How long does the process take

Hi everyone!  I am going to a new-paitient orientation tomorrow and I was wondering how long, from the first appointment (which will be scheduled at the seminar) till you got your surgery? I am hoping that it goes quickly - but I have nothing to reference. Thanks in advance for your answers! Jen

I had my first appt the middle of September and had surgery at the end of November.  Could have been sooner but I went away for half the month of October so that delayed my other appts. Good luck with everything.  What Dr. are you using?

Hi - thanks for the reply; I appreciate your reply.  I am going to see Dr. Abkin/Dr. Bertha.  Going to the seminar tomorrow. Will keep posting as it seems this forum may be my new home away from home. Jen

Hi Kyrasmom, Basically it depends on you and your Insurance co., if you are able to get all your doctor appts. and testing done quickly, and your Insurance company approves you, it would take no time at all.  I went for my first consultation on March 31, 2007, and had my surgery approved by June 29, 2007.  I was scheduled to have my surgery 2 weeks later on July 16, 2007.  So it only took me 3 months.  So it is really up to you.  I will be praying that everything goes smoothly for you, let us know how everything turns out.

Hi Jen, It may depend on your insurance.  I have BCBS of NJ and they require a six month medically supervised diet before I can submit for approval.  I started the process in November and I'm hoping to be approved in May.  Actually, if you do have to wait, it isn't always a bad thing.  I was originally going to go with the lapband and found out my surgeon had not done as many as I thought.  I switched to another lapband surgeon with more experience.  THEN, I discovered a totally different procedure and I am pursuing that with someone else!  Without the required six month waiting period, I probably would already be banded by the first surgeon. Good luck with your journey, Leah

Hi - I have NJ PLUS Horizon BCBS.  I called and was told that as long as its medically necessary, that was pretty much it - have I been lied to?  I have been medically supervised since January.  I also have joined Weigh****chers in January as well as prior to that South Beach (online).  I have been walking every day yet the scale does not budge.

Thanks Leah!

Jen

Hi Jen, I can't say for certain, but I think they are being sneaky.  When I tried to get the exact requirements from an insurance rep, they told me that as long as it was considered medically necessary by my doc it would be covered.  When asked to verify this writing, they continued..."We ASSUME that your dr. would want you to follow a six month medically supervised diet before he would resort to surgery and we ASSUME that he would want proof that you have been obese for 5 years".  Etc, etc. So, I am going to submit before I finish the 6 month diet, but I'm pretty sure they need the following: A letter from your PCP supporting WLS. A note from your PCP listing 5 consecutive years of weights that prove you have been obese. A psychiatric evaluation. A nutritionist visit. Attendance at monthly support groups for  WLS education and behavior modification. A letter from you outlining the history of diets that you have tried, how much weight you lost each time and how long it took to regain it. A six month medically supervised diet and exercise program--your doc should write in his notes your weight, blood pressure, what type of diet you are following, any changes he recommends to your eating plan each month and what type of exercise you are doing. Letters from any other doctors you might see supporting WLS. Your surgeon should be able to tell you exactly what your insurance requires based on prior claims they have submitted for all of their patients.  I got the above list from my first surgeon. Let me know if you hear anything different, OK? Leah

My surgery was done by Dr. Bertha, and i have to tell you that they are really good with scheduling and blood work and they are straight forward with any complication with you or the insurance.

The office will take care of everything for you, but it is your insurance that has the last word. I also recommend Dr. Bertha/Dr. Abkin with my life. They are great.

Good Luck, Hope to see you soon on the LOSERS BENCH!!!

Miriam

Hi Jen

Good Luck!  Abkin / Bertha's office (I see Dr. Garrision from the same office) does great work with the insurance companies but alot depends on your insurance.  Some have rules about doctor supervised diets and I think thats where most people seem to get delayed. 

If you follow what your insurance company wants "TO THE LETTER", you should not have any problem getting approved.

Best of Luck to you!

Vicki

Thanks!  When I spoke to my ins.co, that is what they told me - I spoke to a few people and took down their names.  I asked specifically about the diet and they said that as long as it was necessary and I met the criteria, it would be covered.  I am hoping that is it - if not, I am 2 months into the diet thing.   Again, thanks so much for the words of wisdom - can't wait to go to the seminar tonight! Thanks, Jen