Just Had My Consult! Excited and Anxious

Yesterday, I met with my operating Doctor to discuss my eligibility for surgery. He said I am an excellent candidate and that he agrees that VSG is the way to go. I got a little nervous because he is an out-of-network doctor for me, but he promised me (verbally) that I will see no associated costs from this surgery. He also offered to pay/waive my $200 out-of-network deductible. I am still scared that I will see some unanticipated expense despite his verbal reassurance.

One awesome thing about my appointment was that he said that due to my lifetime dieting (I basically have never NOT been on a diet since I was 15) they were going to fudge to my insurance about the requirement to do a 3-4 month diet. Also, since he works for a Bariatric Group, I now have an appointment to do my next steps: endoscopy, nutritionist, psychologist, and pulmonary specialist...all in one day to save time!

This Doctor came recommended to me via my endocrinologist, and I see he has a lot of very positive ratings/reviews online, but of course I am still anxious since I have never had any type of surgery, really. At one point, I asked him "Does the risk of me NOT getting this surgery outweigh the risk if I DON'T" and he basically told me it does, about four times.

So I guess I am on my way! Any reassurances are always welcome. Anyone had a similar experience regarding insurance and not needing a diet?

welcome to the journey  

I would try to get the money stuff in writing

 and the 3-6 month supervised diet seems to hep people get ready for the surgery and do better with there weight lose post surgery also going to a support group seems as it improves your chance of loosing 100 of your extra weight greatly

Thank you! I definitely will get whatever I can in writing when it comes to the surgery. I will also definitely be going to a support group, which they sponsor.

As far as diet goes, I have no doubts I'll be able to excel post-surgery. I already have a love of healthy, clean foods, and a nutrition background. My biggest problem is the amount of food I shovel into my mouth! LOL. 

MY insurance EXCLUDES bariatric surgery! BOO!!!! So, You are much closer than I am! Good luck..

I agree that you need to get things in writing. Not just the $200, but the "fudging" on the supervised diet. Is your surgeon going to forge chart notes to show that you've had appointments to discuss the progress of a pre-op diet? Or write a letter that says ****ruthfully) that you've done 4 months of a particular diet in the past year under his supervision? (Specific evidence does vary between insurance companies and plans.)

I'm all in favor of working with your doctor. But one who's willing to (potentially) lie to insurance, should it come to that, has me worried from an ethics POV. Plus what happens if insurance denies your claim based on that, and your surgery has to be cancelled or postponed?

It sounded like he is going to write a letter that I have done at least 4 month's worth of dieting under his supervision. While generally this sort of thing would have me worried, he is ranked as one of the top surgeons in the state and I believe he has my well-being in mind, knowing that I am currently (and have been) on a diet sanctioned by my endocrinologist that involves the usage of various diabetes drugs to combat appetite (I do not have diabetes). We also had a very long discussion about my dieting history. I really think he made an exception in my case because when I was there, there were several people who had an appointment before me, who were just there for a second or third pre-op weigh in.

I will absolutely get anything involving my anticipated financial contribution in writing.