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Topic: RE: Health Plus HMO Commercial Members
I'm no expert, but it sounds like you will be good to go, provided that nothing shows up in your pre-op testing.
I have Healthplus too an only just had the psych eval last wednesday, with my follow up being this Wednesday.
How long before your consult.
Steve D
I have Healthplus too an only just had the psych eval last wednesday, with my follow up being this Wednesday.
How long before your consult.
Steve D
Topic: RE: We Don't Judge Here, Ask Questions, its okay, I promise...
Hello,
I am not sure if you are still on here but I was wondering what type of insurance you have? Also did you get your surgery yet? How long did it take for you to get schedule for surgery? I have my appoitment for consult with surgeon on 8-30-12. I have already had records sent had psych eval and passed. I have health plus commercial hmo so I was just wondering what the average wait time is? Thanks in advance for all your help.
I am not sure if you are still on here but I was wondering what type of insurance you have? Also did you get your surgery yet? How long did it take for you to get schedule for surgery? I have my appoitment for consult with surgeon on 8-30-12. I have already had records sent had psych eval and passed. I have health plus commercial hmo so I was just wondering what the average wait time is? Thanks in advance for all your help.
Topic: RE: Anyone have to do a 6 month preop for Priority Health?
"For God did not give us a spirit of timidity and fear but a spirit of power and love and self discipline." 2 Tim. 1:7 So with HIS power, love and self-discipline - I WILL DO THIS!
HW:250 SW: 232 CW: 164 GW: 150
Thanks for your reply! That's one of our concerns.
I'm glad some insurance companies are careful on behalf of patients who want to jump into bariatric surgery thinking it's an "easy" way out and not taking the time to look into eveyrthing and making good judgements as well as getting their head in the right place BEFORE they go through with it.
But sometimes insurance companies react like yours did which just doesn't make sense. So you put the weight back on and then you qualify again.
Notice though, the biggest buildings in any large city are owned by insurance companies. They're not there because they're not making money hand over fist. They keep those fist tight around that money they make and make us, the patients, fight to get our claims paid.
I've worked in medical billing for 25 years. I've seen it all.
Good luck on your journey.
Colleen
I'm glad some insurance companies are careful on behalf of patients who want to jump into bariatric surgery thinking it's an "easy" way out and not taking the time to look into eveyrthing and making good judgements as well as getting their head in the right place BEFORE they go through with it.
But sometimes insurance companies react like yours did which just doesn't make sense. So you put the weight back on and then you qualify again.
Notice though, the biggest buildings in any large city are owned by insurance companies. They're not there because they're not making money hand over fist. They keep those fist tight around that money they make and make us, the patients, fight to get our claims paid.
I've worked in medical billing for 25 years. I've seen it all.
Good luck on your journey.
Colleen
"For God did not give us a spirit of timidity and fear but a spirit of power and love and self discipline." 2 Tim. 1:7 So with HIS power, love and self-discipline - I WILL DO THIS!
HW:250 SW: 232 CW: 164 GW: 150
Topic: RE: Dr Katz and St Johns Oakland-
I researched RNY, band and sleeve. I decided against the RNY because of the malnutrition possiblilites and against the band because of the poor results and health issues years out. The sleeve to me, is the best of the surgeries. I have to say that dont base your decision on whether dr katz is happy with it cuz he will do any surgery that you want. I noticed when i changed my mind from the band to the sleeve it really didnt matter to him, it was like okay whichever surgery you want. . The VSG (or sleeve) is a newer surgery that gives you the benefits of the rny but not the side effects of dumping and malnutrition risks. Just make sure your research, research and research. There is a group on facebook you can join called VSG vixons...or vsg chatterbox. . With the sleeve there is no dumping, no malnutrition. im not trying to talk you out of the rny, but just make sure you do your research. Good luck and keep me posted.
HW: 280
SW: 255
CW: 194.4
SW: 255
CW: 194.4
Topic: RE: Anyone have to do a 6 month preop for Priority Health?
Sounds like your friend is very close to the minimum BMI to qualify for surgery. I would recommend that they play whatever game the insurance co. is requiring but to NOT loss the weight. I was in a similar situation and looking to have lap band surgery a couple of years ago. I was required to do the 6 month weight loss prior to surgery. When I met with the surgeon, I was assured that losing weight for 6 months would NOT disqualify me from having surgery but....it did. I tried to abide by the insurance company's rules and gave an honest effort and ended up losing 43 lbs which then put my BMI too low to qualify for surgery. So tell your friend to be careful about losing too much weight during the 6 months or they may end up not qualifying. I'd hate to see someone else have to go through the same disappointment as I did. :(
Topic: Physician Health Plan (medicaid)
Does anyone know what is need for Physician Health Plan (medicaid) to be approved for WLS?? Any and all help is appreciated. I live in Michigan.
Topic: Anyone have to do a 6 month preop for Priority Health?
"For God did not give us a spirit of timidity and fear but a spirit of power and love and self discipline." 2 Tim. 1:7 So with HIS power, love and self-discipline - I WILL DO THIS!
HW:250 SW: 232 CW: 164 GW: 150
Looking for a friend who will be having a VSG through Grand Health Partners where I had mine (highly recommended by the way).
She has Priority Health and she has to go through a 6 month pre-op because her BMI is not over 50!! It's only 41! Mine was only 38 for BCS
She has the co-morbidities but apparently Priority Health just changed their rules as of 6-1-12.
She was told she can't go below a certain weight.
But does anyone else know what they're looking for?? What might get her tossed out?? Etc??
Thanks
She has Priority Health and she has to go through a 6 month pre-op because her BMI is not over 50!! It's only 41! Mine was only 38 for BCS
She has the co-morbidities but apparently Priority Health just changed their rules as of 6-1-12.
She was told she can't go below a certain weight.
But does anyone else know what they're looking for?? What might get her tossed out?? Etc??
Thanks
"For God did not give us a spirit of timidity and fear but a spirit of power and love and self discipline." 2 Tim. 1:7 So with HIS power, love and self-discipline - I WILL DO THIS!
HW:250 SW: 232 CW: 164 GW: 150
heidi12472
on 8/16/12 5:47 am
on 8/16/12 5:47 am
Topic: RE: Dr Katz and St Johns Oakland-
Hello that's awesome to hear! At first I was going for the sleeve, I think I was so afraid of complications that a sleeve would be better.....but after my psych eval I changed my mind and decided RNY. I went in to talk with him again and he was fine with it! So RNY it is! I'm excited to start the journey. You look fabulous by the way! Did he do the surgery in Oakland? What kind of pre. Op did u have? Thanks for responding!
Topic: RE: Just not sure
I am 4 months out and still dont have much of an apetite. But I know with the excercise I have to eat. You have to make yourself eat. I thing the "stuck" issue is eating too much or not chewing good enough. I have that when I eat too much. Its hard to learn your limit but you have to stop before the stuck feelling. I still havent mastered it but I am better than I was. Remember, chew, chew chew.....
HW: 280
SW: 255
CW: 194.4
SW: 255
CW: 194.4
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