entering the unknown - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

mpherrera2000 · 08-25-2004, 12:45 PM

Hi everyone, I am truly treading in unknown water here, but i have been suffering with weight for over ten years and it is truly getting painful. My pcp sent me a referral to go to one of dr. callery's sessions and i am very excited. It is scheduled for Sept. 14 at 5:30. I would really like to know what the next step is after that and approximately how long before i acutally can have the surgery. Any of your comments and support are welcome.

tracyarps · 08-25-2004, 01:15 PM

All of us, depending on our insurance have different stories. Mine took two years and changing insurance from Medi-Cal to Health Net, HMO through my employer. It took me 6 months from beginning to end after my insurance change. If you have any more questions, please feel free to e-mail me.

Tracy

bridgetgirl · 08-25-2004, 01:29 PM

Go to the inforamtion seminar, and figure out if this is what you want to do, that its right for you. You will get a packet at the end, and some advice of what type of exams they will need, for instance you will need a well woman exam with OBGYN if you havent hadnt one recently, you may want to schedule that now, depending on yur insurance type it can take awhile to get an appointment, and at least you've got the ball rolling.
Fill out the packet and return to Dr Callery's office. You wil be contacted for an appointment. There they will let you know what additional tests and exams you will need. You will need a psych eval, again this is something you may want to work on getting scheduled depending on insurance. Just make sure it is scheduled AFTER you initial appointment with Dr Callery/Kelly. Then you get all the testing, labs and proof together and send it to the office. They will then dictate a letter to the insurance company for medical necessity based on those records and your packet and the information they collect from you at your initial eval... then with a few weeks you will hear back to see if you are gonna get a surgery date or if you were denied. The entire process from seminar to surgery date was 5 months... it happened really fast for me. I have a PPO insurance so I didnt have the HMO struggle with getting appointments scheduled. Keep us posted, in the event you are denied there are options available its not the end of the world... from what I can see it appears that the denials are few... it just stinks when it happens to our buddies here!!!! but we can help and get you through any trials or tribulations you are facing... before you know it you will be on the other side right along with us! Best wishes!

Lynne J · 08-25-2004, 02:18 PM

Like Bridget said, it varies by person. My initial meeting was April 27th, my surgery is August 30th, so basically 4 months. I was one of the lucky ones, I wasn't denied first time around. Good Luck. Hope to see you at one of the meetings!!

watergirl · 08-25-2004, 02:33 PM

What Bridget said. It took 4 months for me. I have Aetna HMO.

mpherrera2000 · 08-25-2004, 06:46 PM

I would like to thank all of you for your input and encouragment. I just love how everyone is so responsive i really think i am going to be able to get through this. As far as insurance i have Healthnet HMO and i called to see if i was even covered for such a surgery and they said that i was so i hope this will help speed up my process.

Christina · 08-26-2004, 09:12 AM

Good Luck to you on your journey. You are going to do great.. you are in the very talented and capable hands of Dr. Callery and/or Dr. Potts.

Wishing you the best..

angelav · 08-27-2004, 08:37 PM

I was very fortunate with my surgery. My seminar was May 11th and my surgery was July 9th. The reason for the SPEEDY process is because I was proactive. Like Bridget said, you need a well woman appt. Make sure you make an appointment for sometime after your seminar. At that appointment you can get most of your labs done. Also call your insurance and see if they will give you a referral to see a psychologist, you'll need a psych eval. If you have any questions please feel free to ask, everyone is here to help

Good Luck!!!

Woody · 08-27-2004, 10:00 PM

Like Angela, my process was fairly quick. I went to the seminar in Feb. 02 and had my surgery in April of 02. Also like Angela, I was very proactive. I was in contact with my insurance company (BC/BS PPO) all through the process. I even hand delivered test results to the office rather than trust someone else to fax them. My PCP was very supportive and helped me get my tests done quickly. My wife also had the surgery in May 02, one month after mine. The only reason for her delay was so that I could recouperate enough to take care of her, which was actually 2 weeks shorter than they anticipated.

But, all that being said, everyone goes through the process differently and at different speeds. Don't be shy. Make sure you are proactive, even "pushy" if necessary. This is your life we're talking about. Don't stand back and leave it in the hands of other people.

Welcome to the group and get ready for the ride of your life. It's been quite a rollar coaster ride for us even to this day. We have no regrets except for having to move out of San Diego and missing all the personal interactions.

Post often, ask questions and keep us all informed of your progress. We care.

bridgetgirl · 08-28-2004, 08:19 PM

This info comes right out of the holy blue binder, I will share it with you.

Most frequently asked question: How long will it take before I have surgery?

Work up time is about 3-6 months. Sometimes things go faster if you have already done much of the work up. Patients with PPO insurance have fewer steps and the process goes a little faster. Here is a rough idea of the time line.

Step 1. Education Session, mail in forms (2-3 months)
Step 2. Individual Consultation (4-6 weeks)
Step 3 Get all lab studies and consults (2-4 weeks)
Step 4. All lab reports mailed to Dr Callery's office (2-4 weeks)
Step 5. Labs placed in chart, checked and ready for dictation (1 week)
Step 6. Chart dictation (2-4 weeks)
Step 7. Chart transcription. (1 week)
Step 8. Authorization preperation and mailing (1-2 weeks)
Step 9. Authorization review by insurance (1-6 weeks)
Step 10. Mailing authorization to Dr. Callery's office (1-2 weeks)
Step 11. Laurie calls you to schedule a pre op consulatation with Dr Callery or Dr. Potts and to schedule surgery (less than 1 week)
Step 12: Preop visit with spouse or buddy (2-4 weeks)
End result: SURGERY

This is just a general guideline, although it seems to me that step 6 seems a little long, usually the chart waits for dictation about a week, and step 9 authorization review usually doesnt take that long but although it can, the insurance company has 30 days to review and accept or deny the request.
Hope this guide line helps. Whats the holy blue binder you ask? Every wannabe "loser" who has been to the seminar and turned in their paperwork and has their initial consultation with Kelly gets one. It's packed full of information regarding the surgery.