How do I get started? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

deadboy · 12-01-2005, 08:25 AM

Hello all. My name is Ron and I've been reading this site for a couple weeks, since an internet friend pointed me to it. I'm about 150# overweight and I've been considering GBS for a while. I understand that there is a process you have to go thru involving trying documented excercise/diet plans, there is a psych eval and so forth. But my question is how do I get started? I don't really have a "regular" doctor. I only generally bother to visit a doctor when I'm sick. Is there a referal system or how does this work? Are there other things I should know before I start? It took me several days to work up to the point where I could post, so if I said something stupid or asked a dumb question please be kind

Thanks

Ron Fitzpatrick

justawoman · 12-01-2005, 09:25 AM

Hi Ron,

Welcome to the site! You will find great friends and lots of information and support on this site.

For me it was quite easy, I believe it depends on your insurance company and your surgeon. I went to see my OB GYN doctor and talked to her about my weight and she recommended I check out GBS and I did some research for about a year, then my father passed away from being MO and that is when I decided it was time to make a decision. I contacted a GB surgeon had a consult with him, filled out tons of paper work, never had to have a referral. Sat with him for a few hours as he explained the surgery and such and then they documented all my attempts of diet, excercise and such and submitted it to my insurance. I have one of the easiest insurance companies to work with. They submitted my paper work on Aug. 28th and Sept. 2 I was approved for surgery and November I was in Surgery. I know alot of others here on the site didn't have such an easy time. I really believe it depends on the insurance company and your surgeon. For me it happen quick and without any glitches! Good Luck and I am sure others will respond rather quickly.

coptergirl · 12-01-2005, 09:26 AM

Depends on your insurance sometimes. I went to my primary care doc and talked with him about my desires. I had prepared a spreadsheet that reflects what I tried to loose weight, when i tried it, how miuch I lost, how much I regained, and made any notes. he appreciated that I was so prepared, and agreed with my desires, and submitted his recommendation through to insurance who then approved my consult with the NP at my surgeons office. As of 2 days ago, my advocate at my surgeons office faxed my insurance aproval requests over to Blue Cross, and I am waiting. The NP (nurse practionaer) prescribes what tests to have run depending on her very extensive physical, and as of 12/9, i will only have 2 more tests to go.

Also, it helps to do some research as there are different surgeries out there. The internet, and any bookstore would be a good start. You can also contact your local hospital to see if there is a bariatric support group that meets, and yu could go to those meetings and meet people and ask questions...

I am glad you found us...welcome to the family..we are here to help and encourage you along your way. If there is anything else that you might need help with, please don't hesitate to ask.

deadboy · 12-01-2005, 09:43 AM

Thanks for all your input so far. I think the more I know about the process, before I get into it, the better my chances of getting thru this with head in tact. My insurance is thru United Healthcare and I live in the Kansas City Missouri area. Does anyone have any experience with them or doctors in my area?

justawoman · 12-01-2005, 09:55 AM

Quote:

Originally Posted by deadboy

Thanks for all your input so far. I think the more I know about the process, before I get into it, the better my chances of getting thru this with head in tact. My insurance is thru United Healthcare and I live in the Kansas City Missouri area. Does anyone have any experience with them or doctors in my area?

Hi Ron,

I have united healthcare and they approved me so quickly. They are one of the easiest insurance companies to work with on GBS. They are all for GBS if you are over 100lbs over weight. I did not have to have a referral with them or anything. I went through Barix Clinic in Illinois and they submitted my paper work and they approved within days. I believe you should have a fairly easy time working with them. I am in Wisconsin so not familiar with any of the doctors in your area. I had great success with the Barix Clinic and the insurance company. Any questions feel free to ask.

Kristen · 12-01-2005, 10:13 AM

Hi Ron,

I also had United Healthcare and they were amazing to work with, we actually had an answer in two weeks regarding my approval. I think it took longer for me to get my referral appointments than it did for the actual approval. As was mentioned before, I would recommend taking a detailed list of what you have attempted in the past, doesn't matter what it was, zone, weight watchers, grapefruit diet etc. It all helps when documenting what you have attempted.

Best of luck to you,

Kristen

deadboy · 12-01-2005, 10:14 AM

That makes me soo happy to hear. I have talked to people, and have seen stories here on this forum, that relate nightmarish insurance stories. To know that I don't need to expect a fight from them is great. Now I just need to find a doctor and see what they have to say. Thanks again!

brookscn · 12-01-2005, 02:30 PM

Ron:
Be sure to thoroughly read your company's Medical Plan for your insurance carrier. Larger companies (like mine) determine their own medical plans - what they'll cover, what they won't. I read through mine again yesterday, and it said that it wouldn't cover weight loss programs, except surgery for the MO.

Our medical plan looks like the white pages for a small city. I got through about 15 pages and my eyeballs were rolling backwards in the sockets. There should be an "exclusions" section - read that carefully. Then you'll know for sure if it's covered or not.

Also - see if your insurance company has a website - I'm with Blue Cross, and they have established bariatric "centers of excellence" - I had to choose a doctor from those particular centers. That may be a good start. You can also Google "Bariatric Kansas City" and see what comes up.

Good luck!

nati · 03-03-2009, 06:58 PM

I have UHC.. they denied my request for GBS because it was excluded from my plan.. does anybody think that an appeal might get me somewhere?.. please let me know or send me a email to drbabylinda@hotmail.com...PLEASE HELP!