KtKt 0 Posted July 13, 2007 My name is Katie - I live in Wisconsin and have my "in-take" appt. next week. I'm sure I'll impress the staff with the knowledge I've gained reading here ... You guys will have me so educated and prepared, I'll knock their socks off! I have spent hours and hours (and hours) reading through the postings here... getting to know some of you and learning so much about lap banding. One minute I'm ready to beat down some doors to get it scheduled... and then I read some things that make me stop and wonder if this is really the way to go... Insurance? not sure if it'll cover... but the "team" knows how to jump thru all the hoops, so I'm right there doing what I need to do to make it happen... and if it's an Insurance "NO," then the dh and I need to talk... I've copied and pasted important tips & tricks... some inspirations... some warnings ... and will print them out for my official Lap Band Journey-Journal ... THANK GOD for the internet where you truly can find out about anything and everything... There is nothing more useful to me now, making this decision than to hear the facts FIRST HAND from those who have been there ... THANK YOU for sharing your experiences and so much more... This is a giant decision... As you all have been there... you know the fear, excitement, anxiety, worry, and HOPE I'm feeling now. --KtKt ... who has already started practicing tiny bites and lots o'chewing! and who will get on the "Water Wagon" tomorrow!!! Share this post Link to post Share on other sites
Band Chick 3 Posted July 13, 2007 Welcome to LBT! You and I are very similar. I too have been reading, reading and reading. I come here every day and study. Keeping notes and printing them out is a GREAT idea! Thanks for the tip. Hope to see you around the boards and get to know you better. Share this post Link to post Share on other sites
Walter 0 Posted July 16, 2007 Good luck! Some thoughts about the "I" word (Insurance) Either continue or START a medically-supervised weight loss program as that helps both medically and for coverage. If you are denied all patients should PLEASE REMEMBER that there is a FREE (to you) appeals program available through your LAP-BAND surgeon's office....we'll be happy to help you if we can. Walter Lindstrom LAP-BAND Appeals Advocates (A Program of Obesity Law and Advocacy Center) LAP-BANDED RNY Gastric Bypass patient (May 2003) Share this post Link to post Share on other sites
KtKt 0 Posted July 16, 2007 Thanks Walter... The Clinic I'm using will know all the ins and outs of insurance... I'll find out tomorrow at my "in-take" appt.... I have no problem waiting 6 months if I have to, but I won't be sitting here on my pile o'fat... I'll get on whatever program they feel will work for me... I'm sure it won't hurt to get a head start on this journey. It is a life change... and life isn't 6 mos. from now... it's here and NOW : ) If there is a resounding "no," I'll look at an appeal before paying out of pocket... excited about the future! katie Share this post Link to post Share on other sites
Walter 0 Posted July 16, 2007 No doubt some practices are better at the insurance game than others....but here are some bad things they can and do happen by waiting when you DO NOT HAVE TO WAIT: (a) your insurance changes its requirements to become more stringent; ( your insurance changes and ELIMINATES COVERAGE for weight loss surgery; © your hospital abandons its program; (d) you are successful at weight loss and they deny you because you were successful; (e) you were unsuccessful at weight loss and they deny you because you "were not committed"; (f) you suffer physical injury due to your weight and co-morbid conditions that prevents you from having surgery.... we've dealt with all these problems and they are no fun for patients.....that is why you should start/continue the weight loss program but get the practice to submit to the payer right away and NOT WAIT until the 6 months is over . . . too many bad things can happen. Just some things to consider....best of luck to you! Share this post Link to post Share on other sites
KtKt 0 Posted July 17, 2007 Excellent points! I was going to ask tomorrow what the logic behind "jumping thru hoops" is... should I succeed or is it better if I fail? It doesn't make sense really... I'm married to the perfect example of what can happen... my DH has had 3 spine surgeries, a foot reconstruction, hernia repairs,battles with arthritis, nerve damage, edema and is now on insulin and needs a knee replacement. The pain he has, and the drugs he's on makes physical activity next to ZERO... he weight is way out of control. His annual presriptions are more than this surgery... I know I do NOT want to end up where he is now... In the LONG RUN, it would save the insurance company money... so, we shall see! Thanks for your comments... they are MUCH appreciated! Share this post Link to post Share on other sites
Walter 0 Posted July 17, 2007 Starting, continuing and finishing the program cannot hurt you; waiting for that to occur before submitting the request for surgery is what can hurt... if the program/practice gives you a hard time about "hoop jumping" you can refer them to me . . . we've taught bariatric practices those skills for years and can help them to help you. Good luck! Share this post Link to post Share on other sites
wanna_b_thin 0 Posted July 17, 2007 KTKT - Who is your surgeon? I only ask because some surgeons are better at jumping thru the hoops then others...just wondering. Trying to keep all my options open at this point and if your surgeo is better then mine and I am denied then I would consider other possibilities...Thanks! Share this post Link to post Share on other sites