MEDICAID AND MEDICARE SURGEONS LIST!

Member Services
on 8/31/12 8:45 pm - Irvine, CA
Hello Members,

On a daily basis we get calls from members in desperate need of surgeons that will accept Medicaid and or Medicare for Bariatric surgery.  It breaks our hearts when we have to say "we don't know of any surgeons in your state we can refer you to". 

Can you please help us? If you know of any surgeons in your state that accepts Medicaid and or Medicare, will you list their:

Name

If they accept Medicare and or Medcaid

Phone number

Facility

Address

This list will remain here for our members to access and use.

Thank you so much!!!

ObesityHelp,

Member Services

Check out the videos of Graham's first ever "Fireside Chat" interview. 

 

 

~~Theresa Marie~~
on 2/3/08 4:22 pm - Closing in on SkinnyVille, VA
Commonwealth Surgeons in Richmond, VA takes Medicare & I think they accept Medicaid as well.  I am not sure how the Medicaid works as it is my secondary insurance but I do have Medicare and as stated in a previous post, they do not do pre-authorizations.  They require ABN's to be signed acknowledging that you will be responisble if Medicare doesn't cover.  The surgeons office will submit for payment after the surgery and then Medicare will decide.  It sucks to do it this way but...  That is the government.  LOL!  I am sure that this is how Medicare works with any surgeon that takes those insurances. If you want to contact that office, their number is 804-285-3225.  Hilary Surrat is their Bariatric Surgical Coordinator and I am sure she will be able to answer all your questions.
Melissa1977
on 1/8/10 7:39 pm - Christiansburg, VA
The information that you listed, is it for the actual Gastic surgery or is it for plastic surgery? I have medicare and would really like to find a doctor that will take the medicare as a way to remove the extra skin.
RJSu
on 2/15/08 7:16 pm, edited 2/16/08 7:31 pm

Would like some guidance. I am a Tricare Prime beneficiary. Received referral to local Gastric banding surgeon and Doctor said I was well qualified and needed weight loss surgery (Lab Band -my preference). He said we could be in Surgery in late March/early April.   His office Insurance Coordinator then stated as a Tricare Prime patient, TRICARE required all weight loss surgeries to complete: Psych eval Nutritionists eval Blood and Thyroid tests Show proof of attending a six-month weight loss program within past three-five years (this was a show stopper and meant no surgery until did six month program.  Sept surgery?). My question is does Tricare really require the six month program? RJSu

~~Theresa Marie~~
on 2/17/08 9:36 pm - Closing in on SkinnyVille, VA
It could be true.  I know alot of insurances require some sort of attempts at other weight loss programs or diets.  My insurance required a 6 month pcp monitored diet and weight checks.  I started that just as soon as I contacted my surgeon since I knew it would take 6 months.  Best thing to do is call your insurance company and ask what they require. **Theresa**
(deactivated member)
on 12/18/08 9:27 am, edited 12/18/08 9:28 am
RJSu....
From what I have heard on all the forums and I have talked to SEVERAL TRICARE reps and ...they all tell me NO...they dont require the 6 month program...but you need to get Tricare to send you something in writing stating that...Diff. Tricare reps say diff things tho..I havent gotten as far in the game as you are tho..
spittman
on 5/4/09 12:40 pm - Reston, VA
VSG on 06/29/09 with
Hello RJSu

Yes they do. I have Tricare Prime. If you call the tricare 800 number, the rep will tell you no or no one from a doctors office has called to verify. Once you speak to a surgeon's office that  accepts Tricare they will send you to their rep. Here they will tell you six months doctor documented weight loss program. They do not accept weigh****cher, Jenny Craig, Nutri System.... it has to be with a Nutritionist ooh you must be 100 pounds over weight. I am 90 pounds with 3 comorbidities and they will not allow me to get the surgery, I have to gain 10 pounds then be in a program to loose those 10 probably silly but that is the way they do it.

Hopes this helps

S.
          As of 12/10/10 CW: 150 pounds Lost: 52 
        
DElliottMD
on 4/9/10 12:54 pm
No, Tricare Prime (& standard) do not currently require a 6-month diet.

I am a bariatric surgeon practicing in Richmond performing both Gastric Bypass & Gastric Banding and have numerous Tricare patients approved for surgery without this requirement. 

Because of your message, however, it did raise my concern that they had changed their requirements, so I had my office's surgery  coordinator check with Tricare today, and the 6-month diet is still NOT required.  They do, however still require Psychology & Dietitian evaluations, as well certain labwork (TSH, H.pylori) and an EKG; sometimes cardiology & pulmonary consults are necessary, depending on the patient's health condition.

As a Tricare member myself, I wanted to set the record straight!
Thanks.
David Elliott, MD, FACS, FASMBS
Colonel(R), US Army
Bariatric Surgeon & Bariatric Medical Director
Richmond Surgical Specialists
Parham Doctors' Hospital
(804) 545-4925
www.richmondsurgicalspecialists.com/weight-loss-surgery.htm


PS We also take most Medicaid bariatric patients, but currently not Medicare patients.
bela87
on 5/12/10 10:10 pm - Fort Richardson, AK
 im also tricare prime beneficiary and i was wondering if you could tell me who your surgeon was if you already got the surgery. im stationed in alaska but wanting to get the surgery done in virginia. I dont know if you already got your surgery but im not requried to prove that i did a weight loss program, but then again a referral hasnt been put through for the surgery yet. 
April B.
on 2/22/08 6:17 am - Dumfries, VA
RNY on 01/29/08 with
If you live in the northern Va area and have Anthems Health Keepers Plus  It is the secondary Medicaid  ,  Call Dr Moazzez  703620-3211   He is located at Fair Oaks hospital in Fairfax VA. They take it and do everything to get you approved and then go a step futher to make sure they can get all your appointment for testing and classes on days that are together.  Granted you might be at the hospital all day but it bets going 10 diffent times on 10 different days.  You do have to pay a 200 registration fee but they allow you to do it in payments.   Good luck and I hope this helps
lce27
on 7/9/09 8:27 am - Woodbridge, VA
Dr. Moazzez no longer takes Anthem Health Keepers Plus. The only people are in Richimond and Warrington. Hope this helps
mrsnicolebrown
on 8/24/09 12:27 pm - dumfries, VA
Do you know where in Warrenton? I have medicaid and I really dont want to travel to Richmond. Thank you!
sunsheyen
on 2/28/08 10:57 am, edited 2/28/08 11:13 am
Jennifer C.
on 4/8/08 9:59 pm - virginia beach, VA
Dr Yancey in Chesapeake, VA takes medicaid.  He is very friendly and patient oriented.  He even spent time playing with my daughter last time I was in the office,  their phone number is 757-420-5710
 
Mike George
on 5/1/08 3:57 am - VA
Commonwealth Surgeons St. Mary's Hospital 5855 Bremo Road, Richmond, VA 23226 804-285-3225
MssWho Me
on 5/8/08 5:07 am - Powhatan, VA
I went to the seminar last night to see Dr Hutcher at commonwealth surgeons I am on medicare myself and I was told they accept medicare but as other have already stated you have to go to your pcp and have a 6 mth records of attempted weight loss records Also you have to have a medical condition in addition to a BMI over 40 It makes me nervous that you can't  be pre approved I was told this is only in Va that it is so tough because of TrailBlazer Health Enterprises, LLC http://www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=23967&lcd_version=14&show=all this is their info from their site,,hopes it helps someone. Surgical treatment for primary obesity is not a covered Medicare service. CMS national policy dictates that surgery for morbid obesity is covered for Medicare beneficiaries who have all of the following: - A Body Mass Index (BMI) ≥35.
- At least one comorbidity related to obesity.
- Have been previously unsuccessful with medical treatment for obesity. (thats 6 months of pcp records) Comorbid Conditions Severe obesity is known to aggravate numerous medical conditions. Comorbid conditions for which bariatric surgery is covered include the following: - Type II diabetes mellitus (by American Diabetes Association diagnostic criteria). - Refractory hypertension (defined as blood pressure of 140 mmHg systolic and/or 90 mmHg diastolic despite medical treatment with maximal doses of three antihypertensive medications). - Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications). - Obesity induced cardiomyopathy. - Clinically significant obstructive sleep apnea. - Obesity related hypoventilation. - Severe arthropathy of spine and/or weight-bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for the obesity). - Hepatic steatosis without evidence of active inflammation. Though the conditions listed above need not be immediately life-threatening for Medicare to cover bariatric surgery, the condition must not be trivial or easily controlled with non-invasive means (such as medication) and must be of sufficient severity as to pose considerable short- or long-term risk to survival. Consideration of the risk-benefit for each individual patient must be used to determine that surgery for obesity is the best option for treatment for that patient and no contraindications to bariatric surgery may exist. Hope this helps
FutureWeightlossDiva
on 6/15/08 5:08 pm
I am on Medicaid, and I am going to Virginia Commonwealth University Obesity Surgery Center. They accept Medicaid AS WELL AS all other insurance. Thats what they said. Here's the info: James W. Maher M.D. MCV 980518 Richmond, VA 23298-0519 Phone: (804) 828-8000
lsmith2004
on 5/10/09 5:04 pm - Tomball, TX

Hey Everyone I did some research from a previous post ............
University of Virgina Health System....is located 1215 Lee Street
Charlottesville, VA 22908
Tel: 1-434-924-0211


Make an Appointment

  • Use our online link to Find a Doctor OR
  • Call 1-800-251-3627 or locally: 434-924-DOCS (3627)


  • Make an Appointment
Find a Doctor

Find a Doctor

call 434-924-3627
1-800-251-3627
Insurance Plan Participation 

To better serve the health care needs of our community and beyond, the UVa Medical Center and its doctors, who are managed by UVa Health Services Foundation (HSF), participate in most major insurance plans. These plans include, but are not limited to:

  • Insurance Participation at UVaAnthem Blue Cross & Blue Shield (formerly Trigon) – indemnity & PPO products
  • Southern Health Services, Inc.
  • CIGNA Healthcare of Virginia
  • MAMSI
  • Aetna – indemnity and PPO products
  • United Healthcare
  • First Health 
  • Virginia Health Network
  • Multiplan
  • Optima Family Care - FAMIS/Medallion II
  • Virginia Premier – FAMIS/Medallion II
  • Community Health by Optima – various employer groups
  • Piedmont Community Health Plan
  • Medicare
  • Medicaid
Justin Parsons
on 8/28/09 4:51 pm - Charlottesville, VA
On May 10, 2009 at 5:04 PM Pacific Time, LASHAN S. wrote:

Hey Everyone I did some research from a previous post ............
University of Virgina Health System....is located 1215 Lee Street
Charlottesville, VA 22908
Tel: 1-434-924-0211


Make an Appointment

  • Use our online link to Find a Doctor OR
  • Call 1-800-251-3627 or locally: 434-924-DOCS (3627)


  • Make an Appointment
Find a Doctor

Find a Doctor

call 434-924-3627
1-800-251-3627
Insurance Plan Participation 

To better serve the health care needs of our community and beyond, the UVa Medical Center and its doctors, who are managed by UVa Health Services Foundation (HSF), participate in most major insurance plans. These plans include, but are not limited to:

  • Insurance Participation at UVaAnthem Blue Cross & Blue Shield (formerly Trigon) – indemnity & PPO products
  • Southern Health Services, Inc.
  • CIGNA Healthcare of Virginia
  • MAMSI
  • Aetna – indemnity and PPO products
  • United Healthcare
  • First Health 
  • Virginia Health Network
  • Multiplan
  • Optima Family Care - FAMIS/Medallion II
  • Virginia Premier – FAMIS/Medallion II
  • Community Health by Optima – various employer groups
  • Piedmont Community Health Plan
  • Medicare
  • Medicaid
 I had mine here at UVa Medical center on Medicare. My surgeon was Schirmer, Bruce D., M.D.
LUVNMYBABYS
on 8/22/09 10:22 pm - Richmond, VA
I just received my paperwork to fill out for the first visit.  But it wants a copy of my Anthem Healthkeepers booklet that says it will cover my surgery.  I can't find it anywhere can someone please help me!!