new with questions

[minidriver 0]

Hello. I am thinking about being banded. I have been overweight my entire life and have lost and regained 40 or 50 pounds over and over and I'm sick of it! I already know that my insurance will not cover it - it's a flat out exclusion in the policy. My BMI is 37.5 and I have sleep apnea, high blood sugar, and hip and knee pain. Does anyone have any idea of self-pay costs in the SLC area? I am really ready to give this a try. I think it would be well worth it.

[VegasGrace 1]

Hi! You seem to be just like me....those same pounds gone but then reappear. But with me it seemed like I gained more weight than I lost on any given diet.

SLC area....I'll do some checking. I am not insured and had to go the self pay route but I traveled for my procedure and my follow doctor is in SLC.

[VegasGrace 1]

Someone just posted a doc in Denver for less than 10k. But that's not SLC.

I found plenty of sites but none disclose the costs.

Good luck on your search!

[DonHoll1 0]

My replies are not posting. Will this one???

[minidriver 0]

Well, I wouldn't be opposed to traveling to Denver. It's not so far away. GraceUtah, where did you have yours done? You have been so successful!

[VegasGrace 1]

I chose a surgeon based out of Tijuana, Mexico. I really liked him as he is very skilled and knows all the ins and outs of the lapband. Dr. Huacuz.

Just do the research on any doctor you are considering. And ask them- not the nurse, not anyone else...ask the surgeon if they have had any patients with complications. Your answer should be yes. If they say no, immediately take them off the list as they are not trustworthy.

There is a % rate of complications and theirs should be on that level. My twin sister's doc had patients to die even, but they were tough cases to begin with. He is well respected in Maryland. That was too far for me to travel so I went to MX.

[minidriver 0]

Okay, so I went to a seminar yesterday with Dr. Cottam from Salt Lake Regional. I was very impressed with the facts/figures he presented about his safety record, etc. He also seems to be very active in research, which I really respect. The cash price for lap band is 13850. This is 900 higher than South Valley Surgical and 2500ish lower than Rocky Mountain. Has anyone had experience with/heard anything about Dr. Cottam? I know he has a good reputation for being able to do complicated revisions . . . something I'm hoping I never need!

[Choromom 0]

Minidriver,

I have been working with Dr. Cottam and Dr. Richard's clinic...and have seen Dr. Richards. So far, I've been impressed with her, and with the staff, mostly. Right now, I'm in the final stages of getting insurance approval, and I feel like Jill is dragging her feet, but then, I know that one of the staff is out on maternity leave, and that has to increase everyone's work load.

I had an esophageal scope by Dr. Richards. I was VERY impressed with her bedside manner, and her concern for me. She talked me all the way through, explaining everything that was happening. One of the things she did that made me feel so good...after getting all the equipment out of my throat, and taking out the bite guard, she is the one who wiped the tears from my cheeks and the drool from my chin, and in a kind, sweet manner. She was also very patient with my questions when she came to check on me after the procedure.

Dr. Cottam has been with the clinic for less than a year, but he came from a huge, active clinic in Las Vegas...which I think gives him good marks for experience.

[aculberg 0]

Choromom - I think I talked to you on another post! I have my initial consult scheduled for 6/25/08, youre also trying to go through Tricare, right?? So, how did your consult go? I know you said she's nice, thats who I decided to go with, I met Dr. Cottam at the seminar, but went with Richards in the end. What all did they do at your first appt? I am so nervous, and just hoping they really try everything to get insurance approval...did you have any experience with that? I really hope everything goes well for you, keep me updated and thanks for answering all my ???'s :biggrin: Oh also, did you have to pay for your psych consult, or were you able to get Tricare to cover that? They told me I would have to pay $175 for that on my initial consultation...

Edited June 9, 2008 by aculberg
another question

[Choromom 0]

Yes, I think we have 'met' on another post!

My initial appointment with Dr. Richards was pleaseant and painless. I had discussions with the exercise physiologist, and the dietitian...talking about what goals I could set right now to work on until surgery. Dr. Richards did a quick physical...heart/lungs kind of thing, and reviewed my medical history., She asked me how much research I'd done, or how much I knew about lap band. Then, because I have a history of acid reflux, she had me talk with Jill, the insurance gal, and set up a scope and start insurance processes.

I saw Dr. Colledge for my psych eval...she works with Cottam and Richards.

She is very friendly and cheery. I had the office fax me the paperwork that she wants filled out...a personality test. We talked for an hour about family history, weight history, expectations of surgery, etc. Also pleasant and painless.

Here's a tidbit for you - both Dr. Richards and Dr. Colledge have new babies...under a year.

I'm hoping to get in for the pre-op in the next week or two, and then surgery is usually two to four weeks after that.

I'm sure you will like Dr. Richards. She is very pleasant, no nonsense, but willing to take time to answer questions. The office certainly has that initial patient visit down to a routine...took about an hour.

[aculberg 0]

Ok, so youre going with Tricare Standard, right? Have you figured out what your total costs will be? Also a big question for me is, with Standard, can you just have the surgery done, or does Tricare still have to approve it with the 100lbs overweight and co-morbids?? I have Tricare Prime and am nervous that they wont approve me b/c I am so close to the 100 lbs! I'm wondering if I switch to Standard, I know there would be some out of pocket, but hey, I'm already looking at $675 if insurance covers it anyways, with the psych eval and the $500 program fee!! If I dont have to jump through hoops with Standard, I'm switching!! lol

[Choromom 0]

Well, if you switch to Standard, you will have your $150 deductable, plus 25% of allowable charges at the hospital, doctor, and anesthesiologist...so Prime is the better way to go. Especially since the requirements are identical. 100 pounds over the ideal weight for height and bone structure, plus an associated medical condition, or 200% or more of ideal weight.

If you bill the psych eval to Tricare, at least part of it will be covered, if not all. Tricare covers 8 visits a year without authorization, to a network provider. I don't know if Colledge is network or not, but I am billing my state insurance, and then Tricare, to see how much I get back. The state insurance takes longer than Tricare to process claims, but I'll keep you posted if you like.

[aculberg 0]

I called Triwest to see if Colledge was a network provider, and she isnt! Dang it! They did give me a list of providers that are, but I dont know if the surgeon's office will allow me to go to another psych for the eval. I guess I should try to contact them yet again, which is a pain!! And if the criteria is the same for Tricare Prime and Standard as far as qualifying for the surgery, then I guess I'll stick with Prime and just cross my fingers! Thanks so much for all your input.