Friday, July 30, 2010

How to go about it all questions

Ok so alot of people have asked me questions like, " well how did you get started with it?" and " will insurance pay for it?" So I figured this would be the easiest way to explain it, put it in a blog, and you can read it for yourself and see what you need to do.

1. The first thing you need to do is discuss it with you PCP (Primary Care Physician) and see what they say, if they believe your a valid candidate and such.

2. Contact your insurance and ask about bariatric weight loss surgery coverage,and what criteria you have to meet before it will be covered.

3. Find a weight loss surgeon you can trust and that is covered by your insurance.

My deal was that of course with my weight I was a candidate, and since I am disabled, and partially because of my weight was I awarded my disability, my PCP had all the documents in line for me to be proven to be a valid candidate. I still had to contact my secondary insurance though to see if they covered it, and to get their criteria out of the way. Fortunately medicare will only allow you to go to a center of excellence, and that along with the referral from my dear friend Andrea, I found Dr. Williams at New Life Center for Bariatrics. I then contacted their office, where they told me what criteria they required before being seen as a patient. Your first step to the process is to go to a seminar that one of the doctors holds. Its free of charge, and they go over all the information that you really want to know about. Luckily the one I attended was held by my physician that is going to preform my surgery, Dr. Williams.

Next step is to attend a support group meeting, and the kind ladies at the desk gave me a schedule and helped me pick one out to attend. Then you will need to feel out the packet of information that you get from the seminar, call the office, and make your first appointment. I was so scared that first day, because if your fat you know what I mean when I say, oh great here's another person that's going to look down on me because I am fat, but they are not like that at Dr. Williams' office. They treat you like a person, and never judge you, so I really felt comfortable.

Most insurances require that you have completed a 6 month medically supervised diet plan, if not with your PCP, then with the center you choose for your surgery.
I had already done this, but because of my size, Dr. Williams still wanted me to loose 45-60 pds if I could before the surgery. No one ever told me this before I began the weight loss surgery journey, but your liver gets fat along with the rest of you, when you are obese. And, if you are not currently loosing weight before the surgery, then it might be to large for the Dr. to move around to get to your stomach, so you have to begin loosing before surgery. Its similar to the Liver of an alcoholic, even if your like me, and never drink!!

You also might have to see specialist to get a clearance for surgery, before they will submit your forms to insurance for approval. I had to see a cardiologist, pulmonologist, and a Neurologist, as well as a Psychiatrist, all before I could be approved for surgery. Then the office will submit your paper work, and get your approval. If your insurance covers it, Dr. Williams and the staff at NLBC will get you approved most generally. They know the steps to take, and my approval came back within a week of Jennifer, the insurance lady, submitting it.

You will be assigned a coordinator that will work with you from this point on, shes the one that calls you to tell you if you have been approved. The office I go to has three, Melissa, Donna, and Stephanie, all of whom are a delight to be around, and treat you with the utmost respect. My coordinator is Stephanie, and she is the one that let me know I had been approved, and scheduled my next set of appointments and my surgery. I will update more on things, as I go along.

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