I Am Sooo Angry!!!!

[rroswelltx 1]

I'm sorry ya'll this may be rather long winded, but I am so angry! I have been looking at this surgery for over 1 year and when I finally decided to do it in Sept. I was working with a Dr. Fox. They didn't kow if I would have time to get it pushed through my insurance by the end of the year, and since my insurance was going to change to a harder insurance (Aenta) Jan1 2006. So I kinda gave up till next year. Well one day on line I did a BMI calc through the barix Clinic web site. I filled out a form for information on their clinic. They called me, and talked to me at length. I told them the situation with my insurance and they said they believe we can get it pushed through, so I decided to give it a shot. So I had my consultation with the surgion the end of Sept. He KNEW very well that the lap-band was the ONLY surgery I would be interested in. He told me that the Barix clinic had only recently started doing the lap-band several months ago, and I would be a good candidate for it. I explained to him about my insurance situation and he said that would do everything the could do to have it done by year-end. OK so at that time I got excited, I got letter of medical nec. from my PCP, I got the physic eval, I got letter from cardiologist, foot doctor, nutritional eval and all the required stuff. It was turned into insurance last week. I have talked to the patient counselor at the barix clinic on the phone just about every day asking questions, and talking about it getting done before the end of the Year!!! I talked to the insurance company yesterday and they said they would have an answer by end-of day TODAY!!! OK here is the kicker. Last night a nurse called me from the barix clinic because I had some questions about what size band etc. that they use. I was told by her, that they are scheduling their FIRST lapband surgeries for the first week in Jan. I explained to her that wasn't possible that the Dr. and everyone knew I had to have it done my end of year, and she said. Well I don't know why they would have told you that, we have NEVER done a lap-band surgery here, this will be the first one, and the doctor has completed his training but has to have an Inamed rep and another surgerion here to supervise his first ONE!!!! I was floored, they had never told me he hadn't done the surgery before, in fact led me to believe the opposite. She said well he has done thousands of the RNY and GB so this is a peice of cake for him. I told her then I would not be having surgery there, because after Dec., my insurance would change and #2, I didn't want to be the FIRST patient of someone who has never done it. So in closing, I may get my insurance approval today, but it was all for nothing!!! My hopes and dreams are dashed, and I am livid. I hope I explained this well enough, but I was so decieved by this clinic it is UNREAL! Thanks for letting me vent!

[MyKdsDad 1]

Regina, from what I've been able to learn, once you have your insurance company's approval for the surgery, you can go to whatever doctor YOU choose. It's YOUR choice! Get on that phone and call around. Tell them you have your insurance approval and you need this done before the end of the year. I'll bet you will be surprised.

[loopylou 0]

oh honey I'm so sorry!!

[bubblesstina 0]

regina, Call Dr cribbons in Plano. See if they can get you scheduled before the end of the year. There is also a group at Lake Point, I don't know the Dr. names but you can call the hospital ref. line and they can give you the names..

If you alrady have the ins approval you should be able to change surgeons very easily

Call your ins company and ask them how you get the surgeon and facility approval changed and they will be able to walk you through it.

As far as the Bariatix clinic...Now that they have your name and address...you willbe getting stuff from them for years!!! Is it the one in Wylie??

I called them about 4 years ago and asked for some information aboutWLS and have never been into their office but am still getting mailers and have even gotten phone calls from them wanting to know if I had made a decision about the srugery yet....they need to find someone else to call!!

Good luck and let us know what happens

If you need Dr. Cribbons phone # PM me and I will get it to you ASAP

[rroswelltx 1]

Ok well here is an update. I called my insurance this morning, and didn't say anything to them about the situation. I just wanted to see if I had approval yet. They said it was denied. I ask why and they said all that it said was they did a Peer to peer consultation with the doctor and it was determined that the answer was DENIED. I wonder if it was because the doctor told them it couldn't be done till January and of course they won't be my insurance then and they know it!!!! ARGH, so no approval and no doctor. Guess I will start over again nect year on Aetna which I have been told is extremely difficult to get approved through. Thanks ya'll for listening.

[HarleyNana 10]

I was my doctors first, but he had a proctor assist, so I actually got two doctors for the price of one. So, maybe if there's a doctor who's willing and as I understand it, they must have an experienced doctor assist.

I wish you the best, I know how disappointed I'd be.

[Anwyn 0]

I also wouldn't be concerned about being a surgeons first lapband because of the proctor (who is always a very experienced lapbanding surgeon). But the surgeon misleading you about being his first is unforgivable. I'm so sorry - Good luck with your new insurance!

[MerryHearted 20]

I wouldn't worry about the surgery part because of the proctor -- but I'd definitely worry about the aftercare! Especially if it's a center that has been doing all GB until now.

Definitely try to switch to a center that has experience banding aftercare. That's at least, if not more, important than the surgery itself as you will be needing support, fills, and instruction on banding rules/eating. Not to mention a doc who has seen complications in his practice and can recognize the symptoms / get you treatment right away if you run into them.

[ladysplenda 1]

Where is Roswell Texas? I am in East Texas.There is a good doctor in Nacadoches and Texarkana.

[bubblesstina 0]

lady,she is from Royse City which is a small town east of Rockwall. Almost a suburb of Dallas..

[Cheri 0]

Girl, I would be getting my money back from that doctor!!!!! He blatantly lied to you, and if you can prove it, you could have a lot more than just the consultation fees (for your mental anguish and emotional hardship!!) I would seriously talk to him about it, and keep pressing - the amount isn't the issue, it's the principle...how many more hopeful bandsters has he done this to??

I can't believe the lines they will use to get patients - you must be from an area with choices in bariatric surgeons. Where I am from, we have very few in the field, so it is not easy to get in. They don't have time to feed you lines of bull, and I guess they don't need to!!

I am so sorry about this whole situation for you - don't lose hope that you will make it into bandland!!! My insurance didn't cover it either, but we figured the financial hardship now is a better option than any of the foreseeable other options!!!

Good luck with the whole process, and visit anytime you need to vent!!!!

~cheri

[Victoriana 10]

How very disapointing. I'm sad you had to go through all that.If this happened to me I would be questioning the reality of the whole thing, Its alot of work to get to your point. Are you going to speak to this Dr. and ask him why he was leading you on? I believe that it seems that this door has closed since the insurance co denied your request. I guess that it was meant to be this way and I also believe there is a good reason behind it. I bet you are going to have a real blessing in the future getting a Dr. with experience, Good aftercare and the timing might have a better blessing behind it. Dont loose your hope, you will get what you want and with more and more successes with the lap band I believe that more insurance co will jump on the band wagon. I hope your new company will have different guidelines that will pave the way to a successful experience. Keep us posted, and the new year isnt that far away!

[jenny 1]

just want to say how sorry i am you are going through such a problem it's a hard enough decision to make and then face that, is it a fairly common problem there here in oz as long as our bmi is high we don't have a problem.

love your signature victoriana i must try and live by that

[I'llsucceed 1]

I am so sorry your having to start all over:0( But it is always true that things are happening for reasons we do not nor sometimes never understand. God Bless you & I hope your approved quikly w/Aenta

[rroswelltx 1]

Thank you all for your words of encouragement. I did speak to the Dr. directly on friday. He apologized. He said they did intentionaly miss lead me, but thought it would work out by year end. I asked him why it was never stated that HE had never done the surgery before and he really wouldn't give me an answer. I vented on him, and told him I had spent a great deal of money on evals, administration fee's for letters etc. He just apologized. As far as the insurance I knew it would be a long shot anyway, I mean if an insurance company could drag it out for just 2 weeks, they can keep from forking out alot of money. They are such rackets anyway. I made the decision when I started this journey that it was all in God's hands, and if He made it happen it was meant to be, and if He shut the door it just wasn't my time. So I will try again next year, and turn in over to God again. I don't want anything that doesn't have God's hand in it, because if it's only for me, based off what I want, then I'm sure I would pay the price later. Love this board and all my new support friends. Have a great Christmas everyone, and always remember Jesus is the reason for the season!!!