3 Month Pre-Surgery Program
(deactivated member)
on 6/22/11 6:41 am, edited 6/22/11 7:12 am - PA
on 6/22/11 6:41 am, edited 6/22/11 7:12 am - PA
Hi ya'll!
I'm starting my three month program at Lehigh Valley Hospital on July 7th and my final appointment for that will be October 10th. The surgeon is thinking my surgery will be sometime in November or December.
As far as I know, this three month program consists of a series appointments. A couple with the nutritionist, one with behavioral health, my physical, and two group sessions.
Has anybody done this program? Is it as simple as I think it is? I keep reading that people are losing all kinds of weight during their pre-op programs, but I'm not sure if that's the deal with my 3 month program.
What should I expect? Any help would be greatly appreciated!
-ErinMarie
I'm starting my three month program at Lehigh Valley Hospital on July 7th and my final appointment for that will be October 10th. The surgeon is thinking my surgery will be sometime in November or December.
As far as I know, this three month program consists of a series appointments. A couple with the nutritionist, one with behavioral health, my physical, and two group sessions.
Has anybody done this program? Is it as simple as I think it is? I keep reading that people are losing all kinds of weight during their pre-op programs, but I'm not sure if that's the deal with my 3 month program.
What should I expect? Any help would be greatly appreciated!
-ErinMarie
(deactivated member)
on 6/23/11 2:22 am - PA
on 6/23/11 2:22 am - PA
Thank you! I am more than excited. I just can't wait to actually start. I put it off for so long and completely regret it. But now I'm ready and raring to go!
Well I am the queen of insurance problems, so hopefully your experience will be better than mine was. I have Capital Blue Cross.
The reequirements of the hospital program may be very different from the requirements for insurance coverage, so please be sure to call the insurance patient representative TODAY. Get a COMPLETE list of ALL of their requirements for approval.
My doc's requirements were pretty simple. However, insurance requirements included:
6 month doctor supervised weight loss program with full documentation
Copies of all my doctor's chart notes to verify ongoing obesity related issues
Letter from my doctor stating that I was a good candidate for WLS
Psychological evaluation
Cardiac evaluation and stress test
Sleep study and pulmonary evaluation
Documented attendance at a minimum of 3 support group meetings\
Gastrointestinal clearance due to H pylori (and a week of antibiotics plus 2 trips to the lab for that)
There may have been more....but the deal was that they never provided me with this list and the process just kept stretching out longer and longer - every time I thought I had done everything, BC would pop up with another requirement. I honestly believe that they felt I would just give up.
Flip side is....after my long process, I felt much more prepared for the surgery and had time to really educate myself and do a lot of reading and thinking.
The reequirements of the hospital program may be very different from the requirements for insurance coverage, so please be sure to call the insurance patient representative TODAY. Get a COMPLETE list of ALL of their requirements for approval.
My doc's requirements were pretty simple. However, insurance requirements included:
6 month doctor supervised weight loss program with full documentation
Copies of all my doctor's chart notes to verify ongoing obesity related issues
Letter from my doctor stating that I was a good candidate for WLS
Psychological evaluation
Cardiac evaluation and stress test
Sleep study and pulmonary evaluation
Documented attendance at a minimum of 3 support group meetings\
Gastrointestinal clearance due to H pylori (and a week of antibiotics plus 2 trips to the lab for that)
There may have been more....but the deal was that they never provided me with this list and the process just kept stretching out longer and longer - every time I thought I had done everything, BC would pop up with another requirement. I honestly believe that they felt I would just give up.
Flip side is....after my long process, I felt much more prepared for the surgery and had time to really educate myself and do a lot of reading and thinking.
(deactivated member)
on 6/23/11 2:34 am - PA
on 6/23/11 2:34 am - PA
I also have Capital Blue Cross, but what I've heard from them is VERY different than what you went through. I called them about a month ago to find out everything that needs to be done, requirements, all that good stuff. The woman I spoke with told me that the insurance doesn't require me to do the three month program and that I can just have the surgery as long as my BMI is high enough basically. It's the hospital itself that is making me do the three month program so they can keep their "Bariatric Center for Excellence" title. I talked to the insurance about that a few times to clarify that it's in fact true, then I contacted the surgeon to find out what that was about and they told me that it's all the hospital.
I went to a free information night about this whole thing in January and naturally the doctor went through the surgery details, but everything was very simple and straight forward when it came to the program. I know some people have to do six months, but I only have to do three. I'm going to call the insurance just to clarify again. I'm only 25, but in my experience, if something seems too good to be true, or is too easy, it's usually not true and a lot harder.
My mom went with me to the free information night and I've asked her multiple times if she recalled anything other than the series of appointments over the three month program and she didn't. My mother remembers everything! She actually thinks it's too easy and was surprised that it was.
I will definitely call the insurance again just so I'm not surprised by anything. Thank you for letting me know what you went through! I appreciate it.
I went to a free information night about this whole thing in January and naturally the doctor went through the surgery details, but everything was very simple and straight forward when it came to the program. I know some people have to do six months, but I only have to do three. I'm going to call the insurance just to clarify again. I'm only 25, but in my experience, if something seems too good to be true, or is too easy, it's usually not true and a lot harder.
My mom went with me to the free information night and I've asked her multiple times if she recalled anything other than the series of appointments over the three month program and she didn't. My mother remembers everything! She actually thinks it's too easy and was surprised that it was.
I will definitely call the insurance again just so I'm not surprised by anything. Thank you for letting me know what you went through! I appreciate it.
Well, let me cross my fingers that your process will be a smooth and easy one!
My BMI was def. high enough, no problem there. I didn't have a lot of comorbidities but did have hypertension and high cholesterol.
I think a couple of issues affected my case. One being that my husband's company was about to drop coverage for bariatrics entirely. Not sure if they had a hint of that at the time, but wonder if someone somewhere thought that if I just had to hold on a bit longer....they would be off the hook. Who knows. Got it done!
My BMI was def. high enough, no problem there. I didn't have a lot of comorbidities but did have hypertension and high cholesterol.
I think a couple of issues affected my case. One being that my husband's company was about to drop coverage for bariatrics entirely. Not sure if they had a hint of that at the time, but wonder if someone somewhere thought that if I just had to hold on a bit longer....they would be off the hook. Who knows. Got it done!
Highmark BlueShield has similar requirements as Lynne's. I too advise you to contact your insurance carrier. I had no issues due to health reasons, but you should check. I also agree that the 6 month timeframe allowed me to read more & research more so I could have the best possible outcome. Good luck!
Sara
Sara
I had surgery at Barix, and they had their requirements for surgery - my insurance was Aetna and they also had their own set of requirements. This is what I had.
BARIX: My surgeon required a sleep study and EKG. They also said that if you gained weight between your initial consultation and your date of surgery they would NOT operate on you.
AETNA: 3 Month supervised diet and exercise program. I had to join a gym, use a personal trainer, meet with a nutritionist (outside of Barix), and have my PCP document everything I did. I met with him once a month.
In all honesty it wasn't painful at all - and it really helped me get ready for my surgery. I got into a decent exercise program for my weight at that time, and found the most wonderful nutritionist - she was so supportive and between the two I lost 33 lbs. over 3 months without really 'trying' or dieting. I really just logged my food for the nutritionist - tried cutting out sweets and limiting carbs.
Back to BARIX: My surgeon required a 10 day pre-op liquid diet to prepare my body for surgery - it wasn't the easiest thing I ever did but I managed to get through it okay, and lost another 17 lbs., so I went into surgery having lost 50 lbs!! My surgeon thought that was wonderful and trust me, I had no complaints either!!
Both Barix and Aetna were very specific with what I had to do for the surgery - Aetna sent me a BOOK detailing everything, and the doctors, nurses and nuts at Barix were also very helpful.
My best piece of advice is to make sure you DOCUMENT EVERYTHING with your PCP - keep good records of everything you do, and you should be fine. If you have questions I wouldn't hesitate to call the surgeon's office.
Best of luck to you!!
Kathy
BARIX: My surgeon required a sleep study and EKG. They also said that if you gained weight between your initial consultation and your date of surgery they would NOT operate on you.
AETNA: 3 Month supervised diet and exercise program. I had to join a gym, use a personal trainer, meet with a nutritionist (outside of Barix), and have my PCP document everything I did. I met with him once a month.
In all honesty it wasn't painful at all - and it really helped me get ready for my surgery. I got into a decent exercise program for my weight at that time, and found the most wonderful nutritionist - she was so supportive and between the two I lost 33 lbs. over 3 months without really 'trying' or dieting. I really just logged my food for the nutritionist - tried cutting out sweets and limiting carbs.
Back to BARIX: My surgeon required a 10 day pre-op liquid diet to prepare my body for surgery - it wasn't the easiest thing I ever did but I managed to get through it okay, and lost another 17 lbs., so I went into surgery having lost 50 lbs!! My surgeon thought that was wonderful and trust me, I had no complaints either!!
Both Barix and Aetna were very specific with what I had to do for the surgery - Aetna sent me a BOOK detailing everything, and the doctors, nurses and nuts at Barix were also very helpful.
My best piece of advice is to make sure you DOCUMENT EVERYTHING with your PCP - keep good records of everything you do, and you should be fine. If you have questions I wouldn't hesitate to call the surgeon's office.
Best of luck to you!!
Kathy
'One shoe can change your life'...Cinderella
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