Newbie from Georgia

[georgia girl 35]

I looked at Walmart today and they have the Alpine brand SF apple cider.

Thanks, I will look tomorrow!

[4jin 0]

I have lot's of question's and have tried to read alot of the post here to get answer's, but most fall just short of what I want to know. First off, I live in S.E. Kansas (2 hrs from anywhere, KC, Joplin, Tulsa, Wichita). I dont feel I am having a "mid-life crisis" but we have just had our 1st grandbaby and she has REALLY opened my eye's to the reality that my health may not be up to par! I'd really like to be around to spoil her in the years to come.

Myself, my BMI is 50.1 (5'7" 320lbs) I am scheduled to attend Dr. Kirshenbaum's seminar Dec. 19th in KC. (1st step) I have been told that BCBS "will not" cover this so I started counting my penny's. But then I read on here that some of you are getting them to cover it??? So what's the deal, you have to know somebody or what??? I called BCBS and they all but hung up on me, READ YOUR POLICY, we dont cover weight loss "but they will cover a penile implant"! Doesnt make much sence to me but what do I know!

Reading on in the post, I have seen several different price's mentioned. Dr. K in KC I've heard run's about $16,500, you can go to CO and get it done for $9950 and Mexico for $7,000. What, are we having a blue light special here??? My wife said no way was I going to Mexico to have a surgery. We have been just over the border a few times and I must agree it's not the cleanest part of town we've been in (tourist trap). But I read here the oppisite (not doubting anyone's word) Has anyone gone to Mexico and had a problem with a Dr. here doing your "fills" or will they mess with another Dr's work?

I work where we take most of the winter off so without doing any homework before now, I thought I would just make an appointment and go get it done . . . . . WRONG. Is there a secret to getting the ball rolling so I dont have to wait until NEXT winter to get this done? I dont care if BCBS pays or not, I just want to get it done while I'm in the mood and have time before heading back to work.

Anyone else in the S.E. Kansas area have this done? Where do I go to find other perspective Dr's? I told you I didnt know what the heck I was doing! Any help would be greatly appriciated!

Dear Steve,

Take a deep breath please! Ok...now that you are breathing ok...:guess

OK....don't let anyone discourage you!!

In order to get the ball rolling this is what I did:

1. I called my insurance company with my group # info only....

This is what I told them(was told to do this because they can be sneaky sometimes)....Don't give them your info...just say your employer gave you this group id#, you are thinking of switching to them and want to know certain things regarding coverage....

Then ask what is your group id's policy for morbid obesity procedures for those who are medically necessary. Give them this CPT code #43770(lapband & port surgery for medically necessary).

I have BCBS of GA. This is their policy in general if they do cover it, but check with your plan or while you have them on the phone ask how you can view their general requirements online(but they might be the same I am attaching the link to)

SURG.00024 Surgery for Clinically Severe Obesity

2. At that time they should be able to tell you if your policy has an exclusion to any morbid obesity procedures. If they do...it's ok you are going to have to pay for the procedure that's all.

This means that what I have seen people do is they still process under insurance for anesthesia, follow ups, hospitalization(if necessary), lab work,etc...the insurance just won't cover the actual procedure.

The good news is your process will be way faster self-pay.

3. If you are self-pay when you go to a seminar-make sure you let the coordinator there know. They will give you priority....you should be able to see the surgeon within the next couple of days thereafter. Once you have your initial consult with the surgeon if all goes well you shall be scheduled for surgery within a couple of weeks-I have read some within 15 days!

Now, if you are interested in Mexico, Please contact Wassabubblebutt. She is a member here just do a search for her name. She had her surgery in Mexico, although she won't know pricing she can give you advise or at least where to research the doctor/facility you choose there. And can share her experience with you. Be very careful! A better deal from 1 doctor doesnt make him/her the best...just research their stats.

also please remember if you have it in Mexico it will be 100% selfpay, insurance will not cover-not even labwork.

Hope this helps...:ranger:

It's all like everything else ---reading and doing some homework.

I too once was like you...I was even sent to 2 wrong seminars by one of the top hospitals here-they give people the run around to see who really wants it and who doesn't and their informational seminars where so booked I had to wait 2 months...well guess what I found another location- Just as good....and believe it or not I was able to jump thru all the hoops in less than 30 days...

I am waiting for all my medical records to be gathered and sent to insurance which should be at the latest next friday. And I started with my informational seminar on 11/28 and I finished on 12/12. And this is with insurance....hopefully my insurance approval comes back approved just as fast.

Otherwise...that will be my dragging point...

But If I was self-pay...believe me...I think I would already be either banded or with a surgery date for the next few days.

Again if you have any questions...feel free to post or PM me...

I am not an expert but got to understand this lingo process a bit and I can try to be of help.

:clap2:

[georgia girl 35]

I looked at Walmart today and they have the Alpine brand SF apple cider.

Thanks for the tip, I got some today and just finished a cup. It was really good.

[SteveInKansas 0]

Hi, Steve!

I'm from North Central KS, and I was banded in Topeka. Their cash price for banding is $12,000. The best way to get the ball rolling with anything is to go to a seminar, (most bariatric surgeons have these either weekly, bi-weekly, or monthly), and they'll tell you everything you need to know to get started. As far as I know BCBS of Kansas does not cover it, and they have no plans to change their minds. Now, the BCBS companies that you're reading about that do cover it are other state's or the federal policies. If you have the Kansas policy, though, you're barking up the wrong tree trying to get them to cover it.

The biggest thing though, is to not jump in with both feet until you've educated yourself about the process, and how your life will change afterwards. This is not something you decide to do and then just go do it. Some people do that and then they have no idea what they've gotten themselves into, and education is KEY to a successful bandster.

Good luck!

Welcome to LBT!

travelgirl,

Do you, or anyone else have more info on Dr. Brent Steward in Topeka? Website maybe? I'm going to KC Dec. 19th to Dr. Kirshenbaum's seminar to get some answers but not real sure what the questions should be??? I do have a list started though.

I'm starting to feel like I'm shopping for a new car trying to find a Dr. in the area. I'm not understanding why there is such a "BIG" price difference in Dr's when they preform the same surgery???

How did you come to pick your Dr. over another? Travel distance, total package deal, heard he was the best . . . . . ???

We're Dazed & Confused, but not giving up yet!

Thanx, Steve In Kansas

[travelgirl 3]

travelgirl,

Do you, or anyone else have more info on Dr. Brent Steward in Topeka? Website maybe? I'm going to KC Dec. 19th to Dr. Kirshenbaum's seminar to get some answers but not real sure what the questions should be??? I do have a list started though.

I'm starting to feel like I'm shopping for a new car trying to find a Dr. in the area. I'm not understanding why there is such a "BIG" price difference in Dr's when they preform the same surgery???

How did you come to pick your Dr. over another? Travel distance, total package deal, heard he was the best . . . . . ???

We're Dazed & Confused, but not giving up yet!

Thanx, Steve In Kansas

I have no idea why some docs charge more for the same service. I chose Dr. Steward because my insurance (United Health Care) pays 100% for this surgery, as long as the surgeon is in my network. The surgeons at Tallgrass were all in my network, and I've heard great things about them all. I went with him because he was the first available surgeon at the time.

They do require that you attend one of their seminars before they'll even give you the paperwork to fill out to get started. The reason for this is that they want their patients to be well informed of their decision prior to surgery. This makes for the most successful long term outcomes.

Their informational seminars are held on the second Saturday of every month at the St. Francis Health Center in Topeka from 10:00am to noon. The seminars are open to anyone researching weight loss surgery. There is no charge to attend, and this is the first step required to enter the Tallgrass Bariatric Program. There is no pre-registration, and no one will be allowed in the room after the seminar begins, so get there early if you go.

If you'd like more info about Tallgrass, I can PM you the phone numbers to call to find out about their program, and get the ball rolling.

Outside of going outside of Kansas, Tallgrass is the closest bariatric center that performs lapband. I have never heard of one in Wichita, or Hays, which would be the next most likely candidates, I would think.

One more thing, the staff at Tallgrass is first rate. They really took wonderful care of me the day of surgery and called the next day to check on me. They were really top notch. They even made sure that my hubby was at ease, and comfortable with the surgery, and they checked on him several times during my surgery to make sure he didn't need anything, and to let him know everything was going well.

[Kissmygrits 0]

Hi folks,

Just checking in after a little break from LBT to say hello and that I'm getting banded on Thursday morning (20th)!! This liquid diet has been horrendous-- I have been starving the entire time. I'm so glad that this pre-op part will be behind me soon. Thank the Lord I didn't have to follow this pre-op diet during Xmas because I'm sure I would have cheated!

How're the newly banded folks here doing?

[buttercup76 0]

Hey Kissmygrits,

I am doing fine. Lost 4 more lbs in the last 2 weeks. I am so excited for you. You will be in my prayers on Thursday and please keep us posted. Happy Holidays!!!

[4jin 0]

Hi guys my insurance paperwork was submitted yesterday....

Please pray for an approval for me...

thanks

[georgia girl 35]

Hi folks,

Just checking in after a little break from LBT to say hello and that I'm getting banded on Thursday morning (20th)!! This liquid diet has been horrendous-- I have been starving the entire time. I'm so glad that this pre-op part will be behind me soon. Thank the Lord I didn't have to follow this pre-op diet during Xmas because I'm sure I would have cheated!

How're the newly banded folks here doing?

Hey Kissmygrits, glad you're back. Good luck with your surgery, you will be in my prayers.

I am doing fine. Lost 4 more lbs in the last 2 weeks.

Wow, Buttercup, you are doing great.........keep up the good work!

Hi guys my insurance paperwork was submitted yesterday....

Please pray for an approval for me...

thanks

I will be praying that you get approved and have a speedy process!

Haven't heard from some of you others lately (Jeannie, Renewedhope....)

How's it going? Hope you are all doing well!

Merry Christmas everyone!

[4jin 0]

I think everyone is out xmas shopping...

I know I was....

finally finished I think...knock on wood LOL

I blog during the day.mostly...because of it...can't wait for xmas season to be over...althought I love it...I just look forward to being banded....

[georgia girl 35]

I think everyone is out xmas shopping...

I know I was....

finally finished I think...knock on wood LOL

I blog during the day.mostly...because of it...can't wait for xmas season to be over...althought I love it...I just look forward to being banded....

LOL. I know what you mean. I did most of my shopping online this year and it was great, I love that I didn't have to fight the crowd.

I hope you get an approval soon. Maybe you'll get it before Christmas, that would be an awesome gift.

[georgia girl 35]

4jin, I love your new avatar............so cute

[4jin 0]

4jin, I love your new avatar............so cute

thanks...

you are doing so great .....your stats are awesome!!!!

yes that would be my 2nd best xmas gift in my life....

the 1st was my daughter's birth on xmas!

[georgia girl 35]

thanks...

you are doing so great .....your stats are awesome!!!!

yes that would be my 2nd best xmas gift in my life....

the 1st was my daughter's birth on xmas!

Thanks.

Awwww. I bet that was the best Christmas gift ever!!! My due date was Valentine's Day, but my son decided he wanted to come out a little earlier than that.

[4jin 0]

:pray::pray::pray::pray::pray::pray::pray::pray::pray::pray:nice!......

Ok...I called the insurance company because so many people have stories on them not having all the paperwork...or not receiving it until like 15 days later than when it was faxed....so I mustered up some courage and called.... the first call was unsucessful and I was fustrated....but I felt she just didn't care or didn't feel like giving good service(probably overworked today as lots of people like to take off around the holidays) so I called back to the precert number on the back for providers...oops...oh well...the service rep was excellent..she even put me on hold and spoke to the people that process the approvals and she said they received all 15 pages and have 7 to 15 days to return a decision which is normally how they process....other than that then they have until 1/14/08 at the latest for me to hear back....

awesome.....

nervous now..and just praying I fall in the 7-15 business days(excluding holidays and weekends) with an approval.....

otherwise...we are looking at February...yikes....

please pray....I will be until my knees bleed!

:pray::pray::pray::pray::pray::pray: