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Insurance Denied Coverage - Doctor Doesn't Take Cash

I just called the insurance carrier and was informed that our employer has prohibited any bariatric obesity related procedures - so no coverage. I then called the group I was most comfortable with after the seminars and found out they do not accept any cash patients.

It's been over a year of research, and I'm back at square one. Does anyone know of clinics in MI that accept cash?

sad and confused....:cursing:

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i was a self pay in canada.... why not hop over here for ur sirgery?... or maybe mexico if ur brave.... wierd a doctor wont take cash because thats all my guy accepted!....

not to worry...u should not have any problem finding a bariatric surgeon who will accept a cash paying patient. I am very confident that you should not have much difficulty with that. Just be sure and do your research. Good luck to you in your search. I won't regret the work that you put in to find the "right" surgeon.

Wow I am so sorry. I can not imagine what I would do if my surgeon didn't take cash. My insurance is a joke except the 300 a month I pay for it so I knew they wouldn't touch my surgery. Where do you live in MI? Hate to research someplace too far away from you.

So, let me get this straight - you walk in with cash and they turn you down? I can understand them not giving you credit but if you have the cash its against the law for them to turn you down - in the U.S. at least. Every denomination of money in the U.S. says "This note is legal tender for all debts public or private"

I just called the insurance carrier and was informed that our employer has prohibited any bariatric obesity related procedures - so no coverage. I then called the group I was most comfortable with after the seminars and found out they do not accept any cash patients.

It's been over a year of research, and I'm back at square one. Does anyone know of clinics in MI that accept cash?

sad and confused....:biggrin:

Leelanau, the same thing happened to me! I was six months into my pre-op stuff, had my tests all done, stress test, psych eval., sleep apnea only to find I had a clause in my insurance plan that indicated there was no coverage for any type of bariatrics. The sadder thing to me was that ALL treatment was not covered including the opposite condition that I have...bulemia. Can you image? Fortunately, this was a hidden victory. I ended up shopping for surgery, found a doctor I LOVE LOVE LOVE, discovered Denver and parts thereabouts, has a breeze of a surgery at a beautiful facility and made some amazing friends out there.

Trust fate. Follow your dream to get this done. Insurance does NOT have the final say in our health. We do have a voice even if we have to pay for it ourselves, even if we have to go to other means to get it done.

LUCK :thumbup:

I just checked that website, and it looks as if the closest doctor is in OH or WI - none listed in MI.

If you contact them they may be in the process of getting surgeons on board. I sent an email and got a very quick response from Regi. He is working on getting the 2 doctors I am interested in signed up.

Don't give up

Hugs

Rita

So, let me get this straight - you walk in with cash and they turn you down? I can understand them not giving you credit but if you have the cash its against the law for them to turn you down - in the U.S. at least. Every denomination of money in the U.S. says "This note is legal tender for all debts public or private"

It's not illegal for the doctor to refuse cash payment since he is not required to perform surgery on her. He hasn't done the surgery yet, therefore there is no debt owed.

Hi, I Had Mine Done At Harper Hospital In Detroit...group Of Surgons There Called Great Lakes Weight Loss. They Work With People Who Must Self Pay. Everything Is Included From The Consult To The Surgery, Overnight Stay And Follow Up. My Surgon Has Been Great As Has Been The Staff. Check Them Out On The Web. Dont Be Concerned About Heading All The Way To Detroit...its A Great Hospital, And I Dont Live Too Close So I Had Not Been There Before Either.

I just called the insurance carrier and was informed that our employer has prohibited any bariatric obesity related procedures - so no coverage. I then called the group I was most comfortable with after the seminars and found out they do not accept any cash patients.

It's been over a year of research, and I'm back at square one. Does anyone know of clinics in MI that accept cash?

sad and confused....:thumbup:

Wow... I don't believe I have seen that before for banding. I have for bypass but not banding.

I think I wouldn't want to go to a doctor that doesn't take cash band patients. The first thought that comes to my mind is that he is worried about complications and not getting paid for them. It just makes me look at that policy with a raised eyebrow.

I would venture a guess that most docs take cash pay patients, it's far easier on them... no paperwork.

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It was finally communicated to my husband (owner of the insurance policy) that the company had a restriction to 'medically neccessary' which of course I can prove - so the situation resolved itself. As I have had diabetes for years, and can make some of the other co-morb's fit, we should be able to make it work.

What a load off my mind!

The clinic I want to work with had made the decision to not accept cash due to the risk of something going wrong during the surgery that wasn't originally paid for. The told me that because of the risks involved, and the fact that the patient would be 'out' and couldn't give permission to proceed (guaranteeing payment), they decided they would work with insured customers only.

As a business person I can understand their position, but it would be easy to have someone sign legal documents beforehand in the case of emergency to guarantee payment, or have a line of credit set up in advance. I think they will change this position over time, as it would mean turning away a LOT of patients.

I have been told that some doctors aren't taking patients without insurance any more -- that it was some sort of trend in the industry -- but this is the first time I've heard about it happen to a real person. It's kind of scary if this is a trend.

:smile2: Congrats on getting the insurance coverage straightened out. I wish mine had the medically necessary clause. Instead they have paid for a heart cath, 3 hospitalizations, stress test, lung scan, 1 er visit, a CT scan & ultrasound of GB and carotid(Sp), CPAP (can't use) nearly monthly visits to heart, lung & kidney drs, plus thousands of dollars for meds in the last 1 1/2 years. All with no real diagnosis. That is not counting 6 days in CCU, heart cath, & 3 echos for congestive heart failure in Oct 06. Payment for WLS, ZERO.:mad: Sorry bout the rant :)

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