Coventry POS

[samnic 0]

has anyone dealt with coventry POS of md or de , trying to start the lap band process, went for consultation and have a bmi of 40 with co morbidity of joint problems, has anyone had any experience with them ? If so did you get approval

[Jonna 4]

Hi there! I have Coventry and have been approved for my surgery. I will tell you though, I found a loop hole luckily with mine. I live in Delaware, but work in Maryland. Delaware does not cover it unless your policy is different than mine. However, because I work in Maryland and there was a law past in July 09 that says all Maryland Ins companies MUST cover the surgery. That was my loop hole and I thank God when I found out. I've had to go through 6 months worth of Nutritional classes (the first visit was one on one with Nutritionist and the last one will count with the Surgeon) so basically you only go 4 months. I also have to get clearance from the Physc, Heart and Lung doctors. I only have the Lung doctor to go to on March 31st. I'm having my surgery done in Milford by Dr. Brebbia. Best of luck to you!

[samnic 0]

Hi there! I have Coventry and have been approved for my surgery. I will tell you though, I found a loop hole luckily with mine. I live in Delaware, but work in Maryland. Delaware does not cover it unless your policy is different than mine. However, because I work in Maryland and there was a law past in July 09 that says all Maryland Ins companies MUST cover the surgery. That was my loop hole and I thank God when I found out. I've had to go through 6 months worth of Nutritional classes (the first visit was one on one with Nutritionist and the last one will count with the Surgeon) so basically you only go 4 months. I also have to get clearance from the Physc, Heart and Lung doctors. I only have the Lung doctor to go to on March 31st. I'm having my surgery done in Milford by Dr. Brebbia. Best of luck to you!

[samnic 0]

Hi there! I have Coventry and have been approved for my surgery. I will tell you though, I found a loop hole luckily with mine. I live in Delaware, but work in Maryland. Delaware does not cover it unless your policy is different than mine. However, because I work in Maryland and there was a law past in July 09 that says all Maryland Ins companies MUST cover the surgery. That was my loop hole and I thank God when I found out. I've had to go through 6 months worth of Nutritional classes (the first visit was one on one with Nutritionist and the last one will count with the Surgeon) so basically you only go 4 months. I also have to get clearance from the Physc, Heart and Lung doctors. I only have the Lung doctor to go to on March 31st. I'm having my surgery done in Milford by Dr. Brebbia. Best of luck to you!

Thanks for the response. I am so anxious about this whole thing. I have found out that thru my plan from coventry my employer does cover bariatric surgery. I m just afraid that just my luck they will find some clause that keeps my surgery from getting approved. Are there any questions that I should possibly ask of the insurance co. Where did you find out the info about the law passed in 2009? I actually work in milford hospital. I didn't know Dr brebbia did bariatric surgery. How long did it take for them to approve your procedure and how did you find out that you had to complete a nutrition program. I wish you the best of luck. I would love to get an update on how you are doing post surgery. Thanks again

[Jonna 4]

The rep for Coventry is the one that told me about the law that was past in Jul 2009. Again, that was for the state of Maryland. As far as I know, Delaware still does not cover the surgery. However, Coventry did tell me to keep checking back because they are always changing. Yes, Dr. Brebbia has been doing this for at least a couple years now, from what I'm told. Elsa is the ladies name that works with Dr. Brebbia and is always available for any questions. She is just wonderful and can help you with any questions you may have. She is in between the Milford and Dover offices, their number is 302-674-0600. She is very good at getting back to you within a couple days. I am going to add you as a friend so that we can keep up with each other. Let me know if you have any more questions. I can use a buddy through this process. Best of luck to you and I hope you can find all the answers you're looking for.

Thanks for the response. I am so anxious about this whole thing. I have found out that thru my plan from coventry my employer does cover bariatric surgery. I m just afraid that just my luck they will find some clause that keeps my surgery from getting approved. Are there any questions that I should possibly ask of the insurance co. Where did you find out the info about the law passed in 2009? I actually work in milford hospital. I didn't know Dr brebbia did bariatric surgery. How long did it take for them to approve your procedure and how did you find out that you had to complete a nutrition program. I wish you the best of luck. I would love to get an update on how you are doing post surgery. Thanks again

[samnic 0]

I am excited for you and I would love to be your buddy. I still havent heard anything yet. The way it was explained to me by a Coventry rep is that bariatric surgery is covered and that depends on your employer group whether they include it in your coverage. The bariatric coordinator had explained to me that I have a special situation, in which my insurance covers but the facility that I will have the surgery at has a contract with coventry at the delaware surgery center in dover but they may not include bariatric sx in that contract so she has to contact delaware sx center in dover and speak with the person who handles the insurance contracts and find out whether coventry covers procedures done there. Im biting my nails still. I need to do something about this weight. This is the largest I have ever been and its killing me. I am a RN so Im pretty much always on my feet, my feet and knee are killing me. Im just waiting (cant really say patiently) until I hear something back. I am glad you have gotten through this process. I cant wait to hear how everything goes for you.

[Jonna 4]

Have you thought about having it in Milford? Dr. Brebbia does it at both locations. I do know that Milford has to acquire "Center of Excellence" before i have it done. I was told he is very close at getting that and shouldn't be a problem by April or May.

I am excited for you and I would love to be your buddy. I still havent heard anything yet. The way it was explained to me by a Coventry rep is that bariatric surgery is covered and that depends on your employer group whether they include it in your coverage. The bariatric coordinator had explained to me that I have a special situation, in which my insurance covers but the facility that I will have the surgery at has a contract with coventry at the delaware surgery center in dover but they may not include bariatric sx in that contract so she has to contact delaware sx center in dover and speak with the person who handles the insurance contracts and find out whether coventry covers procedures done there. Im biting my nails still. I need to do something about this weight. This is the largest I have ever been and its killing me. I am a RN so Im pretty much always on my feet, my feet and knee are killing me. Im just waiting (cant really say patiently) until I hear something back. I am glad you have gotten through this process. I cant wait to hear how everything goes for you.

[samnic 0]

I would like to continue where I am but trust me I will definitely think about it. I am still trying to figure this process out. How long til the doctor submitted your claim for surgery? How long was it when u heard anything back from coventry? The physicians office told me that i need to go to the clearance appts before they can submit anything . Is that true? Sounds backwards. How r things going with you? So u said u have to wait now until it is a center of excellence? What's up with that?

[Jonna 4]

I called my insurance company just to make sure they would cover it, then the doctors office called them and told me exactly what the steps were I had to take. Yes, once I have all the clearances they will submit everything to get final approval from Coventry. Its just the process they take, to ensure all the doctors say you are a candidate for the surgery and are healthy enough to handle it. Apparently, even Medicare requires the facilities to be a "Center of Excellence" and so does Coventry. It just means they've done a certain number of surgeries to acquire that title.

I will tell you that I started this process back in late October and as you can see I'm still going through it, so if this is something you really think you want to do I would consider starting it now. Have you been to a seminar yet?

I would like to continue where I am but trust me I will definitely think about it. I am still trying to figure this process out. How long til the doctor submitted your claim for surgery? How long was it when u heard anything back from coventry? The physicians office told me that i need to go to the clearance appts before they can submit anything . Is that true? Sounds backwards. How r things going with you? So u said u have to wait now until it is a center of excellence? What's up with that?