First Appointment

Hi, my name is Tammi and I'm new to this web-site.  My question is what to expect at my first doctors appointment at MMPC in Grand Rapids?  Do I need to bring anything with me , like results of Sleep studies, stress test, proof of past diets?  Will they tell me at that time if I'm a candidate or not. I know it also has to be approved by my Insurance company.  How Is Traditional Bc/Bs with this type surgery?

Hi Tammi, welcome to the board!  I'm not a MMPC pt but I'll tell you what I did to prepare for my 1st appt.  I faxed a release of information to every doctor I had seen in the last 5 years and had them send copies of my charts, plus got copies of my sleep study, cardiac stress test.  I did my psych eval and had the letter from him.  I had also already attended the information seminar (it's required before surgery).  They covered a lot of insurance stuff there.  They actually have a packet for each pt based on their insurance since it is all so different from policy to policy.  Do you have BCBS PPO?  If so the requirements are BMI greater than 40 (or greater than 35 with two comorbidities: sleep apnea, diabetes, high blood pressure, elevated cholesterol etc).  The require the psych eval, nutrition eval and a 6 month supervised diet.  If your BMI is greater than 50 you do not need the 6 month diet.  They also no longer require prior authorization.  They have trusted the physician to follow the rules.   Good luck.  Keep us posted.

Thanks for the response.  I'm 3 lbs below a 40 bmi .  I have PPO.  I join Weigh****cher 3 yrs ago to please my doctor and lost 50lbs still leaving me 40lbs to go.  Then I had a back injury that required surgery and before I knew it the weight was back on.  Does the Weigh****ches count for supervised diet?

I'm not sure about WW, b/c my insurance said I had to have "periodic weigh ins" with my physician over the course of the 6 months, discussing my diet and exercise.  I had BCBS when I started the process last year, then my employer changed insurance co Jan 1st so I had to follow a different set of guidelines.  For my 6months I did follow WW, but continued to see my doctor monthly, discussing target points, exercise, etc. 

I had my surgery at MMPC and they are awesome.  They will take very good care of you.  I would take your prior records from your doctors office.  I have BCBS and had a bmi of less than forty and was covered.  I also used weigh****chers as one of my supervised diets.  Good luck.  Mary Jo

 Mary Jo,  When you use words like awesome, caring, it eases my fears. Thanks, Tammi

Hi Tami, Welcome to the board.  I went thru MMPC and also live in Grand Rapids as you do.  The very first meeting I attended was an Orientation at MMPC.  After that, we met individually with a staff person and she told us what we needed to bring to our first appt.  We also selected the surgeon we wanted at that time. My PCP sent over all the info MMPC requested.  The process went quite quickly for me.  I went to the Orientation about the end of March and began meetingts with the surgeon, psychologist, nutricianist, and excercise person in April.  I was approved for surgery in late May and had my surgery on July 1. Each case if different and of course so are insurance company requirements.  But, I can tell you you will receive excellent care from start to finish with MMPD. All the best and keep us posted as to your progress. Pam

Pam, Thanks for all the info.  You have put some of my worries to rest.  So your 10 days out from your surgery.  How you feeling? Thanks again Tammi 

Hi Tammi, I'm sorry.  I  should have clarified my time.  I am 3 yrs post op and doing great.  My surgery was on July 1, 2005 and I had Dr. Foote.  Still have a little ways to go to my weight goal but thave never felt better in my life.  Let me know how you do.  It is always nice to have someone from the same city and with the same drs. office. Keep in touch. Pam

Tammi, I have bcbs preffered choice (pos) and did not need preapproval, nor did I have to go through the whole 6 month supervised diet bit. According to Dr. Gluck's office in Muskegon bcbs is one of the easiest to get approval from. They said that they base approval on whether or not your bariatric surgeon deems surgery necessary (and that's with a bmi of 40 OR 35 with comorbidities). My bmi is 35, but I have extremely high cholesterol (and can't take statins to lower it due to adverse reactions to them), and also have osteoarthritis.