Medicaid Illinois and VSG...

[VSGtheNP]

Finally approved!!!! The detailed process of Medicaid (IL) VSG process. Also, thank you, everyone, for your support and encouraging words.

Sidebar: I was notified in November 2018 that my insurance would automatically change, however, immediately thereafter, I had the option of selecting the insurance provider I wanted before January 2018. I switched providers after my 2nd appointment with the nutrition. My insurance requirements changed from a long list of requirement to only needing 6 nutrition visits and a psychology evaluation. NOTHING MORE. Your surgeon may require additional requirements.

November 2017:
* Attended 1st support group meeting
* Consultation with the surgeon
* Attended the 1st nutrition appointment
* Scheduled remaining appointments: 3 w/nutritionist and 2 w/dietitian


December 2017:
* Attended 2nd nutrition appointment (started My Fitness Pal journal)
* Selected new insurance provider
* Selected new PCP (Internist)

January 2018:
* Attended 3rd nutrition appointment (MFP Binder)
* Attended 2nd support group meeting

February 2018:
* Attended 4th nutrition appointment (MFP Binder)
* Attended 3rd support group meeting
* Meet new PCP and submitted orders:
1. submitted list of medical concerns, medicinal diets, fad diets, and supplemental weight loss efforts
2. provided a copy of past weight loss history and weight loss attempts from 2010 - 2017
3. Scheduled barium swallow
4. Scheduled sleep study
5. Blood draw (CBC, CMP, etc.)
6. Physical Therapy (back, hip, knee)
* Pyshcology evaluation scheduled via Psychiatrist


March 2018:
* Attended 5th dietitian visit (MFP Binder)
1. Blood draw/lab order
2. Started: B12 (methylcobalamin), D3 (5000 IU), Multi Vitamin (Flintstones )
* Attended 4th support group meeting
* Completed sleep study (mild sleep apnea w/APAP machine ordered)
* Completed barium swallow (no GERD)
* Completed PT appointment (5x)


April 24, 2018:
* Attended 6th dietitian appointment (MFP Binder and total weight loss of 13.1 lbs)
* Psychology Evaluation (PASSED and evaluation submitted during the visit)
1. 250 - 300 questionnaire
2. Presented a picture timeline of weight progression
3. Presented medicnon-medicalmedical weight loss attempts
4. Yes, I was asked questions from childhood to present adulthood
5. Approved for APAP machine

May 2018:
May 3, 2018 - completed file submitted to Medicaid (Thursday)
May 4, 2018 - File assigned to insurance nurse representative (Friday)
May 7, 2018 - Decision made
1. VSG approved
2. Inpatient - DENIED (provider need to resubmit for out patient with 48 hour observation)

* APPROVED for VSG - May 21, 2018

June 2018:
* Appointment with/for:
1. Surgeon
2. Anesthesiologist
3. Barium Swallow

There you have it. I hope this is detailed enough for individuals seeking information for IL Medicaid for VSG. If its too detailed, I do apologize. If you have any questions, please ask me. I know how it feels to view tons and tons of videos or search to only find half answeres.

[Stacey03]

Excellent info for people! Congrats :-)

[sraebaer]

All that hard work paid off. Congratulations!

[VSGtheNP]

Stacey03 and Sraebaer Thank you very much. I thought six months would feel like a lifetime. Well, here I am today waiting for a surgery date.

[Christie13]

Congrats on your approval. Do you have an actual surgery date yet?

[VSGtheNP]

Christie13 thank you very much. I will get a surgery date when I meet with the surgeon and anesthesiologist in two weeks.