Why such a long process? (Rant)

[Jane1979 270]

Why does it take so long from first appointment to surgery day? Can't all these tests be done within a couple of weeks? Papers don't go to insurance until all requirements have been met. Obviously, if you have a very high BMI and all the health issues that come along with it you need this surgery. What's with the proof of other methods tried? Yeah, I had a gym membership. Could t go anymore because it was just to damn painful (back and knee issues) but how do I PROVE that I actually showed up? I've told my PCP when I have gone on diets, but who's to say if she ever actually marked it in my charts? For all I know she thought I was making conversation. I k ow for a fact my insurance does not cover Optifast or any type of diet aid or pills. Cause it's cosmetic.

HOW exactly can they prove I did or didn't drink slim fast or did the south beach crap?

I'm still a long way from my first appointment. And after hearing it could be up to a year before a surgery date is rather discouraging. Hell, anyone can lose weight if all you have is broth and Jello. (Did that too for a couple weeks) lost and came right back because I got HUNGRY! it's insane all the "requirements"

Feel free to add your own rant.

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[KristenLe 5,979]

@@Jane1979 Most of it is because of insurance bureaucracy - they want to delay as much as possible hoping you're give up and they won't have to shell out money for surgery! (I know that sounds cynical but I truly believe that's their intent). With that said - some preparation is necessary and helpful to prepare you for surgery. I think the nutrition counseling and psych eval (if done properly) and any recommended therapy is a good thing - this is a huge change and you need to be sure you understand that (so you won't be one of the people 2 days post op regretting it because you can't have a steak for dinner). Your insurance may not require 6 months of supervised weight loss - so it may go quicker for you. Many people have a faster track. If you are flexible with scheduling appointments and lab work ,etc. - it will go faster. Hang in there!!!

[Jane1979 270]

@@KristenLe guess they rather pay my emergency room visits for the sever pain. But then also not want to pay for the pain meds that I need. I was supposed to be on Celebrex but those boogers are $300!!! Naturally the insurance didn't want to pay for that. I'm sure mines will be the longest track possible. Because my coverage is Nj health care. All they wanna do is give me a damn flu shot once a year but I can bet my life if I had a penis they would pay for me to take a pill to get it working

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[chrissychicago 9]

my insurance United Healthcare did not require any hoops!

Six weeks from first doctor appointment until surgery

[Jane1979 270]

@@chrissychicago that's great!!!!! Assuming that is not a state program insurance. If you don't mind me asking, what was your BMI?

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[chrissychicago 9]

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

[Jane1979 270]

@@chrissychicago awesome! I can only hope that I am that fortunate. My BMI is 64. Keep up the good work

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[KristenLe 5,979]

@@chrissychicago awesome! I can only hope that I am that fortunate. My BMI is 64. Keep up the good work

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My insurance didn't require the 6 month supervised diet because my BMI was over 50 too! You might not have to wait as long as you think @@Jane1979

[Jane1979 270]

@@KristenLe from your mouth to God's ears. September 9 feels like an eternity away for this first visit.

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[JustJoyce 1]

My first appt. is Sept 9th too, and with my insurance I have to do the 6 months dietary plan. But what if my BMI drops below 40, will I not be Approved????

[LisaMergs 2,854]

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

congrats!

I'm in the Chicago area too, and I have BCBS PPO IL. My first appointment was just before Christmas and I originally had my surgery scheduled for March 4- but moved it to go on the road for a few days to see our Hawks play in St. Louis and Dallas. Doc wouldn't let me travel a week post op lol. Priorities!!! So I ended up March 23rd- 3 months after first appt and that was mostly due to scheduling with the NUT, psych and the endoscopy.

Where was your surgery? I was at Evanston.

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[Jen-2+1 131]

I was seen at the surgeon in July, surgery will be in September. Just waiting on insurance approval at this point. Hopefully it will come through this week and I can get scheduled.

The first surgeon I saw runs a six month program no matter what your insurance requires. The second goes by insurance guidelines.

[laceemouse 631]

My first appt. is Sept 9th too, and with my insurance I have to do the 6 months dietary plan. But what if my BMI drops below 40, will I not be Approved????

It totally depends on your insurance. Some WANT you to lose weight on a supervised program before surgery because they want to know that you are serious and will stick to your new eating program after surgery. Some want you to lose weight before surgery just to make it go more smoothly.

I do understand your concern. I am barely BMI 40, in fact when I first start looking into WLS they told me there was no way my insurance would pay because I was below 40 and had no other real health issues. Thankfully it looks like now that my BMI is 40 I have a good chance of approval and will not have to do any dietary plan before surgery.

So, my short answer is, it depends. Good luck to you!!

[chrissychicago 9]

50!

unfortunately, but dropping every day!

I got very lucky - had the surgeon, nutritionist and psych visit in the same day. Two days for insurance approval and bam, - sleeved on July 19th.

congrats!

I'm in the Chicago area too, and I have BCBS PPO IL. My first appointment was just before Christmas and I originally had my surgery scheduled for March 4- but moved it to go on the road for a few days to see our Hawks play in St. Louis and Dallas. Doc wouldn't let me travel a week post op lol. Priorities!!! So I ended up March 23rd- 3 months after first appt and that was mostly due to scheduling with the NUT, psych and the endoscopy.

Where was your surgery? I was at Evanston.

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I had surgery at Northwestern - I live downtown. Couldnt say enough nice things about them. 6 weeks tomorrow and I feel great! I was drinking whole glasses of Water in the hospital - never had to sip sip sip. I feel lucky

[angela9298 15]

I kind of felt the same way in the beginning but I'm actually glad for the process. I went to my first appointment in February and I'm scheduled for 9/26. The process gives you time to mentally prepare and get in your new mind set. The time goes by quickly.

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