Got SSSOOO Many questions before calling a Doc!!!!!

[ThinDolphin3 3]

Well need to know what kind of stuff I should have ready before calling the doc to make an appt to be seen for a consult. I read something somewhere about needing a list of all the diets I've tried, and I've seen some questions on here that I view while I'm at work but never get them written down. Hell I'm at work right now typing this...I have so many things going through my head it's not funny. I'm thinking I shouldnt have waited this long to get this done, but on the other hand I dont feel that I have enough info to make an informed decision. I know I want to lose weight and get healthy(even though hubby is scared I'm not gonna be if I get this done) and make the pains in my knees, my back, my neck, and I want to be able to see my feet and not hurt after shaving my legs in the tub because I gotta move all these different ways just to get to my damn fat thighs! :faint: I've read posts that are post surgery and I love the fact that ppl are happy about seeing their collar bones. I know I have one I can feel it but I cant see it. I'm also tired of not being able to breathe good at night because my breast and fat come up to my throat in the bed and my double chin doesnt help either. All this stuff I'm typing I'm not sure will be okay to say to a doc. I am also fighting with my head at the moment thinking I'm not gonna be able to do this diet thing because food has been there when I was depressed, stressed, happy, etc... I mean hell if I had will power I wouldnt be so fat now right??

I have talked to my insurance and they said I could just go to the lap band doc, that they dont believe I will need a referral from my physician, which not sure but to me that sounds strange. I am also hearing about this pre-diet thing that everyone is talking about but I'm not sure what kind of diet it is, is it just liquid or what? :help: I'm just so tired of being fat and my hubby said when I told him I'm classified as morbid obese he was like really I didnt think you were that big. I said honey I'm only 5'5 and I come from a family of small frame women on my mother's side. Now on my dad's side is a different story, he's huge he had to have the gastric bypass done and he's still huge. So I got my mother's frame and my dad's fatness. He was like "oh okay, well if this is what you want to do then do it and I'll be right there with ya." I said that's good. I said I'm not rushing into this, I am researching daily on everything the pros the cons everything. I'll tell ya with all this research my head is spinning...LOL

So any help would be greatly greatly appreciated!!

blessings to all :ranger:

[reif78 0]

never believe your insurance company cause the minute they say you dont need something they deny you cause you didnt do this. trust me i went a 8 months before i even got my approval cause they denied me cause i didnt do something. heres what i did.

1. consulted family physician . we listed all the diets and medications even over the counter diet aides i used. he then made a referral for me for the surgeon i wanted to use. and have him write a letter of recommendation for you so you can give it to your surgeon. so when they submit it to the insurance it is a better help to get approved.

2. go to the surgeon consult. youll go thier for 6 months of weigh ins.

3. youll have to see a dietitian,a nutritionist, youll be put on a 1200 cal diet to see and prove to the insurance co that dieting dont work.

4. youll have several blood work ups

5.you see a pulmonologist and take chest xrays and a breathing test.

6.psych consult.

7.2 day sleep apnea testing.

8. and whatever else your doctor will make you do everyone is different on what needs done before your info will be submitted to the insurance

company.

I was approved 8 months after i initially started everything to get approved.

some insurance companies may have you go to a seminar about the lapband system. mine didnt. the way i worked i woulda never made it.

but in the end its worth it i was banded 12/12/07 and i love it. you will too its only been 9 days and i feel better and im energetic. and ive lost 29 pounds and i breathe better. cause i have sleep apnea due to my weight. and can actually sleep at night now. and its only been 9 days.

i know most of my weight off now is just Water weight. but weight is weight . hope things go well for you.

[kimmi5207 0]

The requirements actually vary by insurance company.

My insurance did not require anything from my primary physician. They accepted and approved based on the letter of medical necessity from the surgery center (they did a medical evaluation and EKG, and I filled out about 10 pages of health informaton!)

When I went to the consultation, I did have a typed up a list of the diets I had tried in the past, the period of time I was on them, and the results amount lost and amount regained. I think that probably helped them quite a bit when they submitted my letter to the insurance company, as I had pretty detailed information going back to 2000 (I had most of my past WW booklets and found receipts or backup for the other diet centers I had tried in the past).

I was approved within 1 - 1 1/2 weeks of when the surgeon's office submitted the letter.

Other insurance companies require a 3 month, or 6 month supervised diet, but not all do.

Some require you to meet with counselor and be evaluated, and some don't.

Most require that you have a BMI of 40 and a document history of previous weight loss tries (or a BMI of 35+ with comorbities). Generally they ask for 5 years of documented obesity.

I would go on line at your job, and look at your the details of your insurance plan (the detailed plan summary description, not the general info) to see what they will require.

Actually, you can also call and ask if your insurance company covers the lap band surgery, and what are the requirements for coverage and the benefits offered. You may not get all the details, but you will have a general idea.

Go ahead and try and start documenting your weight and diet history, and have your consultation with the surgeon's office. They generally are pretty knowledgeable about what each various insurance company requires, and which ones are easy to work with and which ones have you jump thru 1000 hoops!

I hope this helps! Good luck!

[kimmi5207 0]

Oops...missed that you already talked to your insurance company.

As I mentioned, I did not have to have anything from my primary care physician so what they told you is very possible.

The surgeon's office will let you know within a few days of your visit (generally) what your insurance requires because they will call to verify that you have coverage and to verify what your benefits are.

By the way, I have United Healthcare for my insurance.

[nancy j 0]

Oops...missed that you already talked to your insurance company.

As I mentioned, I did not have to have anything from my primary care physician so what they told you is very possible.

The surgeon's office will let you know within a few days of your visit (generally) what your insurance requires because they will call to verify that you have coverage and to verify what your benefits are.

By the way, I have United Healthcare for my insurance.

ThinD good luck with this insurance company. It's nice to see them start looking at lapbands as a treatment.

Also noted how Kimmi you are having surg next week! Good luck! Keep us posted.

[Big As Life 0]

I Was A Self Pay, So I Didn't Need Anything But Money...i Am So Glad That I Was Banded...i Would Do It Again Tomorrow...i Was Banded On 4/6/07 And I Have Lost 67 Lbs...i Have 35 To Go....is It Easy??? No...you Have To Work With Your Band..it Will Not Work If You Don't Work...you Have To Really Be Committed To This Surgery...you Have To Exercise And Choose Healthy Foods...if You Can't Stick To A 2 Week Pre -op...you Are Not Going To Stick To The 5 Week Post Op....you Have To Make Up Your Mind That You Want This More Than You Want Food...you Can Do This...you Just Have To Be Committed...and Remember...nothing Taste As Good As Being Thin....nothing...

[ThinDolphin3 3]

Thank you everyone for your encouragement and it's nice to know what I'm in for before commiting to the surgery, not sure if I will have the willpower to do it considering I cant even get the energy to do my damn laundry or get up to go to work etc!! But it is very nice to meet ya'll and hope to become good friends with ya!