Recent Posts

Jeannee
on 11/16/07 5:27 am - Wichita, KS
Topic: RE: Help on Insurance rejection

Nope, there were no complications, however I did stay in the hospital overnite because I live in Wichita.  The charges are just outrageous.  For example:

drugs (only one of 25 they submitted!)  charge of $560.75      ins paid $60.05

supplies?!?!?!  get this....3 submitted       $ 579.00     4,023.00     10,211.00   

insurance paid                                                     62.00         430.00       3,369.63

operating room        charge of   $6,594.00      ins paid   706.11

recovery room          charge of    $3,389.00      ins paid  362.91

I don't know why they hike the prices up so high to bill insurance, unless some insurance are willing to pay that much.  Seems crazy to me! 

mjt
on 11/16/07 3:34 am
Topic: RE: Help on Insurance rejection
sorry to stick my nose in as I haven't read all the posts but curious.   Is the total for lap band submitted to insurance?   Was there any complications?    If so,  wow,  what a difference with personal pay.  There has to be something I am missing. sorry if there is. I am self pay and will be having surgery Dec. 3 at Tallgrass in Topeka.  I wasn't sure between Olatha.  It is just closer by about an 1hr.
Jeannee
on 11/16/07 12:14 am - Wichita, KS
Topic: RE: Help on Insurance rejection
I was just on Cigna's website...thought you would find this interesting!!!  The hospital put in their claim for the surgery.  Here are the results!  (does NOT include surgeon...just surgery and hospital charges!) Total claim submitted    $30,914.50 Total paid by Cigna          $5,027.98 My co-pay                              $558.65

Olathemommy
on 11/15/07 11:32 am - Olathe, KS
Topic: RE: Help on Insurance rejection

Thanks Jeannee for the information. That is good info to know. I am scheduled to attend the December Seminar at OMC. I am used to great services at OMC as I've delievered two kids there and have has other outpatient procedures there. I think it will come down on who has the availability I really don't want to wait a year to get banded. I will call Cigna tomorrow and inquire about SMMC. Malley in Mission and the Bariatric facility in Lenexa werent covered- however, I've heard good outcomes from both places.

You're a wealth of knowledge and sound like you're doing great- keep it up!

  Olathemommy  
Jeannee
on 11/15/07 10:30 am - Wichita, KS
Topic: RE: Help on Insurance rejection
Cigan covered my surgery at Shawnee Mission Medical Center.

lizoneil06
on 11/14/07 1:21 pm - Somewhere, KS
Topic: RE: tallgrass and fills
I haven't had any problems getting fills at Tallgrass.  I am self pay 150 for fill w/o fluro...250 with.  The only problem I have had is I had to cancel my fill b/c of bronchitis...they won't fill you if you are sick.  It took me a month out to get back in to see Dr. Stewart.....he is booked.


Olathemommy
on 11/14/07 7:52 am - Olathe, KS
Topic: RE: Help on Insurance rejection
I haven't been submitted yet however I show a great interest in your quest. For insurance reasons, I have chosen Dr. Opie. I am wondering if you spoke to Anthem Blue Cross first for what criteria they are looking for? I have CIGNA and they have been very helpful with the kind of documentation they are looking for. CIGNA won't cover another Surgery Center in Lenexa or Mission but will at OMC. I meet the BMI/Weight cir****tances but arent sure about the rest.  I wanted to attend Dr. Opie's November Seminar but it was full. I am scheduled to attend December seminar and will proceed after that. Did your letter state why you were denied? Do you know what documentation Dr. Opie's office submitted? I'm am sorry that you got that letter. I'm just trying to determine if its what was provided, the facility, or the insurance company in general? I hope you don't give up. I have heard rejections to be fairly common. Please keep in touch and I wish you all the best. I am eager to follow your journey!
  Olathemommy  
Wiseman
on 11/14/07 5:38 am - Wichita, KS
Topic: RE: WLS cut from Recommendation List!
Chad, I am not surprised it got dropped. I think that the KHPA is more interested in coming up with some form of universal health plan. Somehow we need to convince the insurance carriers that it is in thier best interest to cover WLS. They have to think it will benefit them and that it is profitable. And it is. WLS has been shown to reverse type 2 diabetes. If the insurance companies don't see it as saving them 100's of thousands of dollars it will not get covered.  I hope you can find a path to WLS. Good luck and thanks for all the work you put into it.

Life is a journey, don't waste the trip.

Mike Wise

300.6/188.2/178

RNY/11/08/05

RoxyRAJ
on 11/13/07 2:10 pm - Olathe, KS
Topic: Help on Insurance rejection
I have been rejected by Anthem Blue Cross (1st Letter) and am wondering about any suggestions anyone has for me regarding what to do next???????????
J R
on 11/12/07 10:15 am
Topic: NEW on OH?Weight Tracker!

We’re always thinking up new ways to make your experience on ObesityHelp.com the best it can be, so we’re pleased to announce that the latest of the great tools we offer is launching now! Meet the new Weight Tracker, a simple-to-use tool that will allow you to see your weight and BMI changes over time in an easy-to-read graph.   

Weight Tracker is not just for people who are currently losing weight; it’s also a great tool for those of us who are trying to maintain a healthy weight. It’s easy for a pound (or five or fifteen) to creep back on. Weight Tracker will help you see those subtle changes happen so you can know when you may need to renew your efforts to get back on track!   

It’s fun and easy to share … and you can choose your level of privacy. We’ve even created a “widget” that allows you to post your results on your blog or other Websites with just a simple copy and paste! Click on over and give it a try!
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