help in East Texas

hersheymalone · September 2, 2008

I was denied by UHC last week. My BMI is 38.7 w/ no comorbidities. The doctor I saw in Tyler, Dr. Babineau, said they cannot help me. I must go to my regualr doctor and "find" some comorbidities. I don't have a doctor b/c I don't complain about things! I have pitting endema, a severe weak bladder, back and knee pains..... none of this documented and no doctor to go to. Does anyone have any recommendations or suggestions on a new doctor. During my initial consult, the insurance lady said they would fight to get you approved. I was shocked at how she just blew me off and told me they couldn't do anything. HELP!!!!!

jrg1979 · September 2, 2008

I would suggest you go to Dallas. I live half way between Tyler and Dallas and find that Dallas doctors always seem to work better for me, no matter what the issue. It always seems to me that Tyler doctors are "behind times". I used Dr. Wade Barker in Dallas. I was a cash pay, so I cannot say how they are with insurance approval, but i really like Dr. Barker and his staff. I have a friend that used Dr. Benavides in Dallas as well. Keep looking. Surely you'll find the Dr. that is right for you. If the dr. you are seeing is not willing to help you now - run. You definatley want a Dr. that is willing to work with you should any problems occur.

Texasgirl1966 · September 2, 2008

I was also told by my insurance that anything under a 40.0 BMI is not a candidate for lap band. I was a 39.8 at the time. I later found out that I wasn't quite as tall as I thought, so that pushed my BMI to 40.2! I did develop high blood pressure and that only added to my need for lap band surgery. I have my first appointment with the surgeon and nurse on 09/09/08. Psych consult on 09/12/08. Good luck to you.

kyakdreamer · September 2, 2008

I had my surgery in Mexico and am using Dr. Babineau for my fill doctor. I was in the same boat you were as far as not having a regular doctor so I had nothing on file for the past 3 years. My insurance co. would not cover the surgery even if I did have problems. If you are in Tyler there is a great dr. in Lindale. He was my doctor here in Palestine for a long time. He is Great! His name is Russell Bell. He is with the Trinity Mother Frances clinic in Lindale. It is to far to go for colds and such. I found a dr. this past week in Jacksonville that I think I am really going to like.

Also, I started to go with Dr. Barker. I had heard some good things about him. I had a problem getting ahold of anyone at his office. I kept getting the answering machine. In the mean time I was contacted by someone I had sent some info to and things just flowed real smooth and I ended up going to Mexico. I have no regrets and had a great experience. I pd. 7,000 so if Dr. Barker is doing it for 9,500 that is a good deal.

Good Luck!

hersheymalone · September 2, 2008

my insurance will cover it, if.... your bmi is 40+... Babineau said they will not submit an appeal and she acted as if she didn't want to help me. I just needed guidance. They also said if you gain the weight they will not resubmit your papers. Looks as if I need to find a new surgeon. Just don't know who to use around the Longview area.