MPlan

I am going through the MPlan Insurance 6 month program now.  I would've been done with everything by Sept. 25th and ready to hopefully be accepted for surgery, but my appointment with Dr. Jones (the Psychologist) was set back to Oct. 16th now.  After I'm through with this 6 month program can anyone tell me what else takes place and give me an idea how long these other steps take?  Thanks!

Once that insurance gives approval, most surgeries happen with a month or two. Good luck with MPlan. I had such a hard time with them that I ended up switching insurance carriers. I had 2.5 year of physician supervised dieting (at the time, they required 18 months. They refused it because...and I quote, 'don't like the way your pcp keeps his notes'. They wanted me to start all over with the 18 months...with the same pcp, with no guidance as to how he should improved on his note-taking. You may want to mention this to your pcp so that he will know that his notes have to be meticulous or they'll use that as an excuse. BTW..I did appeal and they upheld the appeal. After I switched to Anthem, I sent the same pcp notes to them and was approved within 2 weeks. Good luck! Sherri

Thanks for the info.  Originally they told me that I had to see my PCP for 18 months and I did.  After I did that and called them with that info they sent me a list of other things that I should have been doing.  Go figure!  My PCP wrote them with all the info that she had on me and then they sent me this paper to sign for the 6 month program. 

I have MPlan too.  Once they have gotten you this far the approval is pretty much in the bag.  I had to see Dr Jones for an introductory appt, then back for testing, then a follow up for results of testing.  Stay on top of her office to be sure she gets the report back to MPlan/Clarian Bariatric.  That took a while...

As soon as that is done you will get an appt with Clarian Bariatric for your pre-op surgical eval and nutrition class (that's one you don't want to miss, it is very informative).  You will meet with your surgeon and then the surgeon's office will call with your date for pre-op testing and surgery. Best wishes for a speedy process.

Annette, I'm confused. Isn't Dr. Inman & Dr. Huse both through St. Vincent's? I didn't know they both went to Clarian as well. Aparently MPlan must have change abit since I had it. I'm glad. They needed it! They were cheaper than Anthem but we also couldn't get them to cover Bill's eye care. They just didn't get it that a regular opthamalogist can't handle his eye condition. All the needed specialists were in the St. V's network, and there were no specialist in the Community network..but they kept insisting there were..and kept referring him to regular ole Dr. Tavel level docs. So..even though it cost more, it is very worth it for us to have switched. Sherri

Inman, Huse and Evanson have a practice location at Clarian North.  That's where I had my surgery.  MPlan has changed quite a bit, thank God.  They are much easier to deal with and seem to have their program ironed out.

Thanks!  I had heard that once you finished everything they usually approved you.  I had originally went through the 18 month thing with my PCP and then they sent me paperwork that said that I should have been doing a bunch of other things also.  My PCP sent them alot of info on my medical problems, etc and then they sent the paper about the 6 month program.  I am actually having a revisional surgery.  I had VBG 10 years ago, so of course my surgery has to be an open gastric bypass.  I was hoping to get it done in time, so I'd at least feel like going to relatives for the holidays.  I know I probably won't be eating by then, but at least I can socialize.  Since Dr. Jones had to set my appt. back 3 weeks, I don't have any idea when I'll be getting it done.  I see Roger for my last individual appt. Sept. 24th and her family appt. is all that is left.  He told me that I should call her office every couple of days and try to find out if there are any cancellations.  I've been driving down there from Kokomo for all of this stuff, so I'll be glad to get it done.  I had Dr. Huse before when he was at Winona Hospital. 

I went through a very similar scenario with MPlan.  I got to the end of my original 18 month "program" and they told me the rules had changed and I would have to start over again.  I appealed and asked to have the 18 months shortened to 6. (This was before the law changed)  They compromised and had me complete a 12 month program instead.  But with all the NUT/Psych/group/PCP appointments it took 12 months to complete it all.  I was originally going to go with Dr Huse, but it would have been an additional 3 months to schedule with him, so I went with Dr Inman.  I really like her.   Stay on top with Dr Jones' office, they tend to be a bit lax in getting reports filed and that can hold up your progress. Best of luck.

 Is Dr. Huse that busy?  I know that he was pretty busy when I had him last time.  I think since I'm having a revision, I'll probably have to have Dr. Huse.  I hope that it doesn't take 3 months, but I guess if it does then I can enjoy the holidays.  LOL  I was planning on going to Florida in Feb. but that may not happen. 

What type of protein drink do you like best?  I haven't really tried any yet.  Alot of people I have talked to seem to like Isopure.  When I had my last surgery, they had us drink fat free carnation instant breakfast drink, I think, and it tasted awful!  How long were you on liquids and pureed foods before you were allowed to eat soft foods and then regular foods?  I know that it could vary, depending on how you're doing in each phase.  I really don't have alot of info on any of that stuff.  I know that it's different than the other surgery I had 10 years ago.  Do they have a refrigerator with Crystal Lite in it?  I know that they had that plus sugar-free popsicles when I had my surgery 10 years ago. Thanks for giving me information.  I really haven't heard alot of specifics about the nutrition after surgery or the protein drinks.   Dr. Inman was at Winona when I had my surgery before.  I haven't really met her, but others have told me that they like her.   I hope Dr. Jone's gets my reports filed quickly.  I've had a few people in my therapy group that have told me that she doesn't really agree with the surgery.  That kind of surprised me since she is doing this for MPlan.   Thanks for answering my questions.  I really appreciate it. 

I did fine with the Carnation Instant Breakfast but prefered the Isopure, expecially over shaved ice.  It's like a DQ Mr Misty.  You will be scheduled for a nutrition consultation/class at Clarian Bariatric Center.  Make the most of it.  It was the best resource.  Ruthanne, the nutritionist, is very informative.  I learned more in the two hours I spent with her than I did in the YEARS of visits with the dieticians at Methodist. When you are in the hospital (Clarian North) they will give you a menu with the things you are allowed to have.  You just pick up the phone and order what you want and they bring  it to you, just like room service.  None of that bringing you a tray just because it's meal time on the nursing schedule.  You are allowed one or two Isopures per day.  Order them in different flavors to try as many as you can so you know which ones to buy when you go home.  You can even take them home with you if you don't drink them there.  I like the grape best.   Dr Jones is okay.  I think she may be a bit against the surgery...I should run by her office soon to show her my "after" and maybe convince her that the surgery is a good thing.  She was not the psychologist who did this for MPlan when I started...she took over for one who left.  So I think she kinda got this whole program dumped on her when this wasn't her "thing."