Tag Archives: Insurance

Step 3: Get Approved

30 Aug

I completed all the requirements on Friday, August 23 at 4:30 pm. John at Dr. Jawad’s Office submitted my claim on Monday, August 25 at 9 am and yesterday, Wednesday, August 27 at 5pm I received my confirmation that I am APPROVED TO GET SLEEVED!

For anyone who is wondering, both Allison and I have Anthem BCBS through our employer and they are just PHENOMENAL about insurance approvals and all that jazz. I also have to give a shout out to the amazing staff at Dr. Jawad’s Office because they are a well-oiled machine and really have their stuff together.

The insurance gave me a tentative date of 9/17, which would be AWESOME because our family lucky numbers are 7 and 17. I’m still waiting to hear back from the surgery scheduler to get a definitive though. Here goes everything!


Step 2: Make Lots of Appointments

25 Aug

So, I had posted earlier about my initial consult with my weight loss surgeon. (If anyone is wondering, Dr. Jawad at Orlando Bariatric Center is PHENOMENAL).  Then the real fun began, wherein I spent the next month rushing from appointment to appointment. For those of you considering this procedure, these requirements may be different for you depending on your surgeon’s preference and insurance requirements. However, I will share all the dates and an overview of each appointment to give you a good idea of what this looks like. Hopefully it will help someone plan and prepare.

July 19, 2013
Initial Consultation-Dr. Jawad
3 Hours
$35 Specialist Co-Pay

I think most offices probably do this a little bit differently, but my Dr likes to do the seminar, education session, and initial consultation all in one visit. He usually hosts these each Friday at his Orlando office. Basically I went to the office and (having previously filled out all the new patient paperwork) sat in a small classroom with about 7 other people considering bariatric surgery. The Dr. came in and explained obesity, why it’s difficult for obese people to lose weight and keep it off, and the specifics of each procedure on the whiteboard. There was a short Q & A and then we were free to go to the waiting room. We were seen one by one for vitals and each taken to do H&P with the nurse practitioner. ***Important point I should mention here: If you are on hormonal birth control, STOP. You cannot be on any type of hormones prior to surgery. They looked it up and determine my Copper IUD was A-OK. The Dr came in shortly thereafter to review medical history and discuss the surgery options. He agreed that the sleeve was a good option for me, and wrote orders for all the tests. I got my 5 scripts and proceeded to John, the insurance guy who told me what I’d need to do (5 tests, no waiting period) and he handed me off to the receptionist for appointment scheduling.

Results: Good to go for the Sleeve, follow-up testing needed

July 22, 2013
Psych Eval-Dr. Jawad’s Office
1 Hour
$15 Mental Health Co-Pay

This appt is probably a lot of what you would expect. Tell a little about yourself. What do you want out of this surgery. There’s some fun true or false questions to gauge if you’re cray cray (i.e. T/F, you were on the cover of 3 magazines last week). There were some tears and a lot of emotions I didn’t expect. Be prepared for uncovering feelings you didn’t realize you had.

Results: Sane enough for surgery

July 23, 2013
Lab Draws-Quest Diagnostics
30 minutes
$42.99 towards $100 deductible

Pretty cut and dry. This was for a typical blood count, metabolic, and thyroid panel. Made an appt online. Showed up at the appt time. Filled out some simple forms. Was whisked back. Made small talk with the phlebotomist so she’d be nice. She was. 6 Vials. Band-aid. Off to work.

Results: Disease free

July 24, 2013
Gall Bladder Ultrasound-Dr. Phillips Hospital
2 Hours
$56.19 towards $100 deductible

Made an appointment 2 days before. Had to have nothing to eat or drink 6 hours before. Arrived at 730 am for an 8 am appt. I got unlucky and got the student sonographer. It took her about an hour and 20 minutes to scan 47,251 images of my gall bladder, and then the real sonographer came in and took about 30 minutes to take another 15. All in all it was uncomfortable and frustrating due to the time, but not terrible.

Results: If there’s any stones the gall bladder goes, no stones and the gall bladder stays

July 31, 2013
Manometry Study-Dr. Jawad’s Office
1 Hour
No Copay

Deep breath. This is damn near traumatic to relive. But I’m going to tell you the truth, because everything online is a lie. A LIE! I’m pretty sure manometry studies is how they invented water-boarding. You will feel like you’re going to throw up the entire time. You go in and they make you snort lidocaine gel and gargle and swallow some, for good measure. This part is gross, and sort of cringe-worthy, but you’ll live. Then the terrible part starts. The nurse practitioner will start inserting a tube about 1/8-1/4 inch in diameter into your nostril. Meanwhile a nurse will be giving you lukewarm water through a straw and telling you to swallow repeatedly. No amount of lidocaine will make you feel any better. It is practically torture. You will gag. They will stop and tell you to breathe. You will breathe and gag more. They will continue. Then it “goes in far enough” and you breathe a sigh of relief because it’s almost over. LIES! They will tape the tube in and MAKE YOU LIE DOWN. Then the mad scientist will remove 10 syringes of warm water from a secret compartment and explain the REAL procedure.

  • You MAY NOT SWALLOW unless you’re told to…even though every instinct in your body will tell you to swallow because there’s a tube down your throat
  • You will get a syringe of warm water in your mouth while laying down and you may only swallow once or you screw the whole thing up
  • You will screw the whole thing up…or at least I did
  • They will move the tube up a little with each swallow….and you will feel it
  • By the seventh syringe you will feel like you’re drowning
  • By the 9th you will ask for a barf bucket
  • By the time it’s all over you will sing praises to the Lord

Clearly, I’m exaggerating somewhat…but it was THE WORST most uncomfortable procedure of my life…so, BUYER BEWARE

ResultsI screwed up the test with my uncontrollable swallowing and my results were “low-normal” referred for an upper GI series

August 6, 2013
Nutritionist Consult-Dr. Jawad’s Office
1 Hour
No Charge

By this point, you’ve already had a tube shoved down your nose and been water-boarded, and there’s no place to go but up. The nutritionist visit is informative, beneficial and practical. If you’re an obsessive researcher and read everything on the Internet about VSG, most of this will be review for you. It’s still good. I received a packet of diet info for pre-op, post-op and maintenance. Basically, the 2 week preop liquid protein diet to shrink the liver, clear fluids for 1 day prior to and 3 days following surgery. 1 month of liquids post op (foods that don’t need to be chewed, including protein shakes) and 1 month of soft foods (foods that can be cut with the side of a fork) until you’re able to eat 60-80g of protein without supplements per day, with no more than 25-30g per serving. I brought my husband to this session since he’s the cook in our family. I think it was helpful to have him there and get a realistic picture of what our meals will look like post-vsg.

Results: I can do this!

August 12, 2013
Upper GI Series-Orlando Regional Hospital
1 Hour
$0.82 to satisfy remainder of $100 deductible

This is probably the coolest test because you get to see your insides. You go in, nothing to eat after midnight and drink some alka seltzer type stuff to inflate your stomach, then drink some white barium type stuff, then stand on a “wall” and BOOM! it starts moving and turns into a table…WHAAAAAAT? Yeah, it’s pretty futuristic. They spend about 30 minutes taking different pics of your esophagus and stomach, having you spin around to coat your stomach and taking more pictures. Fun times were had by all and I got a CD of my images for my scrapbook.

Results: I have a small hiatal hernia, but no GERD

August 23, 2013
Upper GI Follow Up and Consultation-Dr. Jawad
1 Hour
$35 Copay

Went to Dr. Jawad’s office and he reviewed my Manometry results and Upper GI results. He said he’d fix the hernia while he was in there and he didn’t foresee any problems with the sleeve. Phew!

Results: Ready to submit to Insurance

10.5 hours and $185 to change my life. Worth it!

So, now we wait!

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