How log of a wait till surgery? Insurance hurdles
I've been reading posts for the past several months but now have my first question.
How long of a wait did you have before you can have surgery? My insurance requires a 6 month physician supervised diet program before approving plus psyc eval etc.
If you had to also go through this, did you use your primary care Dr or weigh****chers or another dietitian?
How much weight did you lose before the surgery? Is there a requirement to lose a certain amount.
Sorry for all the questions.
on 5/30/15 8:09 pm
I did the 6-month program offered through my surgeon's clinic. Every month I checked in with a nurse practitioner and took part in a group class led by one of the psychologists, dietitians, or physical therapists (they rotated). It's actually the specific program required by my insurance, but that's because I work for (and am insured by) the health system that the clinic is part of, so they get to make their employees use their own providers. I started in October and had surgery in May. It would have been closer to 6 months, but my surgeon was on vacation for most of April.
I lost 80 lbs before surgery but had no requirement. I just had to be careful not to drop my BMI below 35 (and I came within 7 lbs of it!). All insurances are different in this regard. Some require loss, some don't, and some just want to make sure you don't gain.
on 5/31/15 6:33 pm
Yeah, I started eating high-protein, lowering (but not eliminating) carbs, logging every bite in MyFitnessPal, playing Dance Dance Revolution, and bike riding.
Mine is not typical. I decided I wanted WLS in May of 2014. Scheduled an appt. with the surgeon's office for late June 2014 (orientation & meet the surgeon), got approval in early July 2014 (3 days later)! Scheduled a date, and had surgery in Aug. 2014. I could have had surgery in mid-July but it didn't fit with my schedule. 2 months from deciding I wanted to surgery to surgery date. No pre-op diet, no psychiatrist visit, no nutritionist, ...Another reason I'm very grateful to this site. I learned much of what I needed to know here.
I have United Healthcare through a major computer company (if that helps)...
Lanie; Age: 43; Surgery Date (VSG): 8/12/14 w/complications resulting in RNY next day;
Height: 5' 6" SW: 249 Comfort Zone: 135-140 CW: 138 (10/13/17)
M1: -25 lbs M2: -12 M3: -13 M4: -7 M5: -11 M6: -10 M7: -7 M8: -7 M9: -3 M10: -8 M11: -4 M12: -4
5K PR - 24:15 (4/23/16) First 10K - 53:30 (10/18/15)
My insurance also requires six month supervised diet. I did my six months with my bariatric clinic. First weigh in was in November. Last weigh in for diet was May. Then I have an apt to see surgeon before they will submit to insurance, that apt is June 22. I suspect surgery will be July/August if insurance approves. I had to lose 5% of my weigh and show I can follow a low carb diet (south beach). Had to have a stomach scope, blood work and psych eval as well. I already had sleep apnea so didn't need the sleep study.
Seminar Sept 2014 - 221
First 6 month weigh in - November 2013 - 220
Surgery Day 8/26/15 - 199
Current Weight (9/1/16) 128.0 RNY 5' 2"