How long until all requirements are met before insurance approval & Surgery?

[Mysticpink74 50]

Ok....I had a few different answers on this (but it's to be expected) so I decided to copy what I wrote on another thread & ask the question: How long does it take before insurance approves & surgery is scheduled???? One person sd it only took a week after everything was submitted for insurance approval & surgery was only 3wks after....another person is STILL waiting for approval after everything was submitted In FEBRUARY?!

This is my story:

I had my 6mo of dieting in with a diff doctor before I decided to go through with Route Y surgery!!

I did my initial meeting & had both of my required dietitian Appts....

all I really have left is to lose more 8lbs (my required 5% that I have to lose before surgery) & my Psychiatric appt for him to give the green light so they can get my insurance to cover surgery....

I've been doing the "Bariatric diet" for like 2mo now (meat, 1cup veggies, 1c fruit 3x times a day: no snacking in between...only Water, crystal light, & sugar free tropical Popsicles are accepted)

BUT ..... I was going to do surgery a couple of years ago & started going through the process only to get SHUT DOWN by the psych!! He was a skinny lad that sd I was not a good candidate for surgery cuz of my depression?!

I mean really depression & obesity kinda go hand in hand?? Just saying....

So anyway out of SPITE I did the "Bariatric Diet" on my own for MONTHS & lost like 70lbs....then I plateaued & stopped dieting only to gain the weight bk & then some...

My fear is that something will go wrong with my upcoming Psyhc appt (since its through the only Bariatric surgeons close to me) or I'll have to jump through more hoops before I'm approved for surgery.! I've worked too hard to be shot down now....

my struggle is I always had bad knees & back since I was young....even when I wore a size 5 & weighed 120lbs.....

I had four kids back to back from 2002-2005 & gained like almost 200lbs!!! Cuz of my disability issues I can't "work it off" like normal people...I'm in constant pain & am pretty much immobile ...so surgery is the only option I see to get most of this weight off me so I can start moving again!!! ????

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Edited March 27, 2016 by Mysticpink74

[TLW 163]

There really is no set time frame it all depends on your insurance company and how fast they process the materials. The second determination is your surgeons schedule. I would say expect a 6-8 week wait and that way when it happens sooner, you will be set. My insurance was approved in 2 weeks, but I had a 4 week wait after the approval due to the program requirement and my surgeons schedule. No matter the wait it is so worth it in the end.

[Mysticpink74 50]

There really is no set time frame it all depends on your insurance company and how fast they process the materials. The second determination is your surgeons schedule. I would say expect a 6-8 week wait and that way when it happens sooner, you will be set. My insurance was approved in 2 weeks, but I had a 4 week wait after the approval due to the program requirement and my surgeons schedule. No matter the wait it is so worth it in the end.

So did you have surgery yet or are you anxiously waiting

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[TLW 163]

I had my surgery May 28th of 2015.

[Mysticpink74 50]

I had my surgery May 28th of 2015.

Do you remember how bad the pain was post-op or is it a faded memory cuz of the positive outcome of surgery? That is the only other thing that worries me is post-op pain & excess skin hanging from my belly (& insurance not covering the removal IF I NEED it???)

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[SweetPeas 117]

My approval process took about three weeks. Once that came through they called me to schedule the surgery the next day, with a surgery date about six weeks later due to the surgeon's schedule. At the time it seemed like a really long process, but it gave me time to get prepared, purchase a kitchen scale and smaller plates/bowls, check out Protein powders and drinks, and to read up on what to expect. The first night/next day of pain were the worst and after that my pain was controlled with non-narcotic meds. Walking helped a lot!

[TLW 163]

I was so worried about pain and the gas. I would highly recommend that you bring some of the dissolvable (under the tongue) Gas X and begin to take them a few hours after surgery, and walk, walk, walk. I was up and walking the hall about 7 hours after my surgery and did so every 2-3 hours (about 45 minutes after pain pill) The only time the pain sucked was coughing. have a pillow that you can hold against your stomach when you cough.

The skin didn't really bother me until now, knowing that summer is coming. I can hide my saggy belly skin, but the thigh skin is harder because it droops to the knees, but I know the difference so it looks worse to me. The I have to laugh because I am so vain now, when before the surgery I was a size 20 and right now I am a size 4. However, I cannot wait for my 18 month post op, so I can see about removing some of the extra skin.

[MrsDiva65 4]

I had my surgery May 28th of 2015.

I'm having my surgery on tomorrow March 28th 2016. Wow exactly one year after you. How are you doing after your year out?

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[Jade99 40]

My surgeon's office just sent off the paperwork on Wednesday and she said it should be a 2-3 week wait. I'm not really pressed, because my surgeon wants my a1c under 10, before he will do the surgery. I'm hoping and praying that he will just schedule the surgery and have my alc checked during a pre-op lab work. If not then I'll have to wait until late June or July to have surgery, since I don't see my Endocrinologist again until June.

In the meantime, I'm going to see if I can get this lupron depot induced weight off and start weight training.

[James Marusek 5,244]

The whole process for me took about 9 months from the time of initial consultation until surgery. After the 6 month medically supervised weight loss and exercise program, there was still the pre-op physicals to go through and the second round of pre-op physicals. There was the half day of training classes. There was the waiting for the insurance approval. There was the surgeon's schedule. It sounds like you still have a little ways to go.

One thing that you said was strange. Normally the first step in the program was to undergo the psychological exam. Since you said "upcoming Psyhc appt", it sounds like you did not undergo this initial step. Especially since you had problems with this step initially, I wonder why they did not schedule this at the very beginning.

[James Marusek 5,244]

I had my surgery May 28th of 2015.

Do you remember how bad the pain was post-op or is it a faded memory cuz of the positive outcome of surgery? That is the only other thing that worries me is post-op pain & excess skin hanging from my belly (& insurance not covering the removal IF I NEED it???)

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The pain level will vary by individual. I have a high level of pain tolerance. After surgery when I went into the recovery room, I declined all pain medication. I didn't really need it because at the most my pain level never went above a 2 on a scale of 1 to 10. I walked each day for 30 minutes for months prior to surgery and then when I was in the hospital, I walked a lot. That really helps with the recovery process and reducing pain.

[Mysticpink74 50]

I had my surgery May 28th of 2015.

Do you remember how bad the pain was post-op or is it a faded memory cuz of the positive outcome of surgery? That is the only other thing that worries me is post-op pain & excess skin hanging from my belly (& insurance not covering the removal IF I NEED it???)

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The pain level will vary by individual. I have a high level of pain tolerance. After surgery when I went into the recovery room, I declined all pain medication. I didn't really need it because at the most my pain level never went above a 2 on a scale of 1 to 10. I walked each day for 30 minutes for months prior to surgery and then when I was in the hospital, I walked a lot. That really helps with the recovery process and reducing pain.

no pain! Wow that's encouraging!

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[Mysticpink74 50]

The whole process for me took about 9 months from the time of initial consultation until surgery. After the 6 month medically supervised weight loss and exercise program, there was still the pre-op physicals to go through and the second round of pre-op physicals. There was the half day of training classes. There was the waiting for the insurance approval. There was the surgeon's schedule. It sounds like you still have a little ways to go.

One thing that you said was strange. Normally the first step in the program was to undergo the psychological exam. Since you said "upcoming Psyhc appt", it sounds like you did not undergo this initial step. Especially since you had problems with this step initially, I wonder why they did not schedule this at the very beginning.

Yeah I don't know? I'm just doing what they require of me...still worried I'll be turned down again...next Monday...I guess we'll see! ????

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