Hi, I'm Nick, and a little frustrated

nick · 04-22-2005, 08:51 PM

I've just scheduled my banding for May 2 with Dr .Fielding in NYC. They scheduled me w/o approval from UHC and scheduled me in less than 2 weeks. I'm confused. I've done lots of studying up on this surgery but it seems like they've just blindly scheduled the surgery and now will keep pushing it back until I'm either approved or disapproved and decide to pay myself. In the meantime I've started liquids but am finding it difficult, as in my mind the May 2 date isn't very realistic. Has anyone else experienced something similar?

**Alexandra** · 04-22-2005, 09:04 PM

Hi Nick,

Actually, I think the fact that Dr. Fielding scheduled you so soon knowing that you have UHC and are not yet approved is very encouraging! They know best which carriers and which patients are most likely to get approvals done quickly, and UHC is indeed one of the best. Evidently your medical details are such that Dr. Fielding's office has very little doubt that your approval will be forthcoming quite soon.

For what it's worth, precert requests are usually made less than 30 days before surgery, since the approvals typically have a time limit on them. So it's standard procedure to schedule surgery within a 30-day window from the time the request for precert is submitted.

Try not to worry about it over the weekend, and if you haven't heard anything from UHC or the doctors by Tuesday afternoon give UHC a call. You might be very pleasantly surprised! :)

hagerteresa · 04-22-2005, 09:06 PM

They haven't done any of the testing? Many of us have had to have psch evaluations, see a nutricianalist, blood tests, heart tests, etc. before getting our band. I only had 2 weeks from the time I scheduled my appt till the surgery date but I was going out of country to get mine. If you plan on only getting it with approval from the insurance I would tell the office such and postpone the procedure until you do get approval... Hopefully others that had insurance cover it will pop on with some answers. I know there are others on here that have used that office too. Best wishes, Teresa

nick · 04-22-2005, 09:08 PM

Alex, thanks for the word of encouragement. I'll take your advice and just chill out till next week. You're very kind.

nick · 04-22-2005, 09:13 PM

Yes, I have done all the preliminary test, psych, nutritionist, bloodwork, physical, etc, I'm scheduled for surgery May 2 and pre-surgical testing on Apr 28. I'm just concerned that I don't have approval from UHC. I guess I'll find out before Apr 28. I just find it a little difficult to stay focused with such uncertainty. The good side is I've already lost 18 pounds on liquids and just dieting for a couple of weeks as if I'm not approved by UHC, I will try to be accepted into a low BMI study at NYU. Thanks for you reply.

princess_n_thep · 04-23-2005, 03:15 AM

I agree with Alex. I think the surgeons know in advance what insurance companies and what patients will get approved right off the bat. You might just be an excellent candidate!
And even if you get denied, you will have lost a good deal of weight on that liquid diet so you will be ahead of the game when you appeal!

nick · 04-23-2005, 02:40 PM

thanks for the encouragement. my new issue is that I had already been on a semi liquid diet {one solid meal a day } so the transition wouldn't be so shocking to me. I have in the last 3 weeks lost approx. 18lbs and I'm now a little worried that my BMI will be too low, I'm at 40 now !!! If it takes much longer to be approved I may not qualify for the surgery. should I start to eat more ?

princess_n_thep · 04-23-2005, 03:52 PM

I think your insurance approval is based on the BMI that you submitted in the first place. I wouldn't worry about it. Anyone have an idea on this one?

nick · 04-23-2005, 04:57 PM

thanks Jenna,
I think I'm just going to hold tight. worst case senerio is a little work at a gain ,I've always been good at gaining weight !!!

vinesqueen · 04-23-2005, 05:27 PM

Hah Nick, aren't we all good at gaining weight? :D

Yeah, I have to agree that the surgeon's office should know which insurance will approve fast.

Good luck and keep us in the loop!

sandie1958 · 04-23-2005, 05:57 PM

nick . i have uhc also . my dr. office said they go by the bmi they submitt for the approval as the nurse said because they encourage weight lose before the surgery. my app. is may 2 (1st 0 app. i am just at bmi of 36 losing also so i am afraid i wont amke it either. i have sleep apena. high blood pressure .4 back surgeries so hopefully that will do it for me. did you have to have a documented diet plan for the insurance? sandie

nick · 04-25-2005, 06:07 PM

thank's for the replys, Yes those darn emotions do seem to be, soooo ... emotoinal.
I'm just kicking back and letting it go the best I'm able,I do believe things will work out as they are suppose to be. Sandie I to have sleep apena [about 90 occurances a night] high triglicrites and lots & lots of back pain. No surgeries thank God . I dont have a documented diet plan for the insurance. hope they don't ask !!!

nick · 04-29-2005, 07:27 PM

Hi everybody, I checked in wed. to tell everyone, that by some grace of god I had been approved. I don't know what I did wrong because I tried to post it and it didn't get posted. Anyway my approval scenario went like this: tuesday Dr. Feildings office called and said I had been declined. At that point I was frazzled and heartbroken, A little while later they called back and said UHC put my claim up for reveiw. I didn't get excited, if anything I was prepared to be declined again. Wednesday, my doctors office called back and said I had been approved. Well I was so moved that I started to cry. I never knew what it was to cry out of sheer joy. I found out later that Dr. feilding had called UHC on my behalf. What an extraordinary man he is !!! I finished my pre-op yesterday and I'm all set for Monday morning at 8AM. My partner is a wreck but very happy for me and becoming much more supportive. I can't Thank everyone eough for their replys and support .

**Alexandra** · 04-29-2005, 09:25 PM

Congratulations, Nick!! You're on your way to bandland and a healthier you. Now on to the surgery and the next phases of your journey. Do check in once in a while and let us know how you're doing, and ALWAYS feel free to ask questions.

Best wishes for a safe banding and quick recovery!! :D :D :D

nick · 05-03-2005, 03:39 PM

I am posting this for Nick, I'm his life partner, Bob. He had the surgery on Monday and came home today,Tuesday. He's feeling some nausea and some pain. Afraid to take the pain med as it might increase the nausea. He drank one of his shakes around 1pm and has been nauseous since. I think it was a little too rich for him yet. Don't know what to do for him other than be here for him right now. He's not too happy right now but from reading lot's of stuff here, seems to be pretty normal.
You are all miracles and I wish all of you the best!
Bob