I have a fill / insurance question

JustMarci · March 12, 2008

I've been lurking on the boards for about a month now and finally decided I had a very important to ask all of you experienced bandits..

I had my realize band put in 2/4/08. Best decision I ever made in my life -- no regrets whatsoever. Now, I'm beginning to feel as if I don't have as much restriction as I hoped for. I've been on regular food for 2 weeks and I know I could more than the allotted 3-4 oz. but I choose not to. I've lost anywhere between 19-23 pounds thus far which I know is incredible but I haven't lost any of it since I went to solids.

I was under the assumption that fills could happen at any time post-op as I've seen so many of your posts and noted that many of you have had fills at 1 month post-op. My doctor's office is saying that I cannot have a fill until the 91st day post op which puts me to May!!!! This seems so unfair to me since I want this to be successful and my insurance company says that it CAN be done within that 90 day period following surgery. Has anyone else experienced this type of issue with their fills? Are you all having no problems with your physicians?? I love my doctor (Dr. Abkin) and I have another post-op appointment with on 3/27 and plan on discussing with him further then. Any information I can gather before then would be so helpful!

I love reading all the posts here; you all have been so helpful especially during the liquid phase without even knowing it! :drool:

shortgal · March 12, 2008

Your ins. company probably won't pay your Dr for fills during the 90 day post op period. It probably encompasses all visits during the 90 day period as part of the surgery procedure payment.

so if your Dr. waits until 91 day, they can bill ins co.

If I am correct on this, it is very unfair of your Dr. to do this to his patients. A fill takes very little office time and VERY little cost. A syringe with a needle and saline. THIS IS ASSUMING HE IS NOT USING FLOROSCOPE, as those are more costly with an x-ray tech/radiologist.

mediummike · March 12, 2008

I have a very similar story. Although I feel no "restriction", I am able to just stop eating at will. I lost a lot of weight immediately after surgery during the 2 weeks I was on liquids/mushies, but have leveled off since I have been back on "normal" food. No surprise there. I am still losing, just at a much slower pace, which is good! Your body is probably just catching up with the Water weight you lost so be patient as you get through this plateau. My doctor says he MAY give me a fill at my 5 week appointment (Tuesday), but not definite. I think they want to assess my progress and eating habiys before they do anything. I am fine with that. I see him and his nutritionist every month for the first year for any adjustments (fills) that I may need. I trust my doctor and speak openly with him regarding any issues I have. Sounds like you like your doctor as well and hopefully you can have an open dialogue with him too. Good luck !

mnn2501 · March 12, 2008

JustMarci

90 days seems like a long time and we all want to lose weight right away (or we wouldn't be in this situation) but in the scheme of things 90 days is not really bad - my first fill is at 60 days and I'm thinking that may be too soon. If you are sticking to a reasonable diet you will lose weight long term - 4 to 5 pounds a month is what my doctor says is best for permanant weight loss - even with the lap band. I only check the scale weekly - am less concerned with the scale and more concerned about my clothes getting looser and looser and putting more holes in my belts.

JustMarci · March 12, 2008

He doesn't do the fills in the office; he does them in the hospital under flouroscopy. He counsels all his patients in the beginning that the reason why he does it this way is because you have fewer "misses" and he can ensure a positive experience that way.

I know my original post sounded a bit whiney...I'm so excited I did this and this 20 pounds I'm down is the fastest I've ever seen any type of weight loss on any type of program. I'm just so frustrated in not seeing the scale move at all for 2 weeks straight. I'm following their guidelines strictly with the help of all the fabulous recipes I found here and I get all my Water in and my protein/drinks. I know we are only supposed to lose 1-2 a week and I'd be so happy if I saw that in the past 2 weeks.

those of you going through something similar have you gone back to mushies to give yourself a boost???