How are the banded Notorious Novembers???

[ginny two 0]

Thanks everybody for all the kudos and support. I need to be more careful to log things into my journal so that I'm aware of what is really happening!

I really admire those of you that are exercising the way you are! I'm going to join you. I swear I am. One day at a time. This is one of the hardest things for me to do. So, you all inspire me!:thumbup:

[jms462001 9]

Keep up the good work Cardio is great I hate it in the beggining but feel good in the end!! Awesome job at spin class:lol: you are brave.. i couldn't dare!!!One day though!!

What is spin class??

[elysenoland 0]

What is spin class??

It is a high intensity bike class....where you spend a whole heckuva lot of time standing up and peddling. The time you do spend sitting down leaves your rear end so sore you won't sito comfortably for a week. In a word....torture.

[heather.vasquez 0]

I tried a spin class once. The instructor kept getting off of her bike to ask me if I was ok. I guess I looked like I was going to pass out. Needless to say...I NEVER WENT BACK!!! lol

LOL That would be me:laugh: I think that is why I'm afraid to run on the treadmill at the gym!!

[elysenoland 0]

So I went in for my second fill today, didn't have much restriction this week. I had 3.5 ccs put in a 10 cc band three weeks ago, he put another 3.5 cc in today. I had to do barium swallow 5 times until he was happy with the restriction amount on the fluoroscope. Definitely feel tighter.

[heather.vasquez 0]

So I went in for my second fill today, didn't have much restriction this week. I had 3.5 ccs put in a 10 cc band three weeks ago, he put another 3.5 cc in today. I had to do barium swallow 5 times until he was happy with the restriction amount on the fluoroscope. Definitely feel tighter.

Good for you!! Hopefully we will see the scale move soon.:yikes:

[FrogStar24 0]

guess I found this a little late, but I was banded 11/24/08.

I'm doing well. It's been 6/7 weeks now. I'm eating solids, I think I have a good grip on my diet. I've been cooking most of my meals at home and packing my own Snacks for work. I've tried foods that you could have never made me eat before, but I figured for the sake of starting over I should try new stuff. Not crazy about all of it, but I'm doing what I can. (Almond milk, greek yogurt, soy milk, tofu, making my own fish!)

I think it's going well. Sometimes I feel overwhelmed, like at work, but I watch the clock to see if I should eat or drink instead of listening to my boredom. I've been bringing a book too, in case I need something to do instead of thinking about food.< /p>

I actually enjoy cooking. I was never against it, just didn't have time. I've cut down my prep time with all this practice, and it takes me about 10 mins prep and 10 mins to cook (depending on what.) My new favorite thing is steaming my veggies with a little chicken broth for flavor. My other favorite thing is cream of wheat with almond butter and bananas. YUM.

Hope you guys are all still doing well Mid-January! November Band-its unite

[ginny two 0]

guess I found this a little late, but I was banded 11/24/08.

I'm doing well. It's been 6/7 weeks now. I'm eating solids, I think I have a good grip on my diet. I've been cooking most of my meals at home and packing my own Snacks for work. I've tried foods that you could have never made me eat before, but I figured for the sake of starting over I should try new stuff. Not crazy about all of it, but I'm doing what I can. (Almond milk, greek yogurt, soy milk, tofu, making my own fish!)

I think it's going well. Sometimes I feel overwhelmed, like at work, but I watch the clock to see if I should eat or drink instead of listening to my boredom. I've been bringing a book too, in case I need something to do instead of thinking about food.< /p>

I actually enjoy cooking. I was never against it, just didn't have time. I've cut down my prep time with all this practice, and it takes me about 10 mins prep and 10 mins to cook (depending on what.) My new favorite thing is steaming my veggies with a little chicken broth for flavor. My other favorite thing is cream of wheat with almond butter and bananas. YUM.

Hope you guys are all still doing well Mid-January! November Band-its unite

It sounds like you are doing fantastic to me! Welcome to the Notorious Novembers. I was banded on the 24th, too. :wink2:

[jms462001 9]

guess I found this a little late, but I was banded 11/24/08.

I'm doing well. It's been 6/7 weeks now. I'm eating solids, I think I have a good grip on my diet. I've been cooking most of my meals at home and packing my own Snacks for work. I've tried foods that you could have never made me eat before, but I figured for the sake of starting over I should try new stuff. Not crazy about all of it, but I'm doing what I can. (Almond milk, greek yogurt, soy milk, tofu, making my own fish!)

I think it's going well. Sometimes I feel overwhelmed, like at work, but I watch the clock to see if I should eat or drink instead of listening to my boredom. I've been bringing a book too, in case I need something to do instead of thinking about food.< /p>

I actually enjoy cooking. I was never against it, just didn't have time. I've cut down my prep time with all this practice, and it takes me about 10 mins prep and 10 mins to cook (depending on what.) My new favorite thing is steaming my veggies with a little chicken broth for flavor. My other favorite thing is cream of wheat with almond butter and bananas. YUM.

Hope you guys are all still doing well Mid-January! November Band-its unite

Sounds like you've chosen a healthy way of eating!! I was banded on 11/24 too!!

[elysenoland 0]

Got my insurance info today from the surgery. They billed the insurance 16000. Insurance says I'm responsible for $570. All insurance paid was $855, they wrote off the other 14000+. So I called the Drs office, to make sure they weren't going after me for it, and they said no, they had already adjusted my account. How can they do surgeries for 1400 bucks??

[heather.vasquez 0]

Got my insurance info today from the surgery. They billed the insurance 16000. Insurance says I'm responsible for $570. All insurance paid was $855, they wrote off the other 14000+. So I called the Drs office, to make sure they weren't going after me for it, and they said no, they had already adjusted my account. How can they do surgeries for 1400 bucks??

Thant is so strange:huh2: maybe it's a write off as a business loss for them?? I ahve no Idea??? At least they satated they were not coming after you for the money!!

[gentylwind 1]

Third fill this afternoon of 0.5 cc. I now have a total of 6.5 cc in my band. I can definitely feel this one and I am feeling very optimistic! I have started exercising five times a week, going 3 miles on the elliptical in 45 minutes. I will start to incorporate weight lifting as I get it more into a habit. I like cardio much better than weights when given the choice.

And I am down to 217 from 242 on the date of my initial consult. Yay!

[LSF 264]

Got my insurance info today from the surgery. They billed the insurance 16000. Insurance says I'm responsible for $570. All insurance paid was $855, they wrote off the other 14000+. So I called the Drs office, to make sure they weren't going after me for it, and they said no, they had already adjusted my account. How can they do surgeries for 1400 bucks??

That just happened to me!! I just got the hospital bill for 17,000. My insurance said that all I have to do is pay my $250 co-pay and that they are contracted to pay a certain amount and that the hospital releases the rest. I'm going to call the hospital in another week to see if my insurance paid some of it -

[gentylwind 1]

This is the way all doctors and hospitals who are contracted with a health plan work. They agree to take what the health plan is willing to pay for any given procedure or visit in exchange for being in that health plan's network, thus hopefully generating more revenue by volume of patients who come to see them from noticing that doctor is in network on their plan.

This is also why a health plan pays a lesser percentage (and you a greater one) for an out of network doctor. No matter what, the health plan will shell out more money to an out of network doctor to an in network one. They require you to do the same in hopes you will choose to always stay in network and limit everyone's costs.

The doctor can SAY they charge $17,000 or $80,000...it doesn't matter. The contracted rate is agreed to beforehand and the doctor is not allowed to bill the patient for anything other than what the patient's health plan outlines his or her responsibility to be. The rest gets written off.

This also comes into play ONLY after the patient has met their deductible if they have one. Many plans require the first $2000 or more to come out of the patient's pocket before the plan pays anything at all, in network or out of network. Usually the deductible for out of network is twice the deductible for in network.

Out of network doctors will get paid a percentage of what is "usual and customary" for a procedure. For Lap Band that is probably about $12,000 or so. So the doc gets somewhere around 60% or 50% from the health plan and the rest is up to the patient. But even then, the doctor can ONLY charge Usual and Customary, which is generally decided by Medicare. Anything above that amount has to be written off.

So as an example:

So for an in network doctor it looks like this:

Stated Charge: $20,000

Patient deductible (as an example): $2000

Health plan pays: 80% of CONTRACTED RATE, which is (as an example) $2000

Patient pays : 20% of CONTRACTED RATE plus deductible

Health plan pays: $1600 (which is 80% of $2000, the CONTRACTED RATE that the doctor accepts for being in network)

Patient pays: $2400 (patient deductible plus 20% of the contracted rate)

Doctor collects: $4000 (patient and health insurance payments combined)

Doctor writes off: $16,000 as non-billable due to his contract with the health plan. He is legally required to do this.

For an out of network doctor it looks like this:

Stated charge: $20,000

Usual and Customary Charge: $12,000

Patient's deductible (as an example): $4000

Health plan pays: 50% of Usual and Customary after deductible is met

Patient pays: 50% of Usual and Customary after deductible is met

Insurance payment of 50% of U&C charge after deductible met: $4000

Patient pays deductible plus 50% of U&C charge after deductible met: $8000

Doctor collects $12,000 from patient and insurance combined

Doctor charges patient an additional $8000 to make up the difference OR doctor writes it off if the patient was a good negotiator. He is not legally required to write it off.

Edited January 20, 2009 by gentylwind

[WannaBSkinnyB 0]

I just don't get it. The scale just will not move for me.:thumbup:

I eat 1/4 of what I use to. Get exercise in daily. Band at 7.2cc so I have good restriction. I can't break 200 for nothing. It has been 2 months banded and I am still at an 8 pound weight loss. :w00t: My DH doesn't get it either, he sees what I eat everyday. Anyone out there have any ideas? Anybody else go thru this? :tt1:

Help I am losing my mind.