Recent Posts

Newme.1
on 6/14/11 5:34 am
Topic: Anyone!
Had my surgery, went great, doing great.  I also had hernia repair and gallbladder removed at same time and since those surgeries pay different the hospital lumped my total hospital bill under weight loss surgery only so paying every surgery as a weight loss surgery.  Has anyone else had this?  This is costing me about 10,000 dollars more the way they have this coded.  Hospital states they cannot itemize services and has to go under primary dx even though I knew and planned on having the other 2 surgeries at same time.  ( My insurance only pays 60% of WLS and no out of pocket max and does not apply to deductible.)  Any help with this would be greatly appreciated.  I already called insurance , hospital and surgeon office and the said this is the way its done.  
    
Shelly S.
on 6/13/11 8:31 am - Stillwater, OK
VSG on 12/13/12
Topic: RE: The Sleeve and Medicare
Medicare approved my LapBand surgery with no problem. Don't know about the sleeve, when I had my surgery in '08 Medicare only covered Lapband and RNY.

Shelly

 

    

    
Diminishing Dawn
on 6/11/11 10:28 pm - Windsor, Canada
Topic: RE: Ontario Health Insurance Plan
You should get a call fro
The centre within a few months generally and start the process. Message me anytime for more info and visit the ontario board on ohh

17+ years post op RNY. first year blog here or My LongTimer blog. Tummy Tuck Dr. Matic 2014 -Ohip funded panni Windsor WLS support group.message me anytime!
HW:290 LW:139 RW: 167 CW: 139

ladyjae
on 6/10/11 2:18 am
Topic: RE: United health care choice plus???
I used UHC-It paid for everything-This was in 2005, tho, & I did hear recently they were getting picky about coverage-Definitely let the dr insurance person help-Mine was wonderful-Hope this helps-Jae
ima_ford_gurl
on 6/8/11 12:39 pm
Topic: United health care choice plus???
THIS QUESTION IS FOR A FRIEND ANY ADVICE WOULD BE APPRECIATED!!! She sent this to me thats why its written the way it is!

I have united health care choice plus. I called them the other day and to ask if they covered WLS and they told me no, but on here Ive read several people being approved with UHC choice plus. I know other people who have UHC and it always seemed we had the better policy compared to my friends. I am wondering if there would be a better chance of them covering it if the doctors office called the insurance company? I have several medical things caused by obesity. Just looking for some advice.
Thanks
Eliza55
on 6/8/11 9:56 am - PA
Topic: RE: Cash Pay
Hi Nan
Thank you for the reply.  Of course, I called customer service, and they referred me to the published information.  While I'm doing the 3 month diet etc, my doc is having me go to the cardiologist etc in advance of submitting, just to make sure I don't have anything going on that my PCP wasn't aware of.  My PCP is very good, so I don't think they'll find any thing.
Thanks
Eliza
Eliza
Consult:239   SW:217  1mo:195  2mo:182  3mo:169   6mo:139  9mo GOAL CW: +2 from underweight
  
Samantha.M
on 6/8/11 3:48 am - Germany
Topic: RE: TRICARE for DS?
Hi there, If you haven't already I would think the best thing to do is to call Tricare and see what they say. 

I'm starting the process to get the RNY done myself and I know here at campbell they only do the band and RNY. 

If I remember right though during the class she said something about possibly getting different surgerys off post but then you have to deal with the insureance your self and co-pays. 

Hopefully someone else comes along and can help you out a little better than I. 
Proud army wife and mom of 2 ♥       
clberry05
on 6/7/11 11:26 pm - MI
Topic: Insurance Denied Me!!! Please help with any suggestions!!!

Hello,

I have HAP insurance through my husband’s job and I have been trying to get approved for surgery for at least 6 months.  In that time I have gotten three different denial letters for this procedure.  First time it was because I didn’t have enough information for them to review, so I sent them the information they were asking for!  The second time is because they wanted my records from a doctor that I had been seeing in this weight loss program for over a year, I sent them that information!  Now, this third time was because the doctor that I saw for over a year, they said that he “was not a hospital affiliated doctor."  I have appealed three times and I don’t know what else to do or where to turn too!!!  Is there anyone out there that can give any advice on what steps to take to get this approved!!  I am in tears writing this letter and need help desperately!!! I will try anything!!!

Thanks,

Carol


(deactivated member)
on 6/7/11 6:04 am - TX
Topic: TRICARE for DS?
Finally made the decision to revise my band into a DS only to find out that tricare will NOT cover it?  I have tried to dig around on here and been told by other posters that a few have been successful with a DS at a military facility.  If any of you are here can you please chime in?

thanks
Kristi
Nan2008
on 6/6/11 9:53 pm - Midland, MI
Topic: RE: Cash Pay

Hi,

It sounds like you will be denied, unfortunately, because Aetna is very specific about meeting those requirements in order for them to approve the surgery.  I have Aetna and myself and my three children were all approved, although we all had BMI's of well over 40 so we did not have to prove the specified co-morbidies. 

I am sorry I don't know the answer to your questions, but I would be very curious as to the answer!  Have you tried calling their Customer Service and asking?

Good Luck to you!
Nan

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
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