Once my primary physician faxed the referral to Southern Surgical, I was enrolled into an information session at their office to get details of the program. I called it "fat class". The chairs in the classroom are wide enough to seat 2 average sized people. For Us, they were very comfy. The presentation was good and informative. First you turn in your required documents which include forms that were sent to you by mail, insurance card, picture ID and the dreadful weigh in. I weighed in at 266...this we in June 2011. According to the BMI charts I was 40.6 due to my height of 5'7". With that BMI and my diagnosis of hypertension, I was determined a "candidate"...YAY (I guess).
Click the chart to enlarge image
Deciding on Which Surgery
Here comes the hard part...
At the information session you are given a binder with all the information you will need to know for the program. As they go through the info you have choices that have to be made...which procedure and which surgeon??? Everyone is different so that decision must be based on the individual's reasoning and best judgment. I chose Gastric Bypass because the amount of weight loss is greater that LapBand and my satisfaction works from "results". Therefore, I'd rather see the pounds come off quicker versus over years. To me that's no difference than struggling with diet and exercise and wanting to give up. As for the surgeon, I had chosen Dr. McGuire because he spoke to us that day and made a positive impression on me. Dr. Mann came in later after we had turned in our choices. It just so happened that I ended up having Dr. Mann anyway because Dr. McGuire and Dr. MacDonald left the practice and joined Physician's East. Nevertheless, I've heard good things about all of them. I stuck with Southern Surgical because my journey had already began and no need to start all over with another group.
Insurance 101
BEFORE you get too far along in this process, be sure to verify benefits with your insurance company. Call the toll free number on your card and ask if Bariatric surgery is a covered benefit. I have BCBS so I was able to view my requirements online. I called anyway just to double check. I had to have a 5 year weight history, which I obtained from my primary physician and my gynecologist, documented weight loss attempts (weight watchers, drugs, etc.), thyroid test within a year, medical diagnosis such as diabetes or hypertension based on my BMI, and that's all that I can remember was necessary. Just check on your individual benefits and find out if it's covered and if so how much they will pay. Be sure to include your deductible in the calculation. Most payors will reimburse 80% after your deductible is met. That leaves you having to pay the deductible and coinsurance of 20%. It adds up so be prepared. The physician will require you to pay your coinsurance amount prior to surgery. My cost out of pocket to Southern Surgical was $540. Save up for it!