Recent Posts

montana28
on 9/16/12 6:11 pm - FL
Topic: RE: Insurance Question*HELP
My insurance company's website provides pricing in other cities so I could shop around.  I found an accredited surgeon who's billing dept agreed to accept what my insurance will pay, so there will be no balance for me to pay except my hospital admissions. For instance my insurance said they would pay 26-29k for Dr. A in City A, and 24-27k for Dr B in City B. I called Dr. B and asked what they charge for RNY -28500.00, I explained my insurance would only cover u to 27k and would they except that amount. Yes, they said they would. And since they will accept full insurance amount, I have no co-pay. The Dr. office will bill my insurance 27 k and the amount the insurance pays is what Dr. will accept.. Alway ask your insurance company and Dr. billing department.
Jules
Member Services
on 9/14/12 11:33 am - Irvine, CA
Topic: Meet Our Speakers: Ask The Experts!
                       Save the dates: October 5th and 6th!

Come to Atlanta, GA and ask our panel of experts the questions you want answers to!  If you are unable to atend the event, email your questions to:  [email protected] and we will ask the experts to answer your questions and then we will post them on the message boards after the OH event!

Click here to reserve your tickets today!  We hope to see you there!


Mixed Q & A Panel, 
Grads & Professionals

Friday  2:00pm - 4:30pm

Dr.  Paul E. Macik

Performing operations laparoscopically since 1991.  His practice offers Gastric Bypass, LapBand and Sleeve Gastrectomy options.  Also an Instructor for Quarterly In-Service Program of Bariatric Surgery at Emory Dunwoody Medical Center and Northside Hospital.

Jim Blackburn

Jim lost 215 pounds and found a love for running.  With 58,038 Race finishers at an avg time of 01:17:35, Jim finished the 2012 Peachtree Road Race (10k) in 1:07:57, a goal he's worked towards since having Gastric Bypass.

Dr.  Michael Williams 

Dr. Williams principal clinical and research interest include minimally invasive techniques, and the surgical therapy of morbid obesity.  He has been involved in training surgeons in laparocopic techniques in the United States and the Caribbean.  

Beth Sheldon-Badore

Blogger, & Founder of Bariatric Bad Girls. "Melting Mama" as she's known through her blog has been blogging about life since her WLS in 2004.  Her witty, honest approach to life after WLS has inspired and supported thousands.

Dr. Sheldon Lincenberg

Double-board certified, plastic and reconstructive surgeon and a board-certified general surgeon.  In 1995, he created and began sponsoring Pink Ribbons, an annual October event during Breast Cancer Month to benefit breast cancer organizations.

 Courtney aka tripmom02

An active OH member for 5 years and a frequent poster on the VSG forum! She's bringing her post-op experience as a Lap Band to VSG Revision. Courtney has lost 170 lbs and is training for her 1st half marathon in October. Her goal is to complete an Iron Man in 2014!



Professional Q & A Panel

Saturday  10:30am - 11:55am

Scott Steinberg, MD

Fellow-ship trained advanced laparoscopic surgeon. A member of the American College of Surgeons and the ASMBS. 

Qammar Rashid, MD

Fellow-ship trained in Minimally Invasive and Bariatric Surgery.  A large part of her practice is breast and bariatric surgery.    

Dr. Dennis C. Smith  

The 3rd surgeon in the world to perform the totally laparoscopic DS and the 1st bariatric surgeon in the world to present the Hand-Sewn Duedenal-Ileal Anastomosis technique. 

Connie Stapleton, Ph.D

Dr. Stapleton is a licensed clinical psychologist, received her doctorol degree from Texas A&M University in Counseling Psychology.  

Donna DeMild, LPBLC

Post-Op and CEO of BodySmart, LLC. Donna works at NJ Bariatrics and is a licensed bariatric life coach. Her focus is lifestyle change after wls.   

Jeremy Gentles

A Ph.D Candidate in Sport Science at East Tennessee State University and for a number of years, served as ObesityHelp's Exercise Physiologist. 


LuvMyBoys84
on 9/13/12 11:06 pm
Topic: RE: Insurance Question*HELP
I just wanted to say something since 71 people have read your post yet left no reply of any sort. Anyways I have not had any surgeries done but when I looked into it years ago my doctors office was going to take care of everything with my surgery. Maybe you can call your insurance company or ask at your doctors office staff who does the insurance claims etc to look into it for you to make sure your getting everything you can from your insurance. Good luck I hope they cover it all! Mine would pay for it all but $5000 a few years back but now that I REALLY want to do it my insurance has changed & I'm not covered at all!
Shravan Panyam
on 9/13/12 12:37 pm - Irvine, CA
Topic: Announcing Forum Upgrades!

Its been over six years since we've launched our forums. During this time it has seen thousands of fresh faces, greetings, meetings, partings, arguments, kind words, life transformations, cathartic rants, and simply happy time pass. It has been with us throughout this time, silently observing and facilitating. But like any wise old man, its bones were getting old. Its joints were aching, and it has been needing a new jolt of energy.

A Mobile World
Did you know that over 30% of you visit our website using a mobile device? For those who do visit us via mobile, we owe you a sincere apology, because our forums have been horrendous on a mobile browser. But the big news is that things are about to change! Our new forums are completely mobile friendly and compatible with iPhone, Android, and pretty much any other modern smart phone.

Each post, topic, and forum shows up beautifully, with the full set of features, and in nice large font. See the screenshots for yourself.

You dont have do anything different, just browse to the forums like you normally would. This means that you can finally put these away:



Not Just for Mobile
The interface on your desktop browser has also been cleaned up a great deal. There is now less clutter on the page, and the overall experience is a lot cleaner. Check out some more screenshots here!



You will notice that each post no longer has 400 buttons below it. Only the buttons that are relevant to each post show up, making your screen space a lot less cluttered. Also, when you reply to another person's post, the entire post is indented inside, making it a lot easier to figure out who has replied to whom.

Launching soon! Maybe as early as next week! Maybe.
And do remember that this is not in any way a be-all-end-all when it comes to the forums. We are in the process of constantly learning and improving upon what we have, and this is just one step along the way.

Stay tuned for the changes! We look forward to hearing your thoughts on this.

ObesityHelp Developer

Kristiemarie060504
on 9/10/12 2:17 pm - MD
Topic: Uhc revision questions
Hi everyone my question is the following .... I am almost at the end of all my testing I need done to try to have my lapband removed and get the sleeve . I have united health I was just looking for people who have been in my shoes and what they went threw with the whole insurance process
Trish06
on 9/8/12 5:01 pm
DS on 12/06/12
Topic: RE: Need to qualify!
 Hi,
I know most insurance companies won't consider you for WLS unless you have 35 to 39 bmi with comorbidies or 40+ bmi with no comorbidies. You should be able to call your insurance company and they can tell you exactly what your policy is. 

Good luck,
Trish
Member Services
on 9/8/12 1:46 pm - Irvine, CA
Topic: Meet Our Speakers: Colleen M. Cook

Meet Our Speakers: Colleen M. Cook

 

Hope & Help for the Pain of Regain

Join 17 year WLS veteran Colleen M. Cook for both a shot in the arm and a kick in the seat as she shares lessons from long-term losers and imparts insight, inspiration, and hope for WLS patients struggling with extended plateaus or weight regain. Her thoughts, stories, and personal experiences will inspire and motivate you to reach and maintain your optimum weight loss.

Also, don't miss her Keynote on Friday: Nothing Succeeds Like Success

We hope to see you in Atlanta, GA October 5th and 6th! Click here to book your ticket today!

Fast Facts About Colleen

-Colleen is the author of The Success Habits of Weight Loss Surgery Patients.
- She is the president or Bariatric Support Centers International, a company that specializes in providing education and support services for weight loss surgery patients and the professionals who serve them.
- Colleen currently serves on the National Advisory board for the Walk From Obesity.
-Known as Ms. Enthusiasm, Colleen helps men and women from all walks of life recognize their extraordinary potential and then inspires then to aspire.

groovykg
on 9/7/12 7:59 pm - VA
RNY on 02/27/13
Topic: Need to qualify!
Can anyone advise on the order of the steps I should take to get approval for RNY?

I have a current BMI of 37 with no comorbidiies.  I am not a candidate for lap band because of esophageal problems.  I actually have Barrett's Esophagus, which is life threatening and considered to be precancerous, but the surgeons I saw previously didn't seem to think that would be a comorbidity.

In May and June of this year, I talked to my PCP and consulted with one group of surgeons, and then we were traveling for the summer.  In the spring, I had a sleep apnea test, which  was normal, bloodwork, which was mostly normal, just borderline cholesterol.

My insurance (Carefirst in VA) actually has some weight charts from MetLife that show a range of weights and the policy online states if more than 100 lbs above weight range.  So the medium build range has a high weight of 147, meaning that if I were 247 I would qualify, right?  No one has ever declared me small, medium, or large, but whatever.  247 is a bmi of like 38.  So then I'm there?

Anyhow, I don't know if I should pursue this at current weight, or just forget about this for now and revisit if I develop comorbids or gain 20 lbs?   I have an appt with PCP next wed to begin medically supervised diet just in case, but again, I don't really qualify (I *think*) at this weight.  If a surgeon would fight for me, it might happen, but I wanted to get the ball rolling on this.

I would consult with another surgeon, and don't think I could get an appt until October. In the meantime, I don't know what I should do about my weight/eating.  When I'm restrained, I hang out in the 230s.  If I don't give a darn, I can easily go up to the 240s and hit the 247 I'm seeing in my insurance info (although I have NEVER read anyone being approved from a chart and not BMI).

Sorry for the rambling, but I guess my question is this: What would you do at this point?  

-Proceed at current BMI and do supervised diet?  
-Forget this all for awhile and do what I need to do to get up to a higher weight before I begin supervised diet?
-See surgeon first at current weight before beginning diet?
-See surgeon at higher weight before beginning diet?

If my PCP documents a higher weight and I am able to lose some on supervised diet, hence knocking me out of qualifying range, is this a problem?  Do I need SURGEON to document highest weight or PCP to do so?




nicolejohansen
on 9/5/12 6:53 pm
Topic: One surgery, per lifetime HELP!
Would like your guidance…will try to make this long story short, but want to give you some background info. In 2010 I had Lapband surgery lost 90 lbs and committed to a healthy lifestyle. In 2011, I had the surgery reversed because of the procedure failing and causing major medical issues due to erosion. I am trying to have my surgery to fix the procedure, but they can’t do the same procedure because of the same complications so they want to use the gastric sleeve.

The request to the insurance company and my benefits department at my actual company were denied as were my two appeal due to “One surgery per person per lifetime". They said I've exhausted my two appeals and the corporate benefits people keep referering back to United Healthcare's one surgery per person per lifetime.

I'm at a loss here trying to get them to understand that this is a very different situation, and while I understand the need for the policy due to people trying to use multiple surgeries as a “quick fix", this really an exception to the rule…I’m not trying to have a second procedure, I’m trying to correct the one surgery (procedure) that failed. Had my “one" procedure not failed me, I would still have it and still be doing incredibly exceptional. I'm also at a loss as to who I should be fighting this with....

Just wanted to get your thoughts on who I should appeal to or what help is out there? I can't afford a lawyer and with my company telling me there isn't anything else I can do, I'm not sure where to go
montana28
on 9/5/12 6:42 pm - FL
Topic: RE: BCBS FL State changed policy!!!!!
Thanks Walter. I just found out thru a mutual friend. My Dr. office heard it from a drug rep. Guess BCBS doesn't want to get flooded with requests just yet. The timing didn't make any difference, my Dr was out of town last week and I've been out of town for the last month. Dr. office submitted forms today and BCBS returns denial/acceptance w/in 72 hrs, so it's all good.
Jules
Jules
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