iwant2becurvynotlumpy

Has anyone had their surgery with Dr Roshek? He is with Nicholson clinic in Plano. I've tried searching for his patients and have found only three. I'm sure he has had to do more then just that. Would love to hear experiences. I have a date on the 21st. Was going to go with Dr Nick but he got booked up.

@iwant2becurvynotlumpy. Yes it is for any bariatric procedure but i also have an annual $350 deductible. See the info below that i pulled from the website. I'm a little confused.

What is the overall deductible?

In-Network $350 Individual/$1,050 Family Out-of-Network $750 Individual/$2,250 Family Doesn’t apply to services that charge a copay, prescription drugs, and In-Network preventive care and diagnostic tests. Co-pays do not count toward the deductible

Are there other deductibles for specific services?

Yes. Bariatric surgery deductible $5,000/person. In- and Out-of-Network Prescription deductible $100/person. There are no other specific deductibles.

Oh wow. What plan do you have?

Is that you specific plans deductible? I have BCBSTX as well. I have a $2000 deductible. I've met my deductible so now the actual surgery part is a little over $800 that I have to pay.

Okay I just called! ???? it got to them yesterday on the 4th not the 3rd like my caseworker said (may have been late in the day when she sent it) so it hasn't been sent to review yet. ???? I asked her how long it usually takes and she said 7-10 business days. I've seen so many people on here say it only took like 3 days! I guess I will give it til Wed and check again.

I called my insurance company and they were able to tell me they had not got my paper work yet. The lady was so nice and told me they have to tell you give it 30 days, but she said it really only takes about 7 days. So give them a call, they are really nice. At least BCBS of Al is.

Have you gotten your approval or are you still waiting?

I went to bcbstx.com, created an account, and found out that way. I was anxious and checked every day!

I have an account. Where in there did you go to find out?

I called my insurance company. I approval on October 30th but didn't receive my letter until yesterday.

When was your info sent in? I don't want to be too pushy. It's taken all I have to restrain myself from calling!

I've read here that people have found out the were approved for surgery before they got their letter in the mail. How do you find out? Mine was sent off November 3rd so it's only been a couple days. I'm in a time crunch to get it done before the end of the year because I'm switching insurance and new insurance doesn't cover WLS.

Looking for Houston area surgeons. Please give me your experience, what they required if they required anything other than what insurance required, and what your time frame was. I am on a time crunch to get surgery completed by the end of the year. My insurance got deactivated and won't be reinstated until the end of October. Husbands company is changing insurance at the first of the year and will not cover Bariatric surgery.

I've started the process with Dr. Nicholson's office in Plano but may have to switch. When insurance is reinstated I will have had my psych, my EGD, and my nutrition visit (that was required by Dr. Nicholson office) and sleep study.

My husband informed me today that his company sold to another company and our insurance is switching and my deductible is starting over. I had BCBS of Texas. My deductible was met and I was almost done with everything to be submitted to insurance. I am so frustrated and feel defeated.

I don't know what plan we will have yet so I don't know if WLS will be covered or not.

If you have UHC can you tell me what plan you had, if it was covered and what the requirements were? Also if you had UHC and used Dr. Nicholson in Plano that would be a plus since that was who I've started my process with.

I went through the Nicholson clinic and had UHC which my plan excluded any WLS so I went the hernia route. Insurance pays to repair the hernia and while the doctor is in there he does the sleeve which cost me 4000 dollars out of pocket but my bmi was to high for them to do it out patient so it was done at forest park hosital in Dallas my wife also had hers done but she was able to go through True Results in Plano and have it done outpatient she has UHC also and the financed the sleeve. Dr Rosek done both of our surgeries.

Wanted to find out your experience with dr rosnek? I had planned to go with Nicholson but I may have to switch doctors due to available appointments.

Hey I had the basic UHC plan along with my insurance. Anyway They require 6months pre-op which means monthly appts to help you create a healthy lifestyle before surgery so that you can be successful after surgery. After this they will be able to decide if you're a candiate for surgery based on weight history, previous attempts to lose the weight and the pre-op evaluations made while working with your hospitals bariatric team. I'm sure they will be able to transfer all of the work you've put in thus far over to the new bariatric team. Try speaking with someone that is head of the bariatric team on both sides and letting them know of your previous efforts and work that was done before hand. Do not be afraid to be a little defiant and insisting as this journey sometimes requires us to be with possible set backs or denials. Please stay strong, and know that your journey is not far away. You will thank yourself for the struggles you face now in a year or two! And trust me, time flies! lol Stay positive!

Thank you! Trying to stay positive but knowing I was less then a week away from a surgery date kind of stinks!

You may be better off to go the hiatal hernia route.

How does that work?

My husband informed me today that his company sold to another company and our insurance is switching and my deductible is starting over. I had BCBS of Texas. My deductible was met and I was almost done with everything to be submitted to insurance. I am so frustrated and feel defeated.

I don't know what plan we will have yet so I don't know if WLS will be covered or not.

If you have UHC can you tell me what plan you had, if it was covered and what the requirements were? Also if you had UHC and used Dr. Nicholson in Plano that would be a plus since that was who I've started my process with.

Can't figure out how to delete the post??

If you use Instagram I'd love to have more VSG people to follow/follow back. My user name is flufftofab my account is private but if you send a request I'll accept and follow back!

The it's cheaper with in network insurance.

What is the cost with in network doing it hiatal hernia route? I have BCBS Tx and they said my part would be like $2,800 because I hadn't met my $2,000 deductible at the time of consult. I mentioned hiatal hernia route and they said it would add an extra $4,000 or so to the total. This is with the Nicholson Clinic

What made them go the hiatal hernia route? Was this found during the EGD?

I'm using Dr Nicholson! I am hoping to get a surgery date for October but it will be close. Had my nutrition consult last night and I have my sleep study this Saturday.

I had a psych eval Monday but he wouldn't approve me because he wanted me on a diet plan for 4 weeks before he would approve. However I'm thinking about using one online on Friday to hopefully speed up the process. Really think that the nutritionist is the one that should decide that and fatter talking with her last night I've got some strategies to accomplish it.

Hoping insurance doesn't take too long to approve so that I can get a date.

That sucks!!

I needed up getting the referral from my surgeons office. My appointment is tomorrow morning. As far as I know I will be out of pocket my 20 copay, I wonder why this doc you saw needs such a long time to approve??

Ended*

I had to pay my $30 copay but my $2,000 deductible hasn't been met so I had to pay $264 for the visit. Very frustrating! He just wants me on some sort of diet and workout plan for 4 weeks. When really the nutritionist should be calling those shots, I would think. Good luck on your appointment!

https://www.bariatricpsychevaluations.com

They were great!

Ugh! I wish I knew they existed before today, like yesterday lol I just had my evaluation where I shelled out close to $300 and they would not approve me at the moment. Nothing wrong with my mental health I was told but he wants to see me on a nutrition plan and excersie plan (which I really think that's the nutritionists expertise) for 4 weeks before he will consider approval.

Grrr!!

I used Dr. Kevin Smith. I don't have his number off the top of my head. His main office is in Downtown Houston but he's in Baytown 1 day a week, Thursdays I believe. Try to google him and if you can't find it, I'll did the number up for you.

Thank you I'll try to locate his information! I'm going to Dallas because my parents and sister live a hour away in Greenville. My husband works out of town all week and is only home on weekends. I've got two kiddos, a Great Dane, a cat, and two guinea pigs to care for so I'll need some help! Haha

Check with your doctor to see if he'll accept them but my doctor recommended bariatricevaluations.com - they are really friendly and accept various insurances or self pay if needed.

Thanks! I'll look them up and see!

I need to get a psychological evaluation and clearance by a licensed mental health professional.

I am in the southeast Texas area (Beaumont). I am using a surgeon, Dr. Nicholson, in the Dallas area so the people they suggest are all 5 hours away.

Any suggestions for one that deals with bariatric clearance?

I hope he has surgery times left near the first of July.

Were you able to get a surgery date?

Thanks so much. Sylvia, the coordinator called me back finally as well as a nurse from Dr. Nick's office. Lisa had already stared things in motion, which is great, but wish she had let me know. Appreciate the extra numbers though! I have to wait 3 weeks because of the steroid injection, but can call Lisa Monday to set the date!

Welcome! Glad they got back with you! Aww that stinks about the extra 3 weeks! I was hoping to get a consult sooner but he's out for vacation right now and then I guess booked up til the 23 of July for consults.

I'm getting there. Much better today. Having trouble getting a call back from Dr. Nick's scheduler to reset surgery.

Not

Sure if you had been talking to Keisha but she is no longer there. Was trying to set my consult up and never heard back from her.

This is Abby's number that took her place: (972) 432-6832

Dallas, TX

Or a main number that is different from the 800 number (could never get an answer at 800 number) : +1 (972) 494-3100

Plano, TX

Hope that helps!

I saw dr Nicholson and was told the same. I think insurance approves the surgery for hiatal hernia but does not object to bariatric if it is already paying . Two in one.

In full disclosure I am taking the tougher qualification route to instill discipline.

Btw we're you asked to do a sleep study also?

What do you mean by taking the tougher qualification route? I have not yet with him so I am not sure if I'll have a sleep study. My consult is July 23. He is out for vacation and that is his first available date :/

So has your surgery been approved?