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Self-pay and to BLIS or not to BLIS?

Ok, so I am Self-pay. I have narrowed my surgeon search down to two. Each is from a different surgical center, one provides BLIS coverage the other does not. I am torn because I like the place without the BLIS coverage more than the place that does provide it. Here are the specifics:

1) Their prices are very close to each other.

2) I called my health insurance provider and asked them their policy on self-pay procedures and the possibility of complications. The general jist is this - if you have a problem that requires additional surgery to fix, correct or otherwise revise the original self-pay procedure it will not be covered. If, however, you go the emergency room for dehydration and that is what they code - you are covered. If I later require gall bladder removal - covered. So still a huge risk if I have a leak, infection, or bleeding due to the VS procedure itself.

3) Both are within 30 mins of home - so no travel issues.

4) The place without BLIS does VSG as outpatient, you go home the same day and come back in the morning for iv fluids and leak testing. The other is an overnight stay.

5) They both have all of the certificates and awards, centers of excellence, etc.

6) Both have fans here at Bariatric Pal - saying the center is awesome, loved the people, loved the surgeon, etc.

7) I am terrified that I will have a complication and bankrupt my family. But I never have never had complications in the past

Self-payers in the US - what have you done? Did you have BLIS? Did you make your decision based upon the availability of BLIS? Has anyone had a complication that BLIS paid for? How did it go? I thought I remembered a previous post where BLIS was difficult to work with but I couldn't find it again via the search....

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I'm guessing you are choosing between the same two that I had to...PSB or NWWLS? Im self pay and I'll tell you why I decided on NWWLS.

Have you been to the seminars yet? NWWLS seminar, I met the surgeon (along with other employees). He talked quite a bit and also had a Q&A session after, along with staying late to answer individual questions. PSB...only a coordinator came to the seminar. She had some info but not a lot. Couldn't answer everyone's questions (there were only 6 of us). She had been sleeved which I thought would be helpful. She kept talking about how she lost like 80 lbs, had a tummy tuck and has now joined weight watchers to lose more weight (she's still fairly overweight). That was not reassuring to me! She has been sleeved, is an employee there and still feels the need to go to weight watchers for support, nutritional info, etc.?!

Both centers do "outpatient", which is less than 24 hours stay. You are around my starting weight and PSB told me it is an overnight stay for a sleeve at my size. NWWLS is overnight, going home the next morning after your leak test. Both were the same for me as far as a stay.

Overall I felt way more comfortable with NWWLS although I've heard good things with PSB too, it would've helped had the seminar gone better and I met an actual surgeon. They were both very comparable in cost which led me to look at the BLIS insurance as you are. That was the final deciding factor. I can't afford extra hospital bills in case of an emergency when I'm already paying so much for the surgery itself. My dad was in the hospital (in Everett) for 10 days with no insurance...the bill was $90,000!!! And I do have insurance, it just excludes the surgery and complications.

I've had my consult, psych, nutritionist visit and endoscopy so far and all has gone well. I should have a date sometime this week. If I would've doubted the facility or felt uncomfortable at any time I would've had to reconsider but I really feel more at peace having the BLIS.

Im sorry this is so long, I'm sure I've missed parts of why I chose one over the other but I hope it helped.

I forgot to add....I asked the insurance coordinator at NWWLS about the BLIS insurance and she said that they (the office) take care of submitting everything. You do have to go back if you have complications since it is the surgeon who is covered by BLIS, you can't just choose a different dr and go there. Hope that makes sense.

  • Author

Thank you so much Sleeveless, this was exactly the response I was hoping for! You hit the nail on the head with two locations. I did the seminar with NWWLS only, but had I initial consults with both PSBC and NWWLS. I really liked both surgeons so this coverage is my main tentpole. I too am insured with Weight Loss exclusion. Your Dad's story is exactly my fear, that in the blink of an eye I could owe a hospital enough money to put my kid through college! I talked to PSBC about srlfpay insurance and they explained how a complication would be handled, but the monetary risk is still there, especially if I had to be transferred to a hospital.

I don't have an issue with NWWLS, they are very professional and I like everyone I met there. I do like that WLS is their only objective, whereas PSBC does some extra stuff (which good too). But I just felt a little more kinship with PSBC surgeon, so the question is - is the risk worth it because I liked him just a tad bit more?

  • Author

I forgot to add....I asked the insurance coordinator at NWWLS about the BLIS insurance and she said that they (the office) take care of submitting everything. You do have to go back if you have complications since it is the surgeon who is covered by BLIS, you can't just choose a different dr and go there. Hope that makes sense.

Just an update, I have devices to move forward with NWWLS, I have my psych evaluation and nut apps the end week of March.

Thanks for the input, it really helped.

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