Lap Band

Hello everyone! My name is Ann and I live in the west Valley. I am thinking of having the Lap Band procedure and was hoping for some insight/suggestions as to possible surgeon's. I have United Healthcare as insurance and they advised that they do not cover that procedure, but am not deterred. Any help? Thanks Ann

I was Lap Banded on 3/7/07. My surgeon was Dr. Simpson who I felt was the best for me. He has a great office and support groups. He is having a seminar this weekend at his office. Check out his website for more details. www.drsimpson.net or southwestweightloss.com. He has about a dozen websites. Best of Luck, Lorrie

Hey Ann - I fought with my insurance company for 6mths then gave up the battle and went self-pay, it isnt easy but it has been the best $$ I have ever spent on myslef. I like Lori, your other post used Doc Simpson. My reasoning was its the ONLY surgery he does now so I felt he knows all the ins and outs cause its all he does in regards to WLS, he no longer does RNY's or DS's. Had my surgery on 3-14-07 and I am down -37lbs, you can follow my process on my profile. I never would have considered RNY, but if it is something you are considering just make sure you do your research into both surgerys! Good Luck and you will use this board to help you along the way!

I would suggest you also check out Dr. Robin Blackstone. She has another surgeon joining her in July so her surgery schedule won't be so jammed. People fly in from all over to have her. In addition to being a very skilled surgeon, she runs a center of excellence in Scottsdale, and the Shea hospital's bariatric unit is probably the best in the area. Her program is very comprehensive, you won't be wondering what your suppose to do after surgery, or not know what to expect. Her whole staff is great. Her success rate is very high for people losing weight with lap-band. She doesn't have you on all liquids for a month after surgery. Your only on clear liquids for 4 days and then on to soft proteins until your first fill. If you go on the lap-band forum you'll see most of the other surgeon's put their patients through a post-op diet that is mostly liquid for the first 5 weeks. People get pretty hungry on that. I was glad to be on her program, my husband had her do his lap-band as well. She has renegotiated her contract with United Healthcare so you should be in good shape there. I know UHC has her at the top of their list of surgeon's they prefer. She has a great support group that meets right there at the hospital, it's too far for me to go to, but those that do find it very helpful. When I first called United Healthcare they told me the same thing, but as I kept talking to them they said if your PCP gives you a diagnosis of Morbid Obesity then they would cover the procedure. So as long as your BMI is over 40, and we just barely were, you should be in good shape. Otherwise you would have to consider self-pay. Her office though is pretty good with the insurance companies, my request went through the first time, no problem at all. Good luck with whoever you choose, I really like Melissa in doctor B's office, she's the NP and is there when you have your surgery, sees you post-op and will give you all your fills. She knows what she's doing, the way she does them is totally painless. She get's you to restriction pretty fast while your motivated, not 6 months later after your discouraged from not losing very much.

I think it is common practice for insurance companies to tell you when you first call that they don't cover the surgery, but often that is not true. Read your plan description/policy carefully: look in the Exclusions section. If it says "Surgery for obesity is not covered," or words to that effect, then you are out of luck. But if it says "surgery for obesity is not covered unless medically necessary" then you stand a chance. You just have to jump through the hoops they require (which often includes a 6 mo. medically supervised diet and documentation that you have been obese for at least 5 years). Usually, to be medically necessary, you have to have a BMI over 40, or a BMI of 35 and at least one co-morbidity like sleep apnea, diabetes, high blood pressure, etc. etc. Personally, I would only go to a Center for Excellence, but that is just me (I'm older and have lots of co-morbidities; if I was younger and healthier I'd probably not be so concerned about this). Do lots of research; the LapBand board here is quite enlightening most of the time (though things have been a little wild over there the last 24 hours). Read it for a week or two and ask lots of questions.