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Insurance and Adjustments

skyeblu79

By skyeblu79, in Insurance & Financing

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skyeblu79    0

skyeblu79
Posted

Hi, Does anyone know if there is a way to get your insurance to cover your fills? I live in NC and I am planning on going to CO for surgery. I was wondering if anyone self-paid for surgery, but was able to get fills covered.......What is the best way to find out if I can? Should I call the insurance company (UHC) and just ask? Or should I contact the doctor's office first for information?

I have contacted a lot of doctors around here about fills and they are all really expensive. I considered flying back and forth to CO, which may be cheaper than get the fills done here. I just think this may get complicated. What it I was overfilled and I had already gone home? I would still end up going to someone local.

The best rates that I have found here are $500 for the initial visit and $1,000 for the year or $500 for the initial visit and $300 for each fill....The $1,500 for the 1st yr may be the best option, depending on how many times I think I might have to go for fills.

I am just really frustrated and trying to figure out a way to get this done. I am not worried about playing for the surgery, but the aftercare is really adding up. And then I went to my general dr on Thursday and when I was there I asked her whether or not they would be able to take out my stitches there. She basically avoided my question & asked me what kind of surgeon would be ok w/not providing aftercare to their patient. I explained that he does provide aftercare, but I hadn't decided it I was going to do that or just find a dr here. I can't fly back there just to have stitches taken out.

Sorry to ramble.....I would really appreciate any info you all can provide. Thanks!!:party:

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tonya66    13

tonya66
Posted

I have heard that some insurances will not cover the "surgery", however will cover the fills. Weird, but true. I have done a lot of searching for the CPT code for Lap-band fills but could not find one. I know UHC is pretty good and you might just be out a "co-pay" for your fills. You need to find out if the doc is in network or not.

Good-luck.

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TracyinKS    7

TracyinKS
Posted

at my doc office.. they said, as long as insurance approves it the cost of fills is the same as a regular visit co-pay.

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skyeblu79    0

skyeblu79
Posted

I guess I could call the insurance company with the code and check w/them. It would be great to only pay the copay.

Thanks for the responses!!

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      Alisa_S

      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.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      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.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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