The Girl Who Thought She Was 5'10" - ThinnerTimes

annamay · 05-09-2007, 01:04 PM

Hi everyone,

I've been a lurker for about a week now, so I'd figured it was time to step up.

I'm a rambler and I'll understand if ya don't understand or follow along!

I am going through the whole WLS procedure through Bariatric Solutions here in Ohio. One of the 1st things they had me do was to call my insurance and see if it was covered, it's not it's excluded, my handbook even says it's exclude, period. But when the BS office calls the insurance, insurance says it's covered if medically necessary and gave the BS office a set of guidelines I have to meet. WTH?!?!? I have bugged BS several times to see if they've called for the right person, using the right policy number, correct ins. company etc. and they say yes. So, let's hope they are right.

Has anyone had a bariatric center lie about insurance, just so they could patients to sign up and pay fees and such, knowing the insurance wouldn't cover? Yes, I am a paranoid person!

I have had my physician (theirs) and surgeon consultation, my EKG and blood and urine tests, phsycologist (sp) visit. I still have to have a sleep test, nutritionist, and exercise (they say my insurance is weird to require this pre-op) and the 'tube down the throat' test (can't remember the name) and a sonagram (sp) of I think my gallbladder. I've been putting off the tube, sona, and sleep tests since I am still not sure about the insurance. But it did cover the physcian and surgeon visits! (Thank goodness, they were big $$)

I did have my nutritionist visit, but when she found out I was still undecided about which procedure I wanted, she told me that the visit was void . She had to put on paperwork what surgery we discussed and send it to insurance(no one told me that, I thought we'd just talk about eating better period), but the center was nice and gave me my co-pay back, what sweeties!

The nutrionist also told me that she 'didn't want or mean to rush' me to make up my mind about which surgery I wanted, but she was leaving the center soon and wasn't sure how soon they'd get a replacement. That had me stressing, because it seems like I change my mind everyday if not minute to minute! Well, blessing in disguise time -----my psyco doctor (as I jokingly call him to my friends) reported to the center that he thinks I am stable for the surgery, but suggests that I have a 6 mth physcian supervised diet. He's not sure I am ready to change my eating habits. So, now I have to wait 6 months before even having stuff sent to insurance, but I have 6 months to decide which surgery I want also.

Why did I choose my title? The Girl Who Thought She Was 5'10" My first visit to the bariatric center, they weighed and measured me. I am 5'8" 3/4! I said 'No, I'm 5'10"!' So he did it again. I even asked how tall he was and compared myself, luckily he knew I wasn't ANGRY, just surprised and was laughing. So, since I'm shorter than I thought I am technically fatter, bmi-wise than I thought I was.

Thanks for letting the ramble go on and on.

Anna

Andie · 05-09-2007, 01:12 PM

Well welcome to the forum. I'm sorry things are not going so well with the process but sometimes it takes so long. It took me about 4 yrs for my whole process. I hope the insurance covers it. I don't think the drs office would lie. I hope you will keep us posted of your progress!

Linette · 05-09-2007, 01:14 PM

Hello and welcome. Sounds like youi are on the right path. Doing a six month supervised diet is a great idea especially if you are undecided about which surgery you want!

Nette72 · 05-09-2007, 02:02 PM

Welcome to this great forum, there is alot of information on here that maybe able to help you along your journey.

Best of luck with everything

Mavis · 05-09-2007, 02:31 PM

Hi Anna,
Welcome to the forum! If you read through some of the threads, you will see that you are not alone in your frustration. Personally, I think the nutritionist was very unprofessional. I think almost all of us have to show a record of obesity (yeh, like we got this way in the past year). My doctor requested that I lose weight to facilitate the surgery. The fear of having an Open vs. Lap procedure motivated me to lose some weight. So anyway the six month supervised program is actually working toward your surgery. But the waiting is so hard, but it will give you the time to research the types of GBS available so you will make the correct decision for you.
Mavis

Chubbola · 05-09-2007, 05:08 PM

welcome and thanks for the 'tank' analogy! as far as nutritionists go...i could go on forever on my experience---but i'll spare you the details! i was told to practice looking up at the sky and down to the floor and up to the sky and down to the floor, etc... basically, agree with what they say and their ideas or you'll have to go to her another 100 times! lol! oh well---i guess all this waiting will be worth it! good luck on your journey!
~courtney
btw...you think your psycho doc is bad? try a fat nutritionist!!!

Gina in NY · 05-09-2007, 05:17 PM

Sound like things are running about average for you. 6 month diet is becoming the norm. My bariatric center requires 10% weight loss - so now the insurance companies around here are staring to require it too.

And no, I don't think the doctor's office would lie about this.

I've grown almost an inch since losing 108 pounds. I've heard this happens - you don't have the weight compressing your vertebrae and if you're exercising, you get stronger and improve your posture. Who'd have thought??

Mavisavis · 05-09-2007, 06:13 PM

I just wanted to say welcome to a neighbor!! What part of Ohio are you in? I can understand being paranoid and skeptical, but I too can't imagine them being that sneaky. Let's hope you are on your way!

LyndasRoom · 05-09-2007, 06:19 PM

Hi Annamay! Welcome...I wonder if bariatric surgeons' measuring sticks for height are off? I always thought I was 5'5" but my docs office put me at 5'4! The 6 month supervised diet is very common, required by most insurance companies these days to get approval. Keep reading, you'll have a clearer idea of what you want to do, they when you're thru the 6 month, you'll be even more prepared for your big day!

hummingbird5953 · 05-10-2007, 06:24 AM

Hi and welcome, annamay! Hope you find the forum as informative and helpful as I have. I have had a similar experience with my insurance company changing their covered vs. not covered story. My HR department had already told me that our insurance does cover it and the wife of an employee just recently used our insurance to have WLS. The first time I called the insurance company, however, they said it wasn't covered.

I called again the next day, got a different rep, and she said that it was covered.

Later they told my surgeon's office that it is covered, but wouldn't tell them what was required for approval. So, the surgeon's office is going to submit me to insurance after my next visit to see if they approve and, if not, what they're going to require in addition to what I've already done (3 months of supervised weight loss, sleep test, psych evaluation, a myriad of tests).
Insurance seems to be the biggest hassle with this process so hang in there, you'll be on the loser's bench before you know it!