So it is 12:05 in the morning and I just got home from work. Boo! I work at the lovely Anthropologie and unfortunately we have to stay hours and hours after the store closes to make everything look perfect for the next day. Anyways, this is the first chance I have had to sit down and update everyone on my meeting with the doctor today! So here it goes from start to finish...
My appointment was at 2 p.m. and my mom went with me, also known as my number one supporter, but we got there about 30 minutes early. While we were waiting in the waiting room, a familiar face walked in the door. I remembered it was a lady my mom and I met just a few weeks ago at the lap band seminar and at that time she had just had the surgery! We sat and talked for a few minutes and she said how well she had been doing with the band. She has only had the band for 5 weeks and is already down 30 pounds since the day of surgery. She looked great! I can't wait to be in her shoes someday. Anyways, we talked and caught up and then the nurse called my name.
I went back to the hallway where they took my weight, height and blood pressure. You would think I would have remembered to take my medicine with it being my appointment day but typical me, I forgot!! All that to say my blood pressure was really high, my weight was 256 on the dot and I am 5'7'' (I thought I was 5'8''...must have shrunk). Then I waited in the room only a few minutes before the surgeon walked in. He is about 40 years old...fairly young...and the meeting was short and sweet. He told me based on my paperwork the band was perfect for me. He went over a lot of technical things about how it really requires a lot of self-control and determination on my part and if I do it right, things will turn out good. He said typically his patients do not stay overnight and I most likely wouldn't because I am so young. He also told me that he does not fill the band at all during surgery and that he uses the Realize Band. Umm...what else did he say?? He meets with patients in 15-minute time slots so it was definitely short and sweet. I didnt have time to ask him everything but he was busy. (That is the only thing I regret is that I didnt have enough time to ask him all my 140,567 questions haha!)
Then we were escorted to another office to sit down and talk with the "surgery scheduler"...man wouldn't you like to have that official title? :) She was nice...although she seemed to be irritated or maybe it was just that they seemed so busy right at the time I was there. Im not sure. Anyways, she looked over all my paper I had brought in from doctors and all my medical history I had my doctors fax to her. This took her about 10 minutes, meanwhile my mom and I sat ackwardly trying not to interrupt.
FINALLY....drumroll please.....She said I have most of the important things gathered already that needs to be submitted to my insurance to get surgery approval. And believe me, I had sent a lot of doctor co-pays and time getting check-ups and lab work and papers faxed here and there....so I guess it paid off. Although she said I still have to do about 4 other things before she can submit all my things to my insurance company. First, I have to do the sleep study. Second, I have to have a psychological evaluation done (not sure why I need this but apparently my insurance requires it not matter what). Thirdly, I have to do a one-on-one meeting with a nutritionist. And lastly, I have to attend a group nutrition class. She said after I complete these four things and get the paperwork and results sent back to her, she will be ready to send it all to my insurance. I told her I want the surgery in the month of October do to work and vacations, etc. and she said that is definitely possible if I get these four things done soon!
So of course, on my way home I started calling nutritionists, psychiatric doctors and sleep study doctors. I made appointments for ALL FOUR requirements in my 30-minute ride home!! Haha and the funny thing is, 3 of my classes/evaluations are on the same day and last one is a few days later!! I should have everything completed by September 23rd!! I hope I can get all this into her soon after and have my surgery done in October!
WOWOW! I just typed out so much but that was my day! Does any of this sound familiar to those of you who had to go through your insurance company?! I am a little scared of being denied only because in the surgery scheduler's office she had two cubies. One read "insurance approved" and the other read "insurance denied". My mom and I totally curiously looked all around her office while we sat there and waited for her to look over my paperwork. The stack of people who had been approved was about 10 people. The other stack...the "denied" stack...there were about 50 or more!! I must say it freaked me out a little but Im praying things go well. I have put so much time and money into this and Im hoping it all falls into place.
Thank you all for reading about my day and sorry it is so stinking long! Have a great night everyone :)
*Kristen*
Kristin - It sounds like you're on your way! I'll *hopefully* be banded in October too, so we'll be band buddies. I'm also going through the insurance hoops. I had to do a psychological evaluation, provide documentation from my doctors for the last two years about my weight, a bunch of paperwork I had to fill out, doctor recommendation letter, and then complete a 3 month "surgery prep" which consists of visiting a nutritionist once a month.
ReplyDeleteJust for peace of mind, you could call your insurance company directly and have them point you to the section of your policy that covers weight loss surgery. It should specificallly lay out what conditions qualify you for coverage (BMI, a minimum number of weight related health problems, etc.) Then you can verify that you meet the requirements, which would mean you should get approved. I also worry about getting approval, even though I meet my policy's conditions for coverage I won't feel sure until I get the approval call!
Hey Chicky, CONGRATS!! I know how much you were looking forward to this meeting. Everything sounds oh so familiar. I have Aetna and did a 3 month prep. I met with the nutrtionist once a month, had to attend 4 behavioral classes and met with a psych once. As for testing, I had a bunch of lab work and an EKG but that was it. It sounds like you're well on your way. My biggest fear throughout the whole purpose was insurance, it's the one thing you don't really have control of. Everything turned out fine though, and it should for you too! Stay patient and persistent, thats the best advice I can give you!
ReplyDeleteI'm glad your appointment went well! :) I'm keeping my fingers crossed you get it done in October!
ReplyDeleteAs far as I know everyone has to have a psych-eval, they have to make sure you can mentally cope with having the surgery done. On mine I had to talk to the shrink (mine has this really tall curly hair, it reminded me of that science that used tobe on tv when we were kids, lol), then he gave me a few tests to take, and I went home. I found out about a week or two later I passed, I saw him again for a follow-up and that was it.
I never had to do the nutrition class, but I had been doing LA Weight Loss for a year when I decided to get the band (which, btw, is a crock, dont waste your time). But I don't know if my doctor required it either, he may have for other patients, and I also went through the military to get it done since my husband was still active duty at the time.
Now I do know that when we tried to get my husbands band done after he got out of the Army they were going to make him do teh sleep study, but that's because he's got sleep apnea (he had two corrective surgeries two years ago though, so it helps), but I don't, so I never had to have it done.
I think it just depends on what you have may and what your doctor and insurance company requires you do. I didn't have to jump through as many hoops when we through went with the military, but I know civilian doctors you do (and our new insurance company as civilians doesn't cover WLS, so I dont have coverage anymore, boo!).
Congrats again! :)
Kristen - Sounds like it went great. Yep, pretty sure everyone has to do a psych eval. Mine was a piece of cake! No tests, just chatting about my weight loss and diet history. I didn't have to do a sleep study, but did have to do 6 months of diet with my primary doctor and show evidence of two years of BMI's above 40. I was VERY worried about insurance as well, but was approved within a week. If you have everything they say you need you should be fine. I agree with Robyn, I'd call your insurance company just to double check all of the requirements in case your "surgery scheduler" missed something!!
ReplyDeletefirst of all, haha, all those requirements are normal! And like you did like 3 of them in a day at the hospital. The sleep study I had previously had done, so yay for me! But yeah as soon as you do all that she'll just send it in. Depending on who you have it can take from 1 week to like 12 wks. But my MD said most insurance are quick about it now days. My approval only took 1 wk through BCBS, they were fan-tabulous!!! Then they can schedule the surg within 2-3 wks of the approval b/c you have to pay the md and hospital your part of what your insurance doesn't cover first. It soon lady, it's soon! I'm excited for you!!!
ReplyDeletebtw, most of those denials in that pile say something like "you are not approved yet but if you do _________________ then you can be." so don't be too worrisome. Your insurance may come back asking you to do something else, that's no biggie. you just do it and try again! ya know?
It's going to be real soon!
Thank you all so much for your comments! I just love hearing from all of you who have had the band and know what it feels like pre-surgery to go through all the insurance mess :( I am getting really excited and just hope I can get the band SOOON! Thanks again :)
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