Does anyone know when the new requirements for bariatric surgery go into effect for WV medicaid? My surgeon said that medicaid is not approving any new bariatric surgeries until it does, and they seem to have no idea when it will be. My pre-op testing is only good for six months, and I only have three months of that time left. I'm getting concerned that they won't approve my surgery in time.
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Hello! I'm in Morgantown, and a patient of Dr. Akkary. I'm hoping to have surgery in February. I actually started the process three years ago, but due to lack of transportation (Dr. Akkary's clinic was then located in Preston Co, at Preston Memorial Hospital), I didn't get to have the surgery. I did a year-long supervised weight loss with my PCP, but when I went back to see Dr. Akkary at his new clinic in Morgantown, I was told my weight loss had expired. So I had to start again. I have my final evaluation (pulmonary) at the beginning of January, and my final weigh in the middle of next month. I quite like the idea of surgery in February. It feels like a Valentine's gift of love to myself.
Is there anyone here attending Dr. Akkary's support group meetings? I live in Cheat Lake, and would love to have a ride there and back.
I am also wondering about the one year waiting period. I will be starting a new job in August and would love to have it while I am off work. Otherwise I don't know when I'll be able to have it. Is there a way to get it approved faster? I have diabetes, hypertension, and sleep apnea. Thanks
on 3/30/14 9:52 am
Like Brenda, I am sorry I am just now seeing this post. I haven't been online for quite some time. I hope this issue has resolved for you and you have been able to have surgery. It is so frustrating to have weight loss surgery because insurances see things differently-- because this surgery is "elective", they hold up so many obstacles for patients to get approved that they hope you get discouraged and decide not to have it. Medicare made a decision back in the early 2000's (I think around 2003 or 2004) that anyone with Medicare who wants weight loss surgery MUST have it done at a facility that is certified as a Center of Excellence, which means their program does great work and has great outcomes. If you type in Bariatric Surgery Center of Excellence, it should give you a link to who all is certified in your area. Again, I hope you have gotten to go ahead and have the procedure, but if not, don't give up. Where there is a will, there is a way.
CAMC is a center of bariactric excellence too. I decided against Dr. Nease while he is a good doc. Huntington is an hr away from me here in Charleston and with my cardiac history I didnt want to chance it if something did go wrong some strange cardiac dr taking care of me. Camc is also where i had my open heart surgery and my heart caths done so they have record of my cardiac history and all my cardiologist would have to do i go across the river. Which is alot easier than an hr away. Which surgery are you having?
Im in process of having my surgery done at CAMC Weight Loss Center. Ive had several friends of mine that have it done there as well and they are great folks. I was in process last yr but due to my job loss at CAMC due to my heart condition i had to start all over under my spouses insurance which is Anthem BC/BS but through UFCW local 400 which is through the union at kroger. I am a canidate. I had my 3 month appointment yesterday and i was originally was going for the gastric bypass, but even though my cardiologist recommended lap band. Dr Shin who is my surgeon and i discussed and Im going with the gastric sleeve due to my medication requirements like heart meds and seizure meds. im diabetic as well and on insulin. My 6th month visit will be in Jan so im hoping for surgery sometime in jan or feb 2014
Just checking in with you to see if you had your surgery yet? How ya doing?
I had my last visit with my PCP this morning. 6 months of diet and exercise done and being submitted to my surgeon. I went to see him a few weeks ago and he scheduled me for surgery. He was very happy with my progress and decided to schedule me without approval. So he must feel pretty confident about me being approved. Ive had people on here tell me there is no pre-approval for medicare as far as the 6 month diet and exercise but I believe here in WV there is. Im scheduled for the 21st of Oct. I really dont think I will have any problems getting approved. Im down 73 lbs since the 1st week in April. Dr. Nease wanted me to get my BMI down between 55-60. I started at 70. Im currently at 59. So by the time surgery comes around, Im hoping to be even lower.
on 9/9/13 3:40 pm
Im on disability medicaid and going to be medicare before 2 long. They approved you for WLS with medicare? thank you
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Dr Nease came very highly recommended. After meeting him and going thru the seminar, he seems very trustworthy. You can check him out on cabell huntingtons website. And cabell is a COE (center of excellence) facility. I have 2 more months of the 6 month diet and exercise so I can have surgery. Im sure you will love Dr Nease. Good Luck and keep us posted.
by the way, I am 4 hrs away from him. Might wanna check with your ins. co just to make sure they cover WLS and what the requirements are. Maybe you can get started on your pre-op stuff.
Im from Charleston and was originally going to Dr Shin until I lost my insurance through CAMC so I could only go to Dr Shin due to CAMC insurance requirements. However during my 1 yr checkup with my cardiologist he recommended Dr Nease so they are calling me in a referral to him. My mom has a friend that Dr Nease did weight loss surgery on her and her husband and they got amazing results. Even though it is an hr from me Im hoping my husbands insurance through Kroger will cover Cabell Huntington.
hi, I knew of this forum for awhile now. I was seeing Dr Shin at the CAMC WLS for awhile till i lost my insurance through CAMC due to disability. I have had several friends that have had surgery at the CAMC WLS and have had great results. However my cardiologist referred me to Dr Nease at Cabell Huntington in Huntington which is an hr away rather than CAMC. Im hoping someone can shed some light on Dr Nease as a surgeon and how the staff is at cabell
Hello all! I am also from WV but looks like most of you are north, south or west of me!! I live about 50 miles from D.C. and am within minutes of VA & MD state lines. I actually had my WLS in Winchester, VA. I am almost 2 years post op from the RNYGB. I am definitely on the maintenance phase of the program. Wishing the best to all of you who are just starting out on your journey or have only just begun.
If you havent already contacted his office, do so. The nurse was kind enough to send me the 6 forms that must be filled out my my PCP every month when I go weigh in. I live quite a distance away from Huntington so this was a big help for me. I am required to have:
2. stress test
3. Nutrition class
4. chest xray
5. psych. eval.
6. lab work
Some insurances require you lose 10% of your body weight. Unless your way over obese like me. Like I said before, doc Nease wants me to be down to 350. Might want to check with your insurance co. to see what they require. The nurses at Dr. Neases office are very knowledgeable when it comes to insurance and they might tell you what you need to do. Probably similar to what Im doing. Once they get the 1st of those 6 sheets, they will schedule you with Dr. Nease. If you need any help or have questions please ask. Im usually on the Roux-n-Y forum. Lots of great people on there. Im also on MyFitnessPal.com. I keep track of all my food intake on there. Lots of people do. Keep in touch.