Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Self-pay sleeve along with insurance paid hernia



Recommended Posts

Well I can give you my surgeon's name if you are interested. He's the one that suggested to me I buy the eggs and milk together. But he's in the Houston area

Who is your surgeon? I'm also having my surgery in Houston.
I'm actually in The Woodlands area. I used Dr Balette. Below is his website. Since I was self pay it went very quickly. I had my surgery at the end of March. Dr Balette is awesome.

http://www.sgotw.com

Oh, nice! I'm scheduled to have surgery on the 19th. Closer to SW houston, though.
Good luck! I hope your surgery goes well. I had no problems with recovery. Maybe one day of feeling gross. No issues with food. Only the Vitamins make me nauseous so I have to take them with yogurt. I'm so happy I had the surgery.

Share this post


Link to post
Share on other sites

I'm no attorney and I certainly understand your desire to have as small an out of pocket expense as possible but I think charging the operating room expense to one surgery while actually doing two borders on insurance fraud. I expect most surgeons are leery of this. They live or die by the insurance companies. I had to change jobs to get mine covered by insurance (not the ideal situation for everyone, I understand).

Nope. Perfectly legal and not at all uncommon. Search these boards and you will find many who have done this when WLS was specifically excluded by their insurance. It is a "self pay" option that some doctors make available as an adjunct to hernia repair.

Nothing illegal about it at all. The insurance is not billed for the WLS. The surgeon and hospital bill the patient directly at a vastly reduced rate.

Some doctors in the U.S. actually advertise this as an option. Whether a person can take advantage depends on whether their insurance will cover the hernia repair, whether the surgeon is considered in network, etc.

I paid full price for the WLS then my surgeon billed insurance for the hiatal hernia on top of that. Wish I would have visited this site prior to surgery, I would have shopped around a bit more.

Share this post


Link to post
Share on other sites

Has anyone been able to find a surgeon to do this in Michigan? So far my search has yielded no result.

Share this post


Link to post
Share on other sites

I'm looking in Colorado or Wyoming for the hernia repair-sleeve surgery too. Anyone know of a surgeon that wouldn't turn their nose up at me for mentioning it?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×