I am new and FRUSTRATED!

julie.r0cks
on 5/7/09 6:33 am - woodbury, TN
I don't know what to do. How do I get this surgery?
I have talked to my dr. about it for months, I put it off because of a nasty divorce. Now I am ready but can't seem to get a straight answer.

I thought I had to go to a seminar and then take it from there, but apparantely no, I am suppose to have 6 months of dr. supervising me on trying to lose weight on my own, and a letter from my pcp.

I don't see the dr. first?

I am really frustrated and feel like I'm being shuffled to the side and I NEED this surgery. I can't even weigh at the dr's anymore because it only goes to 450.


Ronda S.
on 5/7/09 6:45 am - Cookeville, TN
Depending on what kind of insurance you have, some
do require 6 mths of diet with dr. Have you called any
of the clinics to ask, if so you need to get all your
documentation done first. I know thats probably not
what you wanted to hear.. but some ins. require that.
I would definetly start having it  your weight recorded
somewhere.  Good Luck

Ronda S. 


HW262//CW 122
  140lbs lost !
5"6 Tall

 


  

    
(deactivated member)
on 5/7/09 7:03 am
Hi Julie.I had to  go through the same.But all insurances are different.My surgeon sent me out some paperwork to take to my PCP doctor every month for 6 months to be filled out.Then I had to have a letter from my PCP recommending me to have surgery.Also I had to go to my pschiartrist and have an evaluation done along with a approved letter from him. Nuttrional classes that I had to take and plus a consultaion with my dietician,Not to mention numerous test.But again this is my situation and everyone is different.believe it or not some insurance companies require a 1 or two year weightloss history versus the 6 month history.Try to hang it there.The six months will fly by before you know it.
Pam Davis
on 5/7/09 7:20 am - Franklin, TN

Julie, as Ronda mentioned a lot of the process depends on your insurance - we have many of the major insurance company's criteria listed on our website. This is a link to our pathway to surgery at Centennial http://cmcwls.com/default/pathway-to-surgery.
Thank you,

Pam Davis, Certified Bariatric Nurse, Bariatric Program Director
Centennial Center for the Treatment of Obesity
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Three4Me
on 5/7/09 7:32 am

Julie, it is so easy to get frustrated, but please don't give up.  You have already made a great decision &, like my mom use to say..."every truly great accomplishment is at first impossible".

Right now it seems like six months (if that is the waiting period) is a long time, but, really it's not.  In fact, I was denied by my insurance the first time I submitted because I didn't have the six months.  I was irked, but that six months was absolutely necessary in my success.  You will need that to learn e'thing that is necessary to make this surgery work for you.

I am a huge fan of Centennial (Dr. Houston was my surgeon).  I am seven weeks out from surgery & had to jump through a lot of hoops w/insurance, but I made it.  You will to.  Keep your eye on the prize--you have to.

I believe Pam Davis (from Centennial) posted on this thread--it sounds like you have already done the seminar?  Find out what your insurance requirements are for bariatric surgery (Centennial has a great resource on their site for this)....if you have been meeting w/your pcp for months discussing this you might be able to use some of that as your prerequisites, depending on what you discussed w/him or her & how it is notated in the medical record.  If not, you will want to set an appt w/your PCP ASAP and there is a great Medical Weight Loss Documentation Form that I got through Centennial (I can email you a copy or they may have it on a forms directory on the Centennial site) that is excellent for you to bring to your pcp at each months visit.  Your insurance may also require you to have a pcp supervised exercise program, also, as well as the nutrition component.  It's not difficult, but I promise you that the insurance companies are banking on you giving up to save them money!  Don't let them win--this is your life, your health & your future.

Hang in there.....xo, Micheala.

 

  

Preop Weight 293/SW 289/CW 202.3/GW 165/LW158

Amy_Baggett
on 5/7/09 9:43 am, edited 5/7/09 9:47 am - Monterey, TN
As others have said, every insurance is different.  I called my insurance when my primary care started talking to me about weight loss surgery, it was there that I found out what I would need.   And even though I had my list at the last minute the insurance added a new requirement, but I was determined!

With me, I had to have the six months of supervised diet and while that sounds like a long time, in the grand scheme of things it is just another hoop to jump through.  I went through Vandy and they would have done my six months of supervised visits but I live a couple of hours away so I went to my primary care physician.    You PCP should be able to find a scale, perhaps at a local hospital to help you with that requirement. 

Don't give up, it is all possible with patience and determination!!  
Good Luck!!!


                               Adopted by Centennial 1/27/2010    
"Everyday do something that will inch you closer to a better tomorrow."
(deactivated member)
on 5/7/09 8:22 pm - Nashville, TN
Although it seems like a long time, 6 months will fly by. And while you are keeping all of your weight loss logs, you can meet all of the other criteria that the insurance wants and knock out two birds with one stone.

It may actually be a blessing that insurance doesn't immediately approve you for this surgery. First off, by jumping through these hoops, it will make you stronger post-op. You can look back, remember how determined you were and what you had to go through, and ideally that determination will be what you need to be successful in this new journey of becoming a "smaller you".

Second, during these 6 months you will have the opportunity to truly reflect on whether you are ready for such a big change in your life. No one flips a switch and you suddenly become thin- you have to be disciplined, determined, and work at it.

In my opinion, it's well worth the effort and I would do it again in a heartbeat.

Good luck to you as you begin your new life.


Denise M.
on 5/8/09 5:43 am
 And they call surgery the "easy way out!"

Hang in there and talk with your doctor and insurance plan.  Bariatric surgery takes lots of work, whether it's grapping with insurance or following the post op eating and exercising rules.  But so far, it has been worth it.

You have to be proactive and fight for what you deserve.  

Good luck,
Denise
   
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