first appointment went great!! + insurance drama

chaplainJess
on 7/15/15 8:45 am

I am so excited after my meeting with the weight loss surgery center. I have struggled with my insurance company. I have called them three times to confirm that surgery is covered. Each time I get a different answer. I finally talked with a supervisor who told me that only the RNY is covered. Fast forward to todays appointment. The nurse told me they said surgery is not covered! I almost cried. We got back on the phone ... three people and 45 minutes later.... I'm covered! not just for the RNY but also for the sleeve! yippee! They don't have any requirements, no supervised diet, nothing.

I am officially in love with this nurse. not only did she spend 45 min on the phone arguing for me, but she also pulled some strings and worked her magic to get me a primary care dr. I wanted to go to the facility's medical director as my primary care dr, but he was not taking new patients. She walked across the street to his office and persuaded him to take me on.

so next up is a long list of appointments - medical director/PCP, surgeon, behavioral therapy,  and clinical dietitian. I will need to see a exercise specialist, but I can't make that appointment until I get the official referral from the PCP. I will start attending weekly classes, monthly support group, and have to weigh in/turn in food journal every two weeks. You have to have at least two weigh-ins in a row that show weight loss.

As you can probably tell, my head is spinning from information overload. I had prepared myself to be happy with the RNY, and now I am on my way to a sleeve!

Grim_Traveller
on 7/15/15 9:29 am
RNY on 08/21/12

Make SURE SURE SURE you get approval in writing from your insurance before surgery. Accept nothing other than written confirmation.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

ocean4dlm
on 7/15/15 10:56 am - Liverpool, NY
VSG on 05/27/15

Congratulations !!  It is an exciting journey !!  Sounds like a great nurse for sure !!

Age: 64; 5' 5"; High weight: 345; Start weight: 271 (01/05/15); Surgery weight: 218 (05/27/15); Pre-Op (-53); M 1 (-18); M 2 (-1.5); M 3 (-13.5 ); M 4 (-13); M 5 (- 8); M 6 (-12) M 7 (-5, Xmas); M 8 (- 9) Under surgeon's goal and REACHED HEALTHY BMI 12/07/15!! (Six months and one week.) AT GOAL month 8. Maintaining at goal range (139- 144) ~ four (4) years !!

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