Please Help! Question for Healthnet Users
I'm pre-op trying to get RNY. I've gotten my gallbladder ultrasound, got my psych eval, seen the nutritionist, and been approved to get a consultation with a surgeon. I'm getting kinda worried about my insurance and wanted a little reassurance from the people that have gotten it approved. For all you Healthnet people, how hard was it for you to get approved? As far as previous weightloss attempts, what did you have to have to get approved? Are they really strict about having a documented and nutritionist supervised weight loss before surgery? Any help would be most appreciated. Thank you!
Diane
Thank you both!
Diane, I definitely know what you mean. It's like none of these people communicate with each other and I'm having to go above and beyond to get simple information out of them. I always call and ask questions if I have them but the guy I talked to just said that you had to have attempted weight loss in the past 2 years. I talked to one of my doctors and they made it sound like you need full supervised attempt or documented 6 months of weight loss attempts. So I don't really know what the case is. Maybe I'll call again and ask again. Thank you for the advice. I hope your surgery goes well!
SUMMARY CONCLUSION
There is no literature presented by any authority that mandated weight loss, once a patient has been identified as a candidate for bariatric surgery, is indicated. There is a mixture of results that question whether weight or truncal obesity is a risk factor for complications after bariatric surgery. The more analytic studies have not found that body mass index (BMI) or total weight is an independent risk factor for complications or death from bariatric surgery.
No institution that has recently published data on bariatric surgery describes a protocol requiring weight loss between identification of the need for surgery and the surgery. Many institutions in California have published results of surgery with particular focus on factors that contribute to morbidity and mortality. No paper from a California institution mentions mandated weight loss before bariatric surgery. Nor does any literature regarding the treatment for the morbidly obese recommend continued weight loss during the period between identification of the need forbariatric surgery and the surgery.
Mandated weight loss prior to indicated bariatric surgery is without evidence-based support. Mandated weight loss prior to indicated bariatric surgery leaves the patient at increased risk from the patient’s comorbidities. Mandated weight loss prior to indicated bariatric surgery is not medically necessary. Mandated weight loss prior to indicated bariatric surgery would be deviant from the standard of care practiced in the United States and other published countries. The risks of delaying bariatric surgery, while not entirely known in the short-term, are real and can be measured. Any potential value of losing weight prior to bariatric surgery is theoretical and not supported by any data. An experimental study including fully informed consent to determine if there were a reduction in risks or other benefit from mandated weight loss prior to bariatric surgery is indicated.
http://www.dmhc.ca.gov/aboutTheDMHC/org/boards/cap/Bariatric REV.pdf
Only you can be your best advocate. Fight for what you want. Never give up.
Please make sure you research all your weight loss options. Check out DSfacts.com and Duodenalswitch.com.
May 20, 2009 the day I started my new life. Thank you to my friend and angel, Larra.
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