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Dr. Miles or Dr. Schmitt patients

Savedbygrace

By Savedbygrace, in LAP-BAND Surgery Forums

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aprilapple    1

aprilapple
Posted

There was some talk at the meeting about psch evals. I have not been told that I need to do this. Should I be worried? Also, I saw on another thread where people were hit with surprise fees right before surgery. Has this happened to any of the patients here?

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Savedbygrace    11

Savedbygrace
Posted

There was some talk at the meeting about psch evals. I have not been told that I need to do this. Should I be worried? Also, I saw on another thread where people were hit with surprise fees right before surgery. Has this happened to any of the patients here?

I may not be alot of help on this but during my journey - I didn't have to have a psch eval. I'm not sure if he bases that off your history and physical or what. As far as the suprise charges, they could never give me an estimate - which was frustrating- but I ended up finding someone to show me their explanation of benefits and I based my estimate off of that and was really close to right. I did have to pay a deposit upfront but I had saved during my 6 months so I could be prepared for anything ha.

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aprilapple    1

aprilapple
Posted

OK so riddle me this: My ins. co. says that they pay 100% (physician and hospital) . However there is a $100 hospital copay for inpatient. Why did you have to pay a deposit up front.

I have BCBS Peehip. Help! I don't want any surprises. Who should I talk to at the Dr. office to get an answer? Neiomi? wonk wonk......

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Gracey    7

Gracey
Posted

There was some talk at the meeting about psch evals. I have not been told that I need to do this. Should I be worried? Also, I saw on another thread where people were hit with surprise fees right before surgery. Has this happened to any of the patients here?

It's PSYCH, btw

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Savedbygrace    11

Savedbygrace
Posted

OK so riddle me this: My ins. co. says that they pay 100% (physician and hospital) . However there is a $100 hospital copay for inpatient. Why did you have to pay a deposit up front.

I have BCBS Peehip. Help! I don't want any surprises. Who should I talk to at the Dr. office to get an answer? Neiomi? wonk wonk......

My policy covered 80% of any bariatic surgery and 80% to the surgeon- while it paid 100% of any other sugery.. but anyway.. that's where the deposit came in. Then I had a $150 copay to the hospital. I work in a medical office and my experience with our patients who have PEEHIP.. it's good! So from my GUESSING... you should be fine with only the hospital copay. Check your OUTPATIENT copay... most of their surgeries are done outpatient.

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aprilapple    1

aprilapple
Posted

My policy covered 80% of any bariatic surgery and 80% to the surgeon- while it paid 100% of any other sugery.. but anyway.. that's where the deposit came in. Then I had a $150 copay to the hospital. I work in a medical office and my experience with our patients who have PEEHIP.. it's good! So from my GUESSING... you should be fine with only the hospital copay. Check your OUTPATIENT copay... most of their surgeries are done outpatient.

Thanks Wendy! You really made me feel better. I do need to check on the outpatient coverage.

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Fordgal88    7

Fordgal88
Posted

savebygrace, it is gettting closer. and i think i got everything ready. i still got to go tuesday for my preop and to the day surgery for something. not sure what yet. but i got to be there at 11:30 then at dr.miles @ 2:00. i did go and buy some broth and a few other things last night. my wife was like thats what you are going to eat! lol i said yep. and then i got her to read my book on what i could have.

NMYDASH, i will do just that. my last day at work is next friday and then i will be out for 4-6 weeks.

oh and i will take any ideas or helpful info on things to do our buy before i go.

thanks everyone

Jason R - Just a tip - broth was ALOT nastier than I had ever anticipated. Just smelling it cook made me gag - What I did was strain chicken noodle Soup and it was ALOT easier. Your preadmission testing will consist of an EKG and drawing some blood and to fill you in what you need to do the morning of surgery - no big deal.

=)

Shawna

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Fordgal88    7

Fordgal88
Posted

It was great meeting you on Saturday Di! You know what James was talking about - about the insurance paying the hospital but not paying Dr. Miles? Well my claim finally went through and it paid for the hernia repair but not the band part of the surgery!! So it claims I owe $2900 to Dr. Miles.... Ugh!! I am thankful I heard about this Saturday, so I was not shocked into a heart attack... I will call the insurance today to see what is up and what I need to do!!

Hope everyone else is doing well!!

=)

Shawna

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Di4AU    1

Di4AU
Posted

It was great meeting you on Saturday Di! You know what James was talking about - about the insurance paying the hospital but not paying Dr. Miles? Well my claim finally went through and it paid for the hernia repair but not the band part of the surgery!! So it claims I owe $2900 to Dr. Miles.... Ugh!! I am thankful I heard about this Saturday, so I was not shocked into a heart attack... I will call the insurance today to see what is up and what I need to do!!

Hope everyone else is doing well!!

=)

Shawna

It was great to meet you too, Shawna. I thought it was a good meeting. And I'll only miss the September and November meetings. I really do get motivated when I go. Down another 2 lbs this morning!

I think it really depends on who's handling the claim. Mine went through, no problem. I knew there were people who were denied, some even twice and then got approval for the surgery. Persistence is the key, I guess.

Sorry, I didn't get to meet the others here. Where were you??????

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Di4AU    1

Di4AU
Posted

When my co-worker had to have a psych evaluation and I didn't, I thought it was because on the form we filled out about past dieting and weight loss, I had filled it out completely and she didn't put anything. I thought maybe they just wanted to find out if she had ever tried anything before and if she was serious and knew what she was getting into. At the meeting Veronica suggested it was required for those taking certain medications, like anti-depressents, which my friend does take. So, I don't know, really.

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alabamagirl1975    2

alabamagirl1975
Posted

When my co-worker had to have a psych evaluation and I didn't, I thought it was because on the form we filled out about past dieting and weight loss, I had filled it out completely and she didn't put anything. I thought maybe they just wanted to find out if she had ever tried anything before and if she was serious and knew what she was getting into. At the meeting Veronica suggested it was required for those taking certain medications, like anti-depressents, which my friend does take. So, I don't know, really.

Hi everybody! First, I want to apologize to everyone for not going Saturday - I had no babysitter! It's hard to find anyone who will watch 5 girls for 2 hours! I did have to have a psych eval because of the medicine I am on. That is what determines if you need one or not. It wasn't that bad ~ a bunch of written tests and memory games~ Anyways.... I have a question ~ when is the next meeting? Do I not have to go to one for Naomi? Hope you all have a great Monday!!! :blush:

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Savedbygrace    11

Savedbygrace
Posted

Hi everybody! First, I want to apologize to everyone for not going Saturday - I had no babysitter! It's hard to find anyone who will watch 5 girls for 2 hours! I did have to have a psych eval because of the medicine I am on. That is what determines if you need one or not. It wasn't that bad ~ a bunch of written tests and memory games~ Anyways.... I have a question ~ when is the next meeting? Do I not have to go to one for Naomi? Hope you all have a great Monday!!! :wink2:

Yes you are required to go to at least one. I went to the one after the seminar so I didn't have to make more than one trip. I found it very intresting.. just can't seem to get back down there on a Saturday. Looks like the next one is Sept 20th. You can see the schedule at their website -

www.alabamawls.com

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alabamagirl1975    2

alabamagirl1975
Posted

Thank you for that! I will have to go to the next one. I get my CPAP on Wednesday so I am getting excited about that. Yea, I know...i'm goofy!

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Go To Topic Listing LAP-BAND Surgery Forums

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    • Alisa_S

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      1. LeighaTR

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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.
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      1. summerseeker

        summerseeker

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