dr appt already!

jillrn · October 14, 2005

I turned in my paperwork to the surgeon on Monday and they told me to wait to hear from them probably in about a month or so! I was kinda disappointed on how long it would take. 2 days later the office calls me to make an appt to see him. I said "why?" She said are you no longer interested in the Lap Band? I said No I am very interested, does this mean my insurance approved me? SHe said that they verified coverage, but now we have to prove medical necessity anyone know how hard this is?? I have a BMI of 44, I am border line diabetic taking oral agents, I have PCOS, GERD, hypothryroidism, and problems with sore feet from my weight. I am hoping I can qualify. I have Anthem BCBS My appt is next Thurs I am so surprised this happened so fast! Jill

ReneBean · October 14, 2005

You start with your doctor's appointment. They will refer you to the other pre-op tests that you need.

You can pretty much count on bloodwork and an ekg.

I had those plus a psychological evaluation and a meeting with a dietician.

You may need to do a sleep study or a stress test, too.

You should also start compiling your diet history. Find any records you have on medically supervised diets and write down a list of all the non-supervised diets you have tried.

Once you meet with your doctor, it will all seem a little more clear - I hope!

:]

Time to love me · October 15, 2005

Yes, I agree with Rene.

Just to add, If you had recent blood work, EKG or any other test that's required, you might be able to get a copy of those results and use those, instead of taken them again. It has to be within six months (some allow a year). Also, I did not have to have a sleep test or stress test. For me, I didn't have any medical reasons to have this done. But your Dr. may still have you do it. All Dr.'s are different.

Like Rene said, get your weight history together. I got advice from a lady whom was already banded, so what I did was gather history from youth to adulthood. I then put what diet or exercise program I used, start weight, how long I was on the diet & how long it took me to gain the weight back.

Example: Age 20 Weight Watchers: 7-8 months, start weight 180, lost 20 pounds and gained 30 back within 6 months.

Also, I went to WW, curves and any other program I used and got all my history from them. I then handed all this info. into my surgeons office and they submitted it to the insurance company, along with a letter from my PCP (primary care doctor). One last thing (my PCP had me do this).. just in case the insurance company denies you and wants you to go on a supervised weight mangagement plan, make an appt. every month with your PCP and make sure you have them note it as a weight related appt. and when you go, just do a weigh in and tell the dr. that you have been eating a healthy diet to try to lose some weight (have him/her give you a list of healthy foods to eat while dieting,he'll have to note this in your file). This will give you a head start and also count for a supervised diet with many insurance companies.

I have to say that I do not have my date set for surgery yet, but I have been in contact with my insurance company and I spoke with the person handeling my case to make sure all my info. was accurate. She complimented me on how organized I was with the info. and told me it was very detailed, that I most likely will have no issues with being approved. I gave them everything they needed and then some so that they won't have much to kick back and say I need this and that and this and that. On top of that.. at my surgeons office they do meetings in groups of 4 and out of the 4 I am the first to go because I have everything all done. One of the other ladies is now waiting until Jan. just to see the Dr. I went in Sept. and I have an appt. on Nov. 2nd. So go prepared with you test results, if you have any and all the info. you can get. It may save you a step down the line. Best of luck to you!