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Old 07-13-2006, 01:07 PM   #1 (permalink)
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Join Date: Jun 2006
Location: Massachusetts
Posts: 156

Weight Statistics

7/26/06
Start Date:
10/3/06
Surgery Date:
Height:
314 lb
Start Weight:
145 lb
Current Weight:
145 lb
Goal Weight:
169 lb
Weight Loss:
53.821656051 %
% Lost:
10/3/07
Goal Date:

Body Mass Index
52
BMI Start:
24
BMI Current:
24
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Wink Patient criteria question

Okay so I received a copy of my medical policy from the Insurance Company, I have a few questions about it When they say the patient is enrolled in a program which provides pre-op and post op multidisciplinary evalualtion and care including behavoral helath, nutrition, and medical management. What exactly does that mean? I think it means that I have to be with a program that does the consults first, They told me the nutritionist, and psycoligist and surgeon will be in attendance at my first meeting I think this is what that means? Does that make sense?
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Yes, you can often get insurance cover for your Weight Loss Surgery.
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Old 07-13-2006, 09:10 PM   #2 (permalink)
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Join Date: May 2006
Location: In the country
Posts: 336

Weight Statistics

August 2006
Surgery Date:
Height:
210 lb
Start Weight:
141 lb
Current Weight:
125 lb
Goal Weight:
69 lb
Weight Loss:
16 lb
Lb Left to Lose:
32.8571428571 %
% Lost:
August 2007
Goal Date:

Body Mass Index
38
BMI Start:
25
BMI Current:
22
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Good grief, guess they didn't write your insurance book in plain English, huh? Mine is, so it was much easier to understand. I think you are on the right track with what you said it means, though. Maybe you could call them and ask them to explain it to you so you can actually understand it!
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Old 07-13-2006, 10:20 PM   #3 (permalink)
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Yup, I'd say you'v got it right.
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Old 07-14-2006, 05:56 AM   #4 (permalink)
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OK, too me multidisciplinary means many areas covered. So, sounds like they want you to see a psychologist to make sure you are MENTALLY prepared, a NUTRITIONIST to make sure you are aware of how you will have to change your eating habits, and your SURGEON and other doctors to cover the medical end. I think the medical part includes all the others you need to see.............for me that was a Cardiologist, Gastroenterologist, and my PCP, and additionally some ultrasound tests. Some also need to see a pulmonologist and have a sleep study.

Good luck to you...........sounds like you are on the right track. S
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Old 01-04-2007, 12:26 AM   #5 (permalink)
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Join Date: Dec 2006
Location: St. Louis, Mo.
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Are these tests done before the insurance will approve you or do they approve you first and then you have them done? In other words , are they out of pocket or does your insurance company pay for them?



"Cardiologist, Gastroenterologist, and my PCP, and additionally some ultrasound tests. Some also need to see a pulmonologist and have a sleep study."
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Old 01-04-2007, 04:54 AM   #6 (permalink)
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Join Date: Jan 2006
Location: SOMEPLACE LONG ISLAND, NY
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Weight Statistics

June 1, 2005
Start Date:
5' 5"
Height:
310 lb
Start Weight:
167 lb
Current Weight:
159 lb
Goal Weight:
143 lb
Weight Loss:
8 lb
Lb Left to Lose:
46.1290322581 %
% Lost:

Body Mass Index
51.5810650888
BMI Start:
27.7872189349
BMI Current:
26.4560946746
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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MUFFINS in my case all the preop clearances were done prior to
my insurance approval.

hope that helps!
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Old 02-04-2007, 12:12 PM   #7 (permalink)
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This is what it means. They just want who ever you use to have a full program. Any of the Bariatric Centers of excellance should meet these criterias
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