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What should I do? Need your advise

dovie6523

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dovie6523    0

dovie6523
Posted

Hey everyone... I need some advise. I am working on getting approval from my insurance for the surgery. I am currently doing the "required 6 month weightloss program that my insurance is requiring me to do. It was the only thing standing in the way of the approval (We will see:rolleyes: ) Anyway, this is the delima... My surgeon (who is in my ins PPO network) does his surgerys at USMD Hospital here in Arlington. He also does them at the "Speciality Surgery Center in Ft. Worth. Neither of these two locations are in my PPO network. I called the insurance coor. for Dr. Carter office and she said I should just wait until I am approved to worry about it. Well if I wait until July and found out that Dr. Carter can't do my surgery, I'm back to square one again and have to start over with another doctor. I guess I am looking for some insight from y'all as to what I should do now before july. I have been working and waiting since November. I am so close now, I don't want to have to wait again. What should I do?:)

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Elisabethsew    50

Elisabethsew
Posted

I would get a list of all the MDs who perform lapband surgery in hospitals that your insurance company DOES cover and check them out. Ask your present MD to give you copies of all the reports in your chart. The requirements for the surgery are pretty universal so whatever you've had done already will, for the most part, be accepted by the new surgeon you choose. To put it simply, use the waiting time to develop a "plan B" in the event "plan A" falls through.

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dovie6523    0

dovie6523
Posted

I have been trying to work on that, however alot of the doctors that do WLS in my area, work strictly with a WLS surg. center or a specific hospital and that makes it hard to find a doctor and the hospital that are BOTH in the PPO Network. Thank you for the advise. I guess I just needed to hear someone tell me I wouldn't have to start over. Thanks again!

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DonnaB    3

DonnaB
Posted

DON'T WAIT! Your insurance company is in business to MAKE MONEY. If they have any reason to deny your surgery they will. Sorry to be so negative but don't wait. You WILL have to start over and they're hoping you'll get frustrated and give up. Don't you do it!

Best wishes for your insurance approval and surgery.

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dovie6523    0

dovie6523
Posted

Thanks Donna.... I am not giving up.. That is for sure! Yes, the insurance companies make it so damn frustrating!!!!!! Thank you for your input! I appericate your reply.

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Mvpo8961    1

Mvpo8961
Posted

Dovie Dr. Richard Carter has priviliges at Medical Center of Arlington. There is no reason why he can't do it there. He may prefer the other places but he can do it at MCA. I would assume that would be in your approved network since it is the big hospital in Arlington. I know my surgeon in Dallas prefers SCOR in Richardson but my insurance requires a HCA facility so I am having it done at the hospital. The benefit is I can go any day he does surgery at the hospital rather than the Wednesday which is the day he goes to SCOR. M

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dovie6523    0

dovie6523
Posted

Hey thanks... I will call Dr.Carters office again. I am somewhat frustrated with the Insurance Coor at his office. I just can't seem to get straight answers from her. I don't know how many times that I told her that USMD and the center in FT. Worth were not in my PPO and ASKED what I needed to do. Wouldn't you think they would be a little more interested in getting my services and isn't all this research HER job? I just hope that this is not the way my followup services will be like. I am almost to the point of going somewhere else. I just am venting... Sorry! Thank you for your reply.

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dovie6523    0

dovie6523
Posted

Yes! I will keep squeaking! Thanks for the info. Good luck with your upcoming surgery. I am hoping everything will go well and I will be behind you in line. Always looking ahead..

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dovie6523    0

dovie6523
Posted

Thanks! It's so nice to have the support! I think everyone gets sick of listening to me:bored . It's a comfort to be able to come and talk to you all! Thanks again!

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jewels411    0

jewels411
Posted

hey anyone out there from san antonio who got there lap band from dr. rincon @the wish center or dr. rumbaut in monterrey? dont know which dr. to pick need help

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Go To Topic Listing Weight Loss Surgeons & Hospitals

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      1. LeighaTR

        LeighaTR

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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