I have an appointment with Doc Schwartz

I go on 12/22/06 i guess to meet with him and Karen ( the lady in charge of the INS. ) I called UHC again today and talked to another person and she said that i was covered 100% for WLS as log as it is medically needed. I told her about my other phone calls and she said that back in Oct they changed things around ( i am assuming there computer program or whatever ). She says that she can view 2 different screens and the main one that pops up says i am covered and the old page says i am not. I asked her when the doctor/hospital sends in the claim which screen will they see and she said the new one that says i am covered. I was on the phone with her for over 20 mins and out of those 20 mins at least 10 mins was trying to find where in my policy it says no. She had to dig! She even had me log on to myUHC.com and look and i couldn't even find it. So she gave me a referance number and said to go ahead and meet with the doctor. So i did! I never thought i would even get this far so its kind of excited but i am not going to let myself get to pumped up because i have read on here how many of you were approved and then not approved. So i am hoping things go ok! The lady at Doc Schwartz said that if everything goes ok i can have the surgery with in 6 months. I just hope everything goes ok because we are losing UHC as our provider here at the casino and i don't know who we will have next. So what should i expect on my first visit? Should i bring proof that i belong to LA Fitness ( the gym ) and get records from my past doctor that i had seen him for Weight issues and that i was taking a pill so i wouldn't be hungry? Its been 8 months since i went there because i didn't feel like it was working. I had even joined Curves but it didn't work with me either. Or will me being 100 pounds over weight be enough? Or will they do some test while i am there? I hope things work out for me. THanks guys for listening to me ramble on and on lol. Billie Jean

Billie Jean, They should have told you if you need to bring anything with you! We have UHC and before we went to the surgeon's office to start the process we had a letter stating the medical necessity. That was what UHC said we needed to move forward. Then your surgeon will have other requirements and testing they will put you through to make sure your healthy enough for the surgery. Psych Evaluation, GYN, Pap, Mamogram, you'll have a clearance from a cardiac center where they will do a couple of tests that includes a stress test and a echocardiogram, possibly a sleep study to see if you have sleep apnea, and from there you'll get clearances from all of them and move on to your chest xray and lab work the doctor wants in the last 30-days. It's a process so don't worry about what you may not have on your first visit! The main part is getting the insurance co working for you, the rest falls in place. Good Luck and stay positive, don't expect anything to go wrong! Every doctor is a little different as to your first appointment, we had a mini nutrition visit where they told us to practice eating without drinking. That's hard, and to loose 10% of our extra weight because it makes the surgery easier. They said if you gain, they will postpone the surgery. Then we saw the nurse practioner who did a mini physical on us and told us about all the tests we would have and had a short meeting with the insurance people. Ours was about a 3 hour appointment because of the different people that we saw, and it was myself and my husband. We did not see the surgeon that day. That comes later as does some educational classes that informs you about the surgery and life after. Our doctor is probably unusual, she is Dr. Blackstone here in Scottsdale. My husband's surgery went really well Nov. 6th, he's already lost over 30 lbs and he's had lap-band. Mine will be the same type in January. Everything is just as they explained it to us, it's very important to follow your doctor's instructions. People on this board have talked about problems they've had and from what I can tell, it's things they were not informed about at all so don't be afraid to ask questions. CaroleM

Thank you for the reply! All they told me to do was have bring insurance card and make sure i have a reg doc by the time i have my appointment. I asked them if they knew any and the lady said yes that Dr. Schwartz wife is one and of course she is PRO WLS lol lol! So i can either go to her or find someone else! But i was told she is on maternity leave and won't be bac****il the 18. My appointment is on the 22 so i don't know if i will be able to get in on time. Going to make a call tomorrow and see if i can and if she accepts UHC. Once again Thanks for the reply! Billie Jean

UHC requirements= letter of medical necessity from pcp, BMI of 40 or 35 or higher with 2 co-morbidities, psych eval. And...if you are over 50 then the hospital will require an ekg with interpretation. Good luck! It'll be a piece of cake! Sugar free of course! Joyce

I brought my medical records and insurance card with my 1st visit with karen got my psych evaluation the next week after and then got approved 2 weeks later and i got a date for surgery the 26th of dec. due to my health care spending acct not kicking in untill 2007 i had to reschedule for the 23rd of january. I have UHC and they didnt require me to have a letter from my PCP.

What type of surgery are you wanting to have? Renee'