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Pre op frustrations!!!


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I am sorry that my first post on this board is a post of utter frustration, but I am hoping that some others have had my experience and can offer some insight.

About me: I am 38, mother of four. BMI of 45.

I am pre-op and jumping through all of the hoops required by insurance beaureaucratic garbage! At first, the surgeon's office my husband and I chose (yes we are both getting lap band) was so very helpful and now all of a sudden, they know nothing...they can't answer questions and aren't helping with the insurance issues like they initially stated they would help with "as this should be as stress free for you as possible".

We have to see a nutritionist before surgery. The nutritionist called to schedule the appointment and the snotty little witch said "I am calling to make your nutritionist appointment, do you have authorization?" Well how the heck to I know????? Don't these supposed professionals know MORE about my insurance carrier than I do?????? She couldn't tell me how to obtain an authorization or even if I needed one or even if my insurance covered it! She was so trite and condescending too...probably a skinny little priss that never suffered an extra pound in her life!

The office STILL has NO IDEA how long I will have to be under doctor supervised dieting...MEDIFAST...before the surgery! OK, I MAY be a little extra sensitive because this is only my second day on medifast and I am in serious carb withdrawal! But honestly, how have some of you dealt with the tangled web of insurance and incompetence of the professionals that are supposed to know how to handle this stuff?

Please help...I am desperate.

Thank you

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Hi,

Most of the posters on this board are patients of Dr. Ortiz and either don't have insurance, their insurance excludes coverage for weight loss surgery, or they don't meet the minimum BMI required in the U.S. for surgery, or were approved for surgery and then for some reason... the insurance company changed their minds... OR <drumroll> they just wanted the BEST Lap Band surgeon around - so they came to our clinic!

We welcome anyone to our boards and are happy to assist in anyway we can.

I hope our patients feel differently about the care they get (especially from ME :-h )

If it turns out you decide not to go with your local doctor, please feel free to give me a call anytime :)

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Hey there, welcome to hell!! Just kidding. It sure can feel like it, though. My old insurance wouldn't cover the band, but I went through all of the pre-op stuff anyway and then decided to go to Dr. Ortiz. But now we have new insurance that DOES cover the surgery so I'm starting to go through an entirely new obsical course.

Please feel free to e-mail me directly and I can give you some tips and hints about finding your way through the insurance obstical course. I'm not promising I can make the pre-op any shorter, but at least I can help you keep a few gray hairs at bay!

My e-mail is elsolomio at yahoo dot com. I get home from work at 5:45 Pacific time and can check it after then. I look forward to chatting with you :)

Beth

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Hello Musicalmomma,

I understand your frustrations!! I have work for healthcare for the last 15 years handling authorizations and now quality management. It is a very frustrating process. But you must be that "squeaky wheel" and make yourself heard. First, find out who does your authorizations and call the group or health plan directly to check status of your referral. Like I said I work in healthcare and I had to be the squeaky wheel with my medical group, it took them about 3 days to give the final OK, basically they were tired of me calling. I got the supervisors direct line and only talked to her, she was very helpful in my situation. Also, it depends on what state you live in some have different timelines to abide by.

Hope this helps!! Don't give up it will be worth it in the end!!! =D>

I am sorry that my first post on this board is a post of utter frustration, but I am hoping that some others have had my experience and can offer some insight.

About me: I am 38, mother of four. BMI of 45.

I am pre-op and jumping through all of the hoops required by insurance beaureaucratic garbage! At first, the surgeon's office my husband and I chose (yes we are both getting lap band) was so very helpful and now all of a sudden, they know nothing...they can't answer questions and aren't helping with the insurance issues like they initially stated they would help with "as this should be as stress free for you as possible".

We have to see a nutritionist before surgery. The nutritionist called to schedule the appointment and the snotty little witch said "I am calling to make your nutritionist appointment, do you have authorization?" Well how the heck to I know????? Don't these supposed professionals know MORE about my insurance carrier than I do?????? She couldn't tell me how to obtain an authorization or even if I needed one or even if my insurance covered it! She was so trite and condescending too...probably a skinny little priss that never suffered an extra pound in her life!

The office STILL has NO IDEA how long I will have to be under doctor supervised dieting...MEDIFAST...before the surgery! OK, I MAY be a little extra sensitive because this is only my second day on medifast and I am in serious carb withdrawal! But honestly, how have some of you dealt with the tangled web of insurance and incompetence of the professionals that are supposed to know how to handle this stuff?

Please help...I am desperate.

Thank you

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