Made appt. with General Practitioner-Newbie

I am have been lurking on this website for awhile and I have finally took the 1st step.  I have an appointment with my general practitioner scheduled for next Tuesday.  Anyone have any tips or questions that I need to be sure to ask?  Also, has anyone had their surgery at Shelby Baptist or University of Alabama at Birmingham?  If so, who was your surgeon and how was your experience?  I have another question (actually I am full of them, LOL)!  I have BCBS of AL PPO insurance policy.  I have to provide a 3 year medical weight history showing a bmi of 35-39 with a co-morbidity or 40+ without.  Do you just have to provide 1 recorded (by doctor or picture w/ date) per year?  The reason I ask is because I have dieted in the past and my bmi might have fell below 35.  This was short lived as I lose and then gain it back plus more.  My current bmi is 40.  I have high blood pressure.  Also, did you all have to have a supervised diet plan?  If so, for how long?  Thanks for the help

First, welcome to the Alabama board.  This is the best board on OH!  I had my surgery at Shelby and had an awesome experience.  My surgeon is Rex Sherer and I adore him and highly recommend him.

I had BCBS of AL and had to provide the 3 years of weight history showing continued obesity.  For me, that wasn't a problem--I got my records from my OBGYN for the previous 3 years.  I did not have any co-morbidities but I had a BMI over 50.  I also had to do the 6 month supervised diet....and there are some pretty strict rules you have to follow on this.  You must go to a total of 7 appointments:  The day of the month of the last appt must be AFTER the day of the month of the 1st one....some people try to "speed up" the process by making their appts closer together each time.....also, BCBS has a form that will detail exactly what your doctor must record and how they must submit it.  Katie at my surgeon's office was most helpful through the insurance process.

Best wishes to you on your journey and again, welcome.  We are here to help if you need us!  If you send me a friend request you'll be able to see my profile.

Kim

Thank you so much for your help!  I have heard great things about Dr. Sherer.  I have also heard that he has moved to UAB but I am not sure (I'm going to have to check into this).  Will you explain the 6 month supervised diet thing again?  Not sure I understand the whole scheduling of the appointments.  How was your experience at Shelby?

Loved Shelby!  Great experience.  There was a doctor in Dr. Sherer's practice that moved to UAB, but Dr. Sherer is still with Cahaba (as far as I know!  I haven't gotten a letter or anything). 

First and foremost, call BCBS and ask them for the link to the documentation on their site that outlines specifically what you are required to do for WLS.  Then, create a checklist from that documentation. 

For the 6 month supervised diet, assume your first appt is on March 1, 2011 (visit 1).  You will have to have an appointment every month April - August (visits 2-6).  Then your final visit is in September (visit 7) and it must be after the 1st of the month, so lets assume September 2nd.  7 visits encompasses 6 full months.  There is a specific form in the BCBS information that outlines exactly what your doctor must do in each of these visits and then the doctor must submit all of the information from all 7 visits to your surgeon.  For instance, weight, BP, record of diet/exercise, etc.  Personally, I gained/lost the same 5 lbs during that 6 month process.  My doctor was really cool in that he told me that if I was capable of losing the weight on my own I wouldn't be asking for WLS in the first place. 

It really is a process to weed out the folks that aren't serious about doing it.....many folks just get frustrated and give up.  I followed their rules to the letter and had no problems in the process.

Kim

Thanks Kim, your awesome.  I found the link on BCBS of AL's page.  I am going to make me a checklist from it.  I go to my General Practitioner Tuesday, Feb. 8th so wish me luck :-)  I will let you know how it goes.  When did you get your appt with the surgeon?  Was it after you completed the 6 months supervised weight loss program?  Or was it prior to the end of it.  I have the paperwork from cahaba valley to fill out (printed it off their website).  When did you send yours in?  Also, do you remember on the diet attempts page (where you have to list all the different diets you have tried, the dates, whether the results were long/short term) how many you listed?  Sorry for all the questions but I really do not want to mess this up.  Thanks again!

No problem!  That is what I'm here for!  When I began my process, I filled out all the paperwork from Cahaba Valley Surgical and sent it in.  Back then, you could not see a surgeon until they had all that paperwork and you had completed the 6 month supervised diet, so I saw the surgeon after that time.  After I sent it in, I got a preliminary letter stating that based on what I'd provided I was a candidate for surgery--and I was in their system.  Their insurance rep, Katie, was so helpful throughout the process.  Once I finished the 6 mo supervised diet my doctor sent those records to the surgeons office and I got my appointment with Dr. Sherer.  He as wonderful--took as much time as I needed in the appointment and answered my million questions.  I thought when I started this process that I wanted a lap band--he actually helped me understand what I'd get out of that but recommended the gastric bypass.  I'm so glad I followed his advice--I've never regretted my surgery or the choice I made.

On the previous diets log, unfortunately I had a lot of history to enter!  To the best of my recollection I filled the page...maybe even added another.  No one can say I didn't try on my own!

I'm here if you need me!