Road to Surgery

Hi Everyone, I was wondering how long it took from the time you first mentioned your desire to have gastric bypass to you primary care physician, to the time you got insurance approval and had your surgery. Any info would be appreciated. Thanks, Wendy

Wendy; I met with my PCP on 4/1/2005, had my first appointment with the surgeon on 4/18, submitted my paperwork to insurance on 4/25 and was approved on 4/27. I could have had my surgery anytime within 90 days of my approval, but had just started a new job, so I pushed it back to day 89. Then, in mid-June, I got a call that on 7/1 our insurance was changing and the surgeon I'd chosen was no longer going to be covered, so I started the whole process over again with a new surgeon. I first met with Dr. Marquez on 9/21. Insurance was submitted on 10/18, approved on 10/21, pre-ops on 10/27 and surgery on 11/15. It definitely depends on your doctors and insurance company as to how fast it can go. I was lucky both times. Blessings, Jennifer 253 / 178 / 137

I went to my surgeon in Sept 2005. My paperwork was submitted to the insurance in January of 2006. I received my denial the end of that month. February I filed a level one appeal.. received that denial the end of that month. Filed level 2 appeal in February, received denial beginning of March. Filed level 3 appeal. That review was done the 2nd week of April and I was approved. So all in all it took me 8 months. My surgery is scheduled for June 20th. Took from Sept to Jan to submit the approval because it took me a long time to get my records together. I moved here from another state so I had to deal with calling Drs offices, faxing authorizations, calling my surgeon to see if they got my records etc. Took a lot of time for some of the Drs to send my info. Also when I had the psych eval they took 2 1/2 weeks to send it to my Dr. Anyways... good luck!

I started researching lap band in December, went to a lap band seminar on 2/9 but found out later that month or early March that Medicare required surgery to be done at hospitals that were approved as Centers of Excellence. The hospital I was going to use was not. So I started looking for another surgeon. Went to seminar for second surgeon on 3/28 and then decided to switch to RNY and I have my first consult with the surgeon on this coming Wednesday 5/10. In the meantime I also got all my medical records together, got my referral letter and am loaded for bear...as they say. Next will come the psych consult, nutritionist consult and lab work and possible EGD...then surgery! I hope I have mine before the end of June.

Hi Wendy, I went to my first informational meeting at the end of February and then 2 more in March. I had my first appointment with my surgeon's assistant during the first week of April. I completed all of my preop testing by April 28. My papers were submitted on April 28, prior to my surgeon getting all of my preop clearance letters. All they had was the psych eval, my letter, their letter, and the nutritionist's letter. I called my insurance company on 5/3 and was told that I was approved. I have a follow up appointment on Monday 5/8 and I will probably get an appointment to meet the surgeon and a surgery date then. I spoke to the surgeon during an informational session, but haven't met with him yet. I hoping for a surgery date right after Memorial Day or by the the first week in June. I've got a busy summer planned and I want to have the surgery completed before it starts. Best wishes on your journey. EW