Newbie looking for local advice! :-)

Hi Everyone! I'm new to the Iowa City area. We lived in Chicago for 15 years and then spent two years in Dallas, so it's GREAT to be back in the Midwest again! Almost two years ago, I scheduled consultations with two WLS surgeons in Dallas and then my company changed insurance plans right before my appointments....the new plan had a written exclusion against WLS, so I had to put the idea aside. Now that we've moved to Iowa, we now have BCBS Alliance Select, whi*****ludes coverage. I'm hoping that some of you from the Iowa City area could give me an idea of where to start--I don't know anything about any of the surgeons here, although I assume there are some good ones with the University Hospital and all. If anyone also has my insurance plan, I'd appreciate any comments on that as well. When I called them to ask about the requirements, the girl said that one requirement was that the doctor writing the surgery recommendation had to be a physician who does NOT perform the surgery itself. However, my plan summary doesn't mention that at all. I'm wondering if anyone has had the experience of having to get approval from a primary care doctor instead of the surgeon? If so, can you suggest a doctor who supports WLS? I've been doing quite a bit of research on my own here, but I'm hoping you guys might be able to help steer me in the right direction (as well as away from the WRONG direction!) so I don't have to completely reinvent the wheel, so to speak. Thanks so much...I look forward to being a part of the Iowa crowd here! Take care! Chris

Hi, Chris, I am not from Iowa City, but Des Moines. I have the same insurance and I am in the process of having the surgery and if all goes well, will be doing it in late October early November. Yes, you do need a note from a doctor other than your surgeon. From your primary care doc. I have a friend who was just approved yesterday, same insurance and her's was held up because she did not have that letter. I can't help you on where to start other than here, I had to go to a community lecture and that started the ball rolling. Good Luck. Michelle

Thanks Michelle...that's good to know. What did you need as far as proof on past attempts at weight loss over the past few years? Since we've moved so much, it will take some doing to get all my medical records, and other than showing that I've discussed weight loss with several doctors, I don't know that my records will show a lot of follow up. I have some personal records of my weight and measurements, but I don't know if that will be good enough. I appreciate your help! Chris

Chris..... The Iowa crowd is the best crowd ever!!!!! Welcome home!!! Check out our older messages for some reason I remember someone else going through the same things. Just get your PCP to write the letter. Soon you will get some answers back from the gang. I think Steven who posted as well has the same insurance - perhaps you can see what hoops he has had to jump through. Once again welcome aboard!!!! check out Andrea's weekly roll call and see what goals we are setting and set some with us!!! Melinda

Welcome aboard! You will find the best support group here. I'm from the other side of the state, western (by Sioux City) so can't help you out with Dr part. You can check out Dr.'s on the Main Entrance to see who is in your area also. It will also let you know what insurance is accepted. Carolyn 4/20/04 265/215/150 check out Carnie Wilson Weekend at: http://groups.msn.com/CarnieWilsonFriendsWeekend click on pictures on left side then show all pictures. We had a great time!

I'm in Dubuque, IA but planning on having surgery at University Hospitals there in Iowa City. I also have the same insurance as you. The first thing you need to do is call University Hospital. You can look up the number in the phone book or on their website. You need to ask for consultation for bariatric surgery. They will mail you a packet that you have to fill out and return...this packet is also where you list the diet attempts. Then after returning the packet, if they "approve you" for an appointment, they will mail you a letter with your appointment date and time. I suggest you do this right away because I had to wait 6 WEEKS from the time I requested an appointment until the time I actually had my consultation. At the consultation, they will answer all your questions about insurance requirements and the surgery itself. There is slightly different criteria depending on your BMI, and Debbi will go over that with you, but you basically need a Primary care doc to refer you for surgery and a psych eval. Also at the consultation, they will suggest you lose 10% of your body weight and require you to keep a food diary. Then they will determine when your 2nd consultation will be based on how much they want you to lose and comorbidities. For me, they said they'd like to see me back in 3 months.... this also gives you time to get the PCP referral and psych eval...this is what I'm currently working on. I didn't have a Primary Care Dr because I have been without insurance frequently. I had an appointment with a local doctor, and he said he would refer me. I still need to follow up with him on that. Now, I need to schedule a psych eval. Like I said, I would suggest contacting the hospital right away to "get on the list." Let me know if you have any other questions. My best friend had the surgery there this January and she was living in Iowa City at the time, too... molly

Thanks Molly! I'll give them a call. I want to research some other programs as well, but since U of Iowa is right here in town, I at least want to check them out. I'm not sure if the long wait is a good thing or a bad thing in my case...we just moved here three weeks ago, and then this past weekend we moved my father in law to a retirement apartment in Iowa City as well. He has metastatic colon cancer and probably has a year or so according to his last oncologist over in Illinois. I haven't mentioned to my husband that I noticed our new insurance covers WLS, and I'm sure he'll feel a little overwhelmed that I'm looking into it so soon after moving, and with his dad's situation and all. This way I can make the point that with the waiting list being so long, I really HAD to get on the list now and not wait. He was initially supportive of the idea when we were in Dallas, but then the more he thought about it, the more nervous he got. I think he was relieved when my insurance company stopped covering it. He kept saying that he's just not sure when to draw that line of saying, "OK, she's really, REALLY given diet and exercise her best shot, and this is the only other option." And the truth is, I'm not sure where that line is either. But at least if I get my name in the hat, I'll still have plenty of time for thinking. Thanks for letting me ramble.....I'll be "watching" you to see how things fall together for you! Chris

Hi Chris Welcome to the IA Boards!!! I am Paula and I had surgery 3 years ago in Nov. I volunteer for Obesity Help with newcomer referrals.... if you'd like I can get you a list of several different programs that are within easy driving distance. The Quad Cities has a couple, Cedar Rapids has one, and ofcourse the one at U of I, depending on you... there are some great ones further west also. Each is slightly different and it's matter of which is a good fit for your specific needs and who you feel the most comfortable with. Email if your interested. Again Welcome, and everyone here is supportive and full of great advice. Paula RNY Nov 01 highest weight 314 weight the day of surgery 298 weight today 129

Paula: I would really appreciate a list...that would be awesome! You guys have all been so helpful. There's nothing like Midwestern folks, I tell ya! I read your profile...you have quite a story! I'm amazed that after all you've been through, you still have such a positive outlook. I think I have more questions, but I'll post a new thread. Thanks again...you can email the info to me if it's redundant to post. Talk to you soon! Chris

I have the same ins. and ours did not require a referral but some surgeons require it...I know Grinnell does, I had my surgery in Ames with Dr. Hardy anyway, all I had to do is fill out his little questionaire about my diet history and they did the rest...I had very little trouble I was approve in a week...2 weeks for my tummy tuck! I don't know of any physicians in Iowa City...I am originally from West Branch...I miss IC. Heather RNY Dr. Hardy 5/23/03 298/150 TT Dr. Yen 7/30/04 150/142