Cynthia

So after a week of phone calls to my medical insurance (Health Net HMO) I finally got ahold of a supervisor at my medical group (Vantage) and she gave me all the info that I needed. I do need a medical weightloss diet program supervised by my PCP for 6 months. The good thing is that they count Weight Watchers. She said all I need to do is join WW and keep all the info I receive from them (the weekly weigh in sheet) and then see my PCP or bariatric surgeon once a month and have her take notes of my progress and then in 6 months I can submit the ppwk for approval. My PCP just submited the ppwk last week for the bariatric surgeon referral so I can get that done and also start meeting with him/her too. I am so excited and feel that it all is starting to fall into place. The other really exciting thing is I turn 30 in May and this surgery will be the best birthday present ever. Watch out 30 here I come......

Vetty

You are so on your way! Good luck! I still have to do the 3mth nutritional supervision

__________________
VETTY


I am sick of being the president of the Pretty face club!!

10/2/2009 Called to ask insurance what’s the "new" process
10/8/2009 Case Manager was assigned
10/13/2009 Medical director agreed to accept my medical evaluation from the first time I tried for bariatric surgery
10/14/2009 Case Manager and orthopedic doc. Proved I had a co-morbid condition
10/23/2009 Quit Smoking
11/14/2009 WLS Seminar

soon2bthin

Thats awesoem that the process has started for you. Congrats!

__________________
Cassie




252/150/137

RNY July 30, 2007

Cynthia

Thank You both. I am so excited and nervous too of course. I have gone to 2 seminars too so I am trying to get all the information I can during this 6 month time. Vetty have you started the 3 months yet?? I wish my insurance only had me do 3 months but 6 months will fly by since there are alot of holidays in between. (That's what I keep telling myself) lol

kantonucci

I didn't have to do the 6 month diet since I've been with my PCP for about 15 years and he's keep a great log of my weight struggles.

Good luck and I'm sure you will be counting down those 6 months.

Cynthia

Wow that is great. Did you get approved easily for the surgery?

kantonucci

I had my first consultation with my surgeon in July, did a sleep study, psych evaluation and had blood work done, 2 support group meetings and that's it. My doc submitted everything yesteday and said he is 99.9% sure it will be approved based on what he's seen with my insurance plan and has even discussed having the surgery done the first week of December. Apparently, I am a perfect patient for the surgery.

I am a diabetic and have mild apnea. On top of that, I have tried every weight loss program. I was even seeing a nutritionist earlier in the year and had no success.

Cynthia

Are you nervous?? I think once they submit everything I won't be able to sleep until I know I am approved. The first of December is going to come so fast and from what I have read your diabetes should go away after the surgery. What type of WLS are you getting. My family wants me to get the Lap Band but I am leaning more towards the gastric bypass sleeve.

kantonucci

I'm not nervous about being approved. I spoke with 3 women at the support group that have the same insurance plan I have and they were all approved, no problem.

I am however nervous about the surgery. All of my research was on the lap band and then my surgeon hit me with wanting to do the bypass the last time I saw him, so that looks like what I will be having. I've been asking a lot of questions on this site for the past week and have received a lot of helpful information. I'm really worried about having the surgery, but even more worried about what will happen to my body if I don't have the surgery. I am at my highest weight right now because of thyroid problems and I just hate getting dressed and looking at my self.

I think the biggest thing I am looking forward to is not having to take insulin shots twice a day once I get the weight down and my blood sugars under control.

I really hope everything goes well for you. If you need have any questions regarding your insurance plans, let me know. I am a Project Manager for a Benefits Administration company. I work with medical insurance carriers every day.

Cynthia

Thanks and keep me posted on your progress. I just sent you a friend request on here too