Self-Pay Surgeon Requirement

[ShavieLou 0]

Hello, everyone,

I've been lurking on this board for a couple of years, now; going back and forth as to whether or not to have the lap band. After yet ANOTHER failed attempt at weight loss (60 lbs this last attempt...now on the weight gain upswing again), I've decided to bite the bullet. I need this surgery.

Since I am now working as an independent contractor massage therapist, I no longer have health insurance. I won't have it until I get married to my fiancee next November. As it stands, I'll have to be self-pay. :drool:

My question is this:

I know this varies, but what are the surgeon's requirements when a patient is self-pay? Most of the frustrating requirements seem to be the doing of the health care providers. It seems that with the insurance companies out of the picture, the surgeons requirements are a bit more leanient.

Those of you who are, or have been self-pay, what were the requirements of you respective surgeons? Also, as a self-pay patient, did you have to wait months for your surgery date?

Thanks for any comments!

-SL

[kimmyv 0]

I was self pay due to my BMI (under 40-mine was 35 at the time of surgery) and no co-mobidities. I had to meet with a nutritionist, pyschologist, my primary care doc (for him to sign off on my physical condition for surgery etc), blood work and my surgeon. It took me about a month from my first meeting to my surgery. And really that was because of my work schedule and the appointments I didn't have to go thru alot of the stuff that insurance companies require because it didn't apply. I had the money and was physically able to go thru surgery and my surgeon thought I was a good candidate-regardless of my lower BMI.

From what I gather it is a MUCH easier process-- I didn't even try to get my insurance to pay. Good Luck! Best thing I ever did!

[HarleyGirl 1]

I was self pay.....the only difference for me was that I didn't have to do the six month medically supervised diet.

I still had to go to my primary care doc for a physical and get a letter of medical necessity. I went through all of the pre-surgery programs.....nutritionist, exercise physiologist, psycologist.

It was a pretty stream-lined process. I started on February 7th and had my surgery on March 18th.

[steph_co 9]

Approval is MUCH easier as a self-pay. I look at what people have to go through with insurance and I don't feel quite so bad that I had to pay out of pocket for a "fast track."

I was 36.5 BMI when I went to my doctor and really, they just took an overall picture of my health into consideration. I also just had to pass the psych to make sure I was doing it for the right reasons and that I had the stick-to-it-tiveness to make the band work for me. I had a few simple co-morbidities and I'm sure that was taken into consideration.

[gentylwind 1]

Self pay here. All I had to do was pre-op blood work, urinalysis, EKG and psych eval. Came to less than $250. Banded yesterday and doing pretty good.

[stevegoad 32]

I was self-pay (I don't have insurance, so it wasn't even an issue).

I guess I had an easy route, even for self pay.

Went in for my initial consultation - blood work, EKG. That was it. I started my pre-op diet the next day and had surgery 2 weeks later. No psych eval, no sleep studies (I was diagnosed with sleep apnea 10 years ago before it became a doctor's favorite diagnosis).

So for me, working through True Results, it was a snap. $150 for the initial consult and lab work, $12,900 for surgery and 2 years follow-ups and fills.

[lapbandtalker 0]

No, self pay is pretty easy.

Just find a doc you like.

Get the cash. (low interest loans from credit union is best if you have to finance)

You will have to meet certain criteria but banding is available to almost anyone overweight.

[luluc 6]

So for me, working through True Results, it was a snap. $150 for the initial consult and lab work, $12,900 for surgery and 2 years follow-ups and fills.

went thru True Results as well, along with hubby. wow they went down in price - we paid 15k each for ours over a yr ago.

insurance paid for all the testing; we were denied REALLY fast - and decided to self pay. 2 wks later we got banded....it was a fast track.

[MissBS 3]

I also went through True Results. My insurance would have covered my surgery, but I chose to pay for it myself. I have some personal issues with insurance companies. Went to my initial consultation on August 13th and they scheduled my surgery for September 12th (ended up having it Sept. 19th because of Hurricane Ike). All I had to have done was blood work and an EKG. I didn't even have to have a psych evaluation. My PCP didn't know I had the surgery until it was over. She is my new doctor and we had only met once. When I read some of the nightmare insurance stories on here, I feel so lucky. I was, and am, very happy with True Results and my surgeon. Good luck to you!!! Becky

[kendallsmeme 0]

I was self-pay (I don't have insurance, so it wasn't even an issue).

I guess I had an easy route, even for self pay.

Went in for my initial consultation - blood work, EKG. That was it. I started my pre-op diet the next day and had surgery 2 weeks later. No psych eval, no sleep studies (I was diagnosed with sleep apnea 10 years ago before it became a doctor's favorite diagnosis).

So for me, working through True Results, it was a snap. $150 for the initial consult and lab work, $12,900 for surgery and 2 years follow-ups and fills.

OMG! Did 12,900 cover dr hospital and all? I just paid 21,000 it freaks me out the different amount these doctors charge for the same thing!!!

[shangefan 193]

I am scheduled for surgery in January (I wanted to get through the holidays first).

After the initial information session, I had a consult with the doctor, where I paid $250. Of course, I submitted a boatload of paperwork beforehand. Then I went to a small group class about the surgery, nutrition, etc.

My surgeon required me to lose 10 pounds before surgery (which I have accomplished) and we set the date.

The total cost was $10K, including one year of fills, nutritional visits, support groups and access to the fitness center for a year. The $250 I paid will be deducted from that.

I think the requirements and costs vary greatly. While I am extremely annoyed that my insurance has an exclusion, it has been nice to not have to engage in the foolishness that insurance often requires.

[Angelhope1982 0]

I was self pay. It took about 5 weeks fro seminar to surgery. I had to get pre-op blood work, urinalysis, EKG and psych eval, chest xray. Just getting into see the psych md when made me wait a extra week. All pre work up was included in the price and 1 yr fills. I also did financing their healthcare card. Good interest rate.

[Kat225 2]

If you go to Mexico it's even less hassle. No psych eval. After-care is the downside, however.

[steph_co 9]

Oh, yeah - I forgot the blood test. It was like a few days before, or something. I didn't do the EKG or sleep study, though.