... Since I'd heard that before I demanded to know why my pre-approval wasn't submitted yet. Grumpily the receptionist grabbed my file and said they were waiting to get my final OK from psych (which was completed and sent to them 1 month prior!). So I called psych and asked them to resubmit it. They did and a week later, now the end of November, I get a call from the surgeon's office that my claim had been denied as the insurance required all the pre-op's to be done before pre-approval... So they were sending me info on the rest of the pre-ops.

I was able to complete all the sleep studies, ended up with a BiPAP in January 2015. My ECG and Upper GI were done right before Christmas and bloods were drawn right before New Year's. But by this point I was fed up with the lies and delays of the surgeon's office that I started researching other surgeon's in the area. I was able to bypass the seminar requirement at Dr. Pohl's office and get an appt with him Jan 21st. Since all the pre-op's done previously looked good and I had my BiPAP, all he required in addition was an abdominal ultrasound. But unfortunately in that time my insurance had changed their requirements, and now no longer needed the i can change program, but now just needed 3 consecutive months with a nutritionist... I only had one appt! So I got a new Nut, and had the ultrasound which showed gallstones.

Now after 2 additional Nut appts I finally got pre-approval and a date of May 13th, 2015, 17 months after I started this whole process, and 10 months after my first surgery consult. Though all of this has been beyond annoying, I have learned quite a bit about the process, and am glad that I have the surgeon I do now! I have come to terms with the prospect of loosing most of my stomach, and as a bonus, my gallbladder! Had I now taken all this time and effort I may have ended up with a lap band, which to my un-educated self was my first choice. I now know that that surgery was not the best for me. Especially since a co-worker of mine was able to get the lap-band done, through a different insurance, in only 3 months, and now wishes she had gotten the sleeve! Also, had I stayed with the first surgeon, I wouldn't know about the gallstones, and would likely be looking at additional emergency gallbladder removal in the near future.

In the end, this is my journey, but it was the right journey for me! Everything will be fine!

[brmbrown 15]

Collenrenee, congrats and glad you're in your way! I'll have to keep in touch with you as it's the same date for my husband and me to get sleeved! I'm excited and nervous!

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