VENT: Does it really take THIS long???

[mommakatx2 0]

Hey everyone.

I am getting so anxious and frustrated here. I know things don't happen overnight and I know how the medical system works (I'm a nurse), but this seems borderline ridiculous.

I started the process for the lapband in December. The timeline has gone something like this:

Early December: Initial appt. with PCP to ask for referral.

Mid December: Referral approved, called surgeon to make appt. Was told I had to attend WLS seminar before I could make an appt.

Jan 15th: Attended seminar. Nurse at seminar told us we could call the very next day for our initial appointment.

Jan 16th: Called for appt. Was told I had to submit 20-page "application packet" before I could get an appt.

Mailed in packet within a week. They received packet and gave it to the nurses for "review".

Called SEVERAL times to check status of packet beginning late January.

FINALLY was told last week that the nurse had my packet and should be contacting me for an appointment.

Received letter on Saturday that I was missing one page from my packet, and that if I don't turn it in within 10 days my file will be placed in "inactive status" and after 30 days they will throw my packet away :eek::thumbup:

MIND YOU...all of this is for an appointment with the NUTRITIONIST, NURSE, and MENTAL HEALTH EVAL which they make you do before you can even MAKE an appt. with the SURGEON!!!!!!!

I also have to pay a $300 "registration fee" which is not covered by insurance and which I have to pay regardless if my insurance even APPROVES the surgery or not.

Is this normal? Are the similar experiences out there where it has taken this long and this many hoops JUST to see the surgeon????

It seems like people just call the clinic and get the appointment, and before long are waiting for their approval from insurance. At this rate I won't even get to see the surgeon until...???

I'm just frustrated. We are military and scheduled to PCS to Hawaii in April, which I very clearly stated to the clinic on several occasions...not to push my application ahead or anything, but to get an idea if this WLS is even a possibility on my limited time left here.

I need commiseration...is this really the way it goes?

[Kat817 19]

I am so sorry you are getting the run around! For some people it goes smooth as silk and within days their insurance approves, and they schedule surgery within weeks. For others the road is not so smooth.

My story was that my insurance required a 12 month medically supervised diet program with a nutritionist consult monthly. Well I am in a rural area, and no nutritionists!!! A 3 hour drive away was my closest. So after several weeks they finally agree to let my PCP do the nutritionist consults---so I have 2 appointments with him every month--they would not combine them (co-pays of course---the almighty $$$). So for 10 1/2 months I meet with my Dr, twice a month, we scheduled and I did my sleep study, my psych evaluation, and a swallow study, that he required because I had GERD.

Then one afternoon, going home, I was in a car accident, and was injured. When I had the resulting surgery, it caused me to cancel my appointment, and reschedule it. When I went in, the office manager---also the Dr.'s wife---told me I had violated the insurance conditions of coverage--my appointment was 4 days past a month! The insurance states it must be 12 consecutive months! Now I fully realize this was their policy, and I did violate it--with good reason, the one I was totally pissed at was my Dr. so I immediately changed Dr.'s----all I was to them was a steady stream of copays and insurance money.

Well I began the new 12 month study, when they informed me, that insurance will only pay for the sleep study, and the psych evaluation every 2 years----and must be completed within 6 months of surgery. So....while I mulled my options, the insurance of the driver at fault contacted me, and offered me a cash settlement on my claim. I took it, grabbed my $$$$ and run for the border!!! Went to MX and had surgery by one of the Dr.'s that my original surgeon recommended.

My DD dealt with military Dr.'s in treating infertility---and they were notoriously slow and behind things with her---where we have a mile of paperwork to do---when you are in the military you have 3 miles of paperwork. However, I have seen LBT members who have gotten it done through the military. It is excellent coverage! I hope they get it together for you!

Have you looked into aftercare in Hawaii?

Where are you going to be stationed? My DD was at Schofield Barracks---Oahu.

Good Luck---keep pushing, I bet, when they get it together it will go much faster---seems like that is how it works!

Kat

[4jin 0]

Hang in there jump all the hoops....skip all the blocks they throw at you. I did it. And in 3 months here I am banded last week!

Hang in there!

[Candle 11]

I'm not sure what "PCS to Hawaii" means but if it means you are moving there, you may want to think about waiting to have surgery until you get there. The band requires A LOT of follow up and most doctors don't like to take on patients that they didn't place the band for. At the very least, line up a doctor in HI to be sure you'll get the proper after care and fills. Plus you can’t do any lifting for about 2-4 weeks after surgery – packing and unpacking would be iffy.

Re: Time frame - I started the process with my PCP in Jan 2007 and had surgery on 8/27/07. I had to do a 6 month supervised diet for my insurance but I also had to see a shrink, nutritionist, get Cardiac clearance (2 visits), Pulmonary Clearance (2 visits + 2 sleep studies), and have an upper GI and EGD (3 visits).

It was A LOT and very over whelming but you do what you have to do and by the time you have surgery it becomes a distant memory. Hang in there.

Re: Program fee - If that includes the Shrink and Nut it's not too bad. I had to pay for both of those out of pocket and they were $250 each!!

Good luck!!

[NewGalWithABand 0]

I was just banded on 02/07/08, my journey began on July 5th. That was the day I went to my conference. There at Dr.R.Bryan Freeman's office in Anniston Alabama, I found out that I had to complete a 6 month diet plan with my PCP due to regulations put in place by BCBS of AL. So I started that day and for the next 6 mths regularly I saw my Dr. and was weighed etc., then I finished on Jan. 4, 2008. I turned in my paperwork for approval and was approved a week later. I waited for my best friend to be approved on Jan. 25th and that day we scheduled our surgery for Feb. 7th. We did habe to pay a $500 program fee, but that is required for all patients. We also had to pay $100 for the psych eval. My insurance pays for the physician's assistant so that was covered. I had a $150 hospital deductible, so out of pocket I paid a total of $750 out of pocket and it was well worth it. I am three days out from surgery and still having some trouble with gas pains and hurting under my left rib and under my sternum during deep breathing. I do feel full all the time right now, but I also realize there is some swelling inside to consider. I am following my diet and I have my first follow up on March 19. Wish me luck!

[Catalystmb 2]

Except for the fact that my "fee" was a little less, our experience is identical.

Hey, I figure I have had this problem for a few years....5 more months isn't going to kill me.

[cakegal 0]

when you had to do your six month diet, how did it go with scheduling your appointments. where they exactly 1 month to the day, or was there a day or so grace period. I'm on month 3/6 and its not always easy to get into my doctor, even when I make the appointment a month in advance. I should probably call my insurance but I'm afraid I might have already screwed it up because my appointments have all been 2-5 days apart each month. How did it work for you?

[WestCoastFatGuy 3]

If I were you I'd wait to have it done in Hawaii, as well. That way your fills can be done at the same place as your surgery. There is a wonderful surgeon at Castle Hospital that several members of these boards have used. I know the nurse practitioner who is the coordinator there for all gastric surgeries. I called her, in fact, to compare answers that I received from my own surgeon's office. She was amazingly helpful. Please PM me if you would like further information and I'd be happy to put you in touch with her to answer any questions about their lap band procedures.

[Catalystmb 2]

when you had to do your six month diet, how did it go with scheduling your appointments. where they exactly 1 month to the day, or was there a day or so grace period. I'm on month 3/6 and its not always easy to get into my doctor, even when I make the appointment a month in advance. I should probably call my insurance but I'm afraid I might have already screwed it up because my appointments have all been 2-5 days apart each month. How did it work for you?

I think you are OK with your appointments being a few days off of a perfect months distance.

I know that whenever I have my May appointment I will be making a June 1st appointment and trotting all of my paperwork on over to the surgeons office for them to submit. They won't even submit until I have this requirement.

The crappy part about that is I can't make my venous duplex appointment until I am approved. I am thinking of making it anyhow( I work with the vascualr surgeons anyhow) and if I am denied, I will cancel.

It seems like a lot of hoops to jump through, and it is. They are all worth it, really. It is for our own good and health assurance. I have to keep reminding myself of this daily.

If everything goes as planned(and really, with Murphy following me around not much does) I should be banded sometime in mid/late June.

[VegasGrace 1]

As you can see by other responses...yes it can take that long when you are getting insurance to cover it.

I decided on lapband then interviewed 4 docs in 2 weeks. Made my choice and within a month had the procedure. That's being self pay.

Hang in, hang on....it will be worth it!

[mommakatx2 0]

Ok....I guess I feel a little better. It just seems over-the-top to wait this long just to get that first appointment. My insurance does not require any supervised diets or anything...at this point it isn't military doctors I'm waiting on, it's just the surgeon.

I would wait to have it done in HI, however my husband will be deploying for 16 months after we get there. With 3 kids...well...I don't really want to undergo surgery without him to help.

I guess I'll just hurry up and wait. What a PITA...but worth it.

[jelbel 0]

I had to go through the 13 steps and it was horrible. I never had to pay a fee,though. I do have to pay $50.00 for every fill plus the co-pay.

It took me 3 1/2 months to do everything and have my surgery.

I will do the paper work in advance for my DH before he does his operation.

[Candle 11]

when you had to do your six month diet, how did it go with scheduling your appointments. where they exactly 1 month to the day, or was there a day or so grace period. I'm on month 3/6 and its not always easy to get into my doctor, even when I make the appointment a month in advance. I should probably call my insurance but I'm afraid I might have already screwed it up because my appointments have all been 2-5 days apart each month. How did it work for you?

CALL YOUR INSURANCE TODAY!

I made sure my appointments were 25-30 days apart because I have heard many horror stories. Some insurance companies are so picky they will make you start over if you don't go every month like clock work! It seems so stupid but I really think the only reason they make you do the supervised diet is to try to frustrate and discourage people from pursuing insurance coverage. I mean really, what is one more diet going to do for us?!?

See Kat's comments above - she was off by 4 days and they made her start over.

Good luck!

[make33 2]

My story was the same as NewGalWithABand and Catalystmb--started at a seminar in March 2007 and was banded in October, 2007. Sorry sweetie, we all just have to go with the flow...

In the meantime, please read, read, read all you can about the band and what your future will be like--take advantage of this time because your life is going to change in ways you can't imagine right now--and you need to be prepared. (For all the good and some of the bad, too)...

[NewGalWithABand 0]

Be sure to check with your insurance company. With mine I made my appointments exactly one ome apart. Not 4 weeks or 28 days but exactly from one day one month to the same day the next month. My PCP made all 6 of my appointments for me on the first appointment. I did not know that since my first appoint. was on July 5 that my last appoint. could not be before Jan 5. Well it was on Jan. 4. Lucky for me my surgeon's billing/insurance clerk saw it before she submitted it and she fudged a little on the date, or else I would have had to start all over because of that one day. I think you are okay being a few days late each month. Just try to keep them as close as possible and not more than one week apart. Make sure your finishing date is as close to your starting date as possible, not before. Good Luck!