Cloteal

I was just wondering, because I'm hearing several different stories about paying upfront or being billed. I didn't know you had to pay your total deductible upfront. I had another friend of mine who has bcbs of nc and paid nothing upfront, but got a bill in the mail, that's why I was asking. I was never told though by the dr's office that I had to pay anything but for the psych eval upfront.

Do you have to pay anything upfront? Like your deductible.

If you don't mind me asking what is a program fee?

Thanks for the info, but is that 3 1/2 months including the initial orientation/consultation and all appts etc? Who are you going through to have your surgery done?

UPDATE!!!! and conflicting stories. I just received a call from my Surgeons Administrator who is responsible for sending the packet to the insurance co., well it has not been submitted yet as she was waiting for a clearance from the Psych Dr. and Nutritionist. I was just told earlier that the packet was already sent to my insurance co and they were waiting on approval, well that hasn't even been done yet.

There's another lady on the forum that went through Dr. Enoch's office, she said she had her eval done by a Psych Dr. at Dorothea Dix for $55.00, and she had it done on her own. I'm pretty sure you can contact that physician to schedule an eval to atleast get that portion done.

Good for you. You should be straight then on your coverage. You shouldn't have to pay anything out of pocket. I'm concerned that I'll have to pay my deductible prior to my surgery. I believe that's $600, I just paid $300 for my phych eval. Times are really hard right now. I probably shouldn't complain because there are some whose insurance won't cover any part. I just thank God, for what my insurance will cover.

Do you have more than one insurance carrier?

Who did you decide to go through to do your surgery?

Congrats to you. Do you have to pay anything up front before you have the surgery?

Good for you, I hope all goes well. Keep us posted on how things are moving along for you. I'm still waiting for an approval from my insurance company too. I'll keep you all posted as well.

Hey Guys, I'm feelin really bummed today :thumbup:. I decided to get the lapband, I went to the orientation here in Fayetteville, NC and completed all the required paperwork. My doctor was even in my corner, she completed all documents needed and wrote a letter of recommendation stating that my BP is elevating due to weight gain, it's not quite high yet, but due to the weight gain it is elevating. On the paperwork it has that my BMI is a 40 for approx 4 out of the 5 years, but based on the surgeons office that I was going to go to the insurance person for that office said it wasn't good enough, and that my insurance co wouldn't approve it because based on their scales my bmi is only 39.8. That really sucks, I did everything they asked and she wouldn't even give me an appt to see the surgeon.:frown: Now, I'm sort of scared to try another surgeon as I may get turned down again. I am scheduled to go to Duke for the orientation. Anybody had any experience as such that can give me a litte advice. Thanks

Well being that said, you guys I guess it all depends on where you go. I was referred to Duke after Pinehurst wouldn't even allow me an appt with their Doc saying my BMI was below 40 and it would basically be a waste of there time. Well, I'm through the final stages of my journey of getting the surgery done. I'm just waiting on insurance approval, Duke has a really great team and they don't mind working. I really appreciate them. Just keep me in your prayers that I get approved. I don't know why I wouldn't my BMI was just a little over 40 and I have high blood pressure, but I am not taking meds for it as of right now. I'm hoping that when I lose this weight I won't even need BP meds. Well I'll keep those informed that want to know what's going on.

Maybe that is what I'm thinking about. Thanks. I hope all goes well for her, like you said it wouldn't make sense for them not to do it. I do think it depends on ones insurance.

Yes, parrothead is correct about having to have comorbidities if your BMI is under a 40, but if it's more than a 50, I think that's another story. I believe you have to have comorbidities as well if its over 50.

Well today I went for my psych eval, all went well, last about 45 min, nothing to it at all. Now I'm just waiting I guess for insurance approval. Wish me luck and I'll keep you all posted.

I don't know about that, I think if your BMI is above a 50 you will need to have comorbidities. I would check to make sure.

I called this number 919.470.7000 and made an appt for one of their seminars, they were really nice, of course they were booked, but I called almost every day to see if someone cancelled, what they did was took my name and number and called me when someone cancelled. I had my seminar on 05/12, my first visit with the Dr on 06/15, my Psych eval is sched for 06/30, this is all with Duke. I am very pleased that I went to Duke, of course there are others that you can attend. Good luck to you.

That would be awesome if I did, but I'm not sure how fast they move. I would be happy with a August date. I don't even know if I'm approved yet, well I'll just speak it into existence.

Hi all, I have an update. Well I finally got to see the Physician who will be doing my surgery (Dr. Sudan) YAYYYYYY! Well everything seem to have went pretty well, I saw the nutritionist and took some test (EKG/Chest xray). I go for my PSYCH eval on 06/30 and after that I should be able to get a surgery date if I'm approved. Hopefully I won't have any problems, my BMI was over 40 and I do have HBP. Wish me luck, it will soon be here.

I'm just like the other writer who didn't get charged by their PP, I can't imagine getting charged, I pay my co-pays every visit. That just does not seem fair, but if I had to pay for the letter, I probably would have but complained about it. They don't write the letters themselves anyway,the office manager does and I'm pretty sure it's saved in their computer and all they have to do is change the name and a few diagnosis, etc. Well that said, I hope all is well for you. Good luck and I do wish you well.

OMG! This was well said and very encouraging to me. I have not yet had my surgery, don't have a date yet, but I go see the Surgeon on 06/15, I'll probably get a surgery date then. I too was concerned about the pre-op, post-op liquid, I didn't know if I would be able to do it, but you are such a great encourager, I now believe I can and will. Thanks for that and keep up with the good job your doing.

Yes, I will investigate more, but I really believe that Duke will be better for me. The staff at Duke is wonderful, they all are very nice and have great customer service. I didn't have a good experience with Dr. Mitchell's office and heard not so good things about Dr. Enoch's office (meaning staff). So far I'm satisfied with Duke, I know it's a long way for me to drive, but it will be better in the long run.

Thanks for the encouragement. I am morbidly obese, my height is 5', and I weigh 207. My feet swell sometimes so bad they throb, I'm considered borderline high blood pressure. My doctor says my weight is the cause of increasing blood pressure. I just pray that I get approved, I can't continue like this.