where to start?

I finally decided that WLS is for me. I have done my research on line and reading books. I have gone to Dr. Anthone's seminar and am scheduled for one from Creighton on the 1st. I have looked all over for my insurance coverage and it excludes it... ambigously. So I think I can appeal successfully. I have rotating between pregnant and post partum for 6 years now, so my PCP was my ob/gyn. She has put me on diets though and taken measurements and all. Now I am getting a new real PCP. I have contacted my insurance for the long version of my policy - to no avail yet - but not sure where to start. my BMI is 46 and I am 26yrs old. What do i do first? Go to Dr. Anthone for a consult, my new PCP for a referral or to start testing, or appeal to insurance for pre-certification? Just very confused as to how to start this whole process. I don't want to appeal before stated medically necessary, but does the doc or surgeon do the paperwork with the insurance co or me? If I'm not certified before the consult, then it won't be covered. I'm so confused...

I would recommend going to your new PCP for a referral first. Usually you do the testing after you meet your surgeon and get a date that way he can get the tests he wants. Good luck, I hope everything goes smoothly for you. Ashes 291/145/144.6 Below goal @ 1 year!

Hi Miranda, I did like you I went to Dr A's seminar and then I went to UNMC's. I still went back to Dr A. I like the idea of the long term overall weight loss maintence and that I could eat like a normal person. But the question you are asking is where to start. I started with my PCP, Benes. Actually she started with me. She made the referral about 6 months before I finally went to the seminar. After I decided on Dr A I got an appt with him and they filed the first and second appeal. My pcp has filed the 3rd appeal and then I can go to outside ..... oh I forget what they call it. I want to call it arbitration. I now go to Anthone's support group every month. It starts at 5:30 the same night as the seminars. The people there are great and you get an idea of what their lifes are like now that they've had the surgery. a great place to ask questions. Who is your new PCP. Are they in the Physician's clinic. The reason I ask is that some are more WLS pro than others. I went to see Zink one day when Benes wasn't in and she didn't seem very supportive (just my perception). One of the first questions I would ask a new PCP is "What is your opinion of weight loss surgery". You'll probably be able to tell if they are supportive by some of their comments and demeanor. Feel free to e-mail me if have any questions, and if you want I'd love to be your angle. While the DS is my choice I believe that each person knows what they need and the one thing most of us have in common is support from others. Elaine P.S. How did you hear about Anthone?

Miranda, What does your insurance policy say about coverage for wls? Sometimes is says EXCLUDED for obesity, but MORBID OBESITY is covered! So if your BMI is 40 or more, you are morbidly obese. Hey, Didya know that you have one of the most experienced and well respected surgeons there in Omaha, Yep, I'm talking about Dr Anthone. He is so modest, he won't tell you.... but while Professor of Surgery at USC he trained many, many weight loss surgeons and helped Dr. Hess improve on the old BPD in order to develop the very successful DS procedure that we have today. Anthone started the bariatric program, which he headed for about 12 years, until he moved back to his hometown of Omaha. Hey, he's so good, that I flew from Calif (where there are many great DS surgeons) to Omaha to have him do my DS. No complications and I'm down 90 lbs in 9 months! Laurie