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Horizon BCBS of NJ nutritionist and physiological part before getting the lap band

The one question I have is about my insurance

I have Horizon BCBS of NJ. I wanted to meet with a few Dr.'s before making my choice on a Dr.

Two of the dr. I have went to say I need to pay them 1700.00 or 1800.00 up front for the nutritionist and physiological part for me to get my surgery. This last one I went to says my insurance co will not pay for a surgical assistant so I will have to pay them 500.00 ontop of the 1700.00. Then the nutritionist that I have seen only once is the Dr.s Niece. They don't seem very professional at all. I called my insurance co and they didn't know what they were talking about when they said surgical assistant. Has anyone ever heard of having to do this??

Thanks

Raf

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The one question I have is about my insurance

I have Horizon BCBS of NJ. I wanted to meet with a few Dr.'s before making my choice on a Dr.

Two of the dr. I have went to say I need to pay them 1700.00 or 1800.00 up front for the nutritionist and physiological part for me to get my surgery. This last one I went to says my insurance co will not pay for a surgical assistant so I will have to pay them 500.00 ontop of the 1700.00. Then the nutritionist that I have seen only once is the Dr.s Niece. They don't seem very professional at all. I called my insurance co and they didn't know what they were talking about when they said surgical assistant. Has anyone ever heard of having to do this??

Thanks

Raf

I have Horizon also - I don't know where you are or who you saw but I saw Dr. Kipnis and he's part of a group of Drs. who require to join Ait Smart or New Beginnings at Virtua. I tdoes cost $1700 but it goes to the program and can be paid out over a year. I never heard of anyone discussing a surgical assistant. The New Beginnings program has a nutritionist and support groups etc. and Horizon requires you to be part of a medically provided weight loss group for 6 months before they will approve the surgery. Dr. Kipnis is in the cherry Hill area. If you are around there call the office and they will inform you of a seminar discussing all of this and the Drs. involved. I checked out Dr. Kipnis and Dr. Ing. Did not like Dr. Ing at all and really liked Dr. Kipnis. Good luck!

  • Author

I just wanted to make sure because there were a few other people that had it done and it was not like that for them. I actually know about the new beginnings program at Virtua. I went to Dr. Goldstein first he out of voorhees and I really really like him. But I just wanted to go see different dr.'s to see if I had the right one for me. This last one I went to wasn't as good as Dr. Goldstein. I have another appt. with a dr. out of stratford and then after that I am going to decide what dr. to go with. I am really thinking it may be Dr. Goldstein. Thank you for your responce.

So when did you start everything? and do you have to wait the 6 months before you get your surgery?

Thanks

Raf

I just started. I called Dr. Goldstein's office and went to their seminar. I was pretty set on him too but then I read some blogs and people were complaining about his office getting back to you and his availablity since he's so busy so my mom called his office for an appointment and they said they would get back to me that afternoon - that was 3 weeks ago. So I called Dr. Kipnis and after interviewing other Drs. I went to see Dr. Kipnis and was totally blown away at the difference in interviews. I walked out of there with my mom and we both had huge smiles and I felt really comfortable. I have a bad back and am possibly looking at surgery but he said I should try and hold off since we both think the weight issue will help my back. I need to lose about 150-170 lbs. He never gave me a number but that's my goal - right now I'm at 410 and I'm 6'4" and I'd like to be around 240. Someone also said that they have Horizon and they don't budge from that 6 month rule -so I guess I'm stuck.

Raf

I didnt have to pay anything up front to my doctor except for my copay. I went to a nutritionist and psychologist that I picked because the ones that they recommened did not take my insurance and I would have had to pay abot $250 each for the visits. I got a list of nutristionists from the online doctors listing for BCBS and called a few to find out if they deal with bariatric patients. I only had to pay my copay for the nutritionist and I dont remember even paying that for the psychologist. My surgeon was fine with this and I had no problems when it came to getting my insurance approval.

I was banded by Dr Bertha of Advanced Laproscopic Surgeons in Florham Park. They perform surgery out of a few different hospitals - St clares, Morristown and St Peter's. I went to 3 different seminars before I found a surgeon that I felt good about putting my life and future in their hands.

  • Author

Thank you very much for your replies.

I think I will look into doing the nutritionist & physiological part myself also.

Thanks,

Raf

I have Horizon BC/BS of NJ. I'm getting banded on 8/1 by Dr. Ewing from Hackensack Hospital. LOVE HIM!!! I used the Nutritionist they recommended (much easier that way) and she cost $100. I went for a Psych eval from a Psychiatrist and that cost $30.60 (after being submitted to ins). The surgery will be fully covered once it's approved, which hopefully be in the next few weeks. Please look into Lap-Band Associates in Hackensack, NJ. They are wonderful! They are a practice with 3 great doctors. Let me know how you make out!! Good luck!

  • 1 month later...

Tracey, I just found this site! Please tell me about your surgery and how you're doing. I'm having the lap-band on Nov 6th by Dr. Ewing!!

Hi Nan! I had the surgery on Aug 1st with Dr. Ewing...I LOVE HIM! He did a great job and I'm feeling wonderful! I'm almost down 13 lbs and I'm thrilled. If you want to know anything else, PM me. Good Luck!! :biggrin:

How long did you have to wait before becoming approved? Was it the full 6 months that I've heard about from Horizon?

aronson - I had my first visit with my surgeon on Oct 19th and my paper work was submitted a few days later and I found out I was approved about 4 days later.

And you didn't have to wait 6 months for approval? I was told that Horizon made you go through 6 months of weight loss preparation before they would approve you. I would love to get approved sooner - I have a bad back and am in constant pain and am hoping that the surgery will allow me to lose the weight and relieve the pressure on my back before I need back surgery.

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