OMG- Could it be this simple

Hello All-
After obsessing for weeks about my appointments that I had today (nutritionist and my surgeon) - it was wonderful. I expected to be judged and told that I was a lazy slob, but everyone was so very nice and non-judgemental- it was great. The nutritionist wasn't a 90 pound 25 year old (couldn't face another one of those!), the PA was very personable and listened to my history with understanding and the surgeon was amazing- very straight forward and accepting.
I have Harvard Pilgrim Insurance and was seen today at the Faulkner Hospital in Boston (may have surgery at Brigham and Women's) and it was just assumed that all would go well. After reading so many horror stories about insurance and jumping through hoops to get approved- everyone was saying that this WILL happen - they even starting discussing dates! I still have to complete the psych evaluation, an upper GI test and some bloodwork, but nothing of great concern. I had to pay $500 for the program that I was not entirely prepared for, but, if I can get this through insurance - it is well worth it!
Did anyone else have an easy first experience like this and feel like they were in another world? I have been very nervous and excited for weeks, not really able to think about anything else. The timing is great- about 6 weeks to lose a pound a week (or so- not great demands- just don't gain any weight) - which I think will give me the time to start the good habits that I will need - eating slowly, chewing completely, no drinks with meals, etc.

I cannot believe it can be this easy - I am afraid to be happy or excited for fear that a show will drop!!

I may get a surgery date for the end of April - or even early May- near my 39th birthday would be perfect!!!

Anyone else have this experience? If this goes as they tell me it will - Harvard Pilgrim and Dr T rock!!

Wishing myself and everyone an easy time with the journey!!

Welcome and congratulations on deciding to have the surgery. To make sure you do everyhthing the insurance carrier wants, call and ask them for a written list of their requirements. May you have continued smooth sailing....

Thank you for the support - I plan on following every rule to the letter (as much as my feeble will power can manage) - I want this soooo badly!

Anyone else shocked by the apparent simplicity of the process? I feel terrible for those who went through (and are going through) so much to get this. Maybe I am fooling myself!

I started the process last August, first I went to a seminar, then called my insurance co. to see if they covered the lap band & what their requirements are. They told me I needed 2 dr opinions & full medical records. I made the appt w/ the surgeon, saw him, the dietician, & had my psyche eval. The bariatric center submitted the pre-auth request & med records & then I waited about 5 weeks. They denied my claim. I called the ins. co again & they said they needed 2 surgeons opinions,so I had to go see another bariatric surgeon, he wrote me a letter, we resubmitted & I got my approval. I am scheduled to be banded March 12 & I just started my pre-op diet today. From what I understand, this was an easy process compared to what a lot of people have to go through. A lot of insurance companies just flat out deny everyone!

I was extremely fortunate Aquameliza, I expected so much more difficulty and breezed through, I started my process early to middle part of December and was banded last week! Some people have to wait months! Good luck on your journey..

Hi Aqua I was banded 11/13/07 at B&W by Dr Vernon, I think I know who your surgeon is as they share the same office. Actually today I went to the Faulkner, just need to learn my way around JP. :)

I have BCBS PPO and had NO issues with insurance or anything.

If you have any questions feel free to ask me

I was self-pay, but my husband saw the surgeon pre-op, insurance approved the next day and he had surgery two weeks later.

The only test he had was a chest xray and some blood work.

Hi,

I too have HPHC. I'm going through Emerson. They also have a $500.00 charge. I started in December and they have still not submitted my info although I think we have about the same to lose and I lost 15lbs the first month. My nutritionist is 25 and emaciated. I was bulimic in the past, that may delay some of my scheduling. I'm hoping that HPHC works as easy for me as it was for you. Maybe, I should have started at B&W hospital. Good Luck to you and kudos for such an enjoyable experience.

I was initially denied for my consultation with the surgeon, I appealed it and won. After that, it was just checking the boxes: psych eval, check up, blood work, gall bladder ultrasound, yada yada (psych eval letter took 2 months to get out of the office).

The surgeon's office submitted my pre-authorization in the middle of December and in mid-January I got approval. The insurance company can take 30 days to respond to the request.

My PCP said most insurance he deals with will deny first requests for consult but will usually approve upon appeal.

I think I went to my surgeon's information seminar in June 2007, I had my surgery Feb. 15, 2008.

It is funny though, I thought the surgery would be the end of my "quest" and that I'd kick back after that and move on...but now--two weeks post-op, I cannot wait for my fills to speed up the process! I realize it is a life-long program and that this time, I will succeed at becoming healthy!

Denise

I am shocked at how easily and quickly I seem to be moving through too. I have been to my initial consultation with the PA, psych eval and nutrition class, but didn't get excited until I called today to pre-register for my Upper GI, EKG and blood work. All of a sudden, as I sat there with the phone in my hand, it hit me and I almost started crying. This is really happening!!

Hopefully, insurance companies are beginning to realize how much money they will actually save by paying for the surgery and will start giving approval more easily.

Good luck to you, Aquameliza and everyone else!!!