mufasas-mom 170 Posted July 10, 2012 Hello - i'm one visit away (Aug. 1) from having my docs sent for insurance approval and obtaining my surgery date. I am really concerned with True Results as their facility (surgery center, not general offices) is NOT a part of my UHC Bariatric approved surgery centers - nor can my insurance advocate with UHC find them anywhere on her database. True Results keeps telling me that they will bill In Network and all will be fine....but that doesn't sound legal to me. Can anyone shed some light on this for me? i've emailed the 'insurance expert' at TR and placed a read receipt on the email -so I know that she opened it up and read it, but has yet to reply to me. I've also left 2 voicemails for her - I'm getting pretty pissed at this point and am thinking of obtaining my records from them and going elsewhere that i know is covered with my UHC Bariatric program. 1 tflemon67 reacted to this Share this post Link to post Share on other sites
tflemon67 88 Posted July 10, 2012 Is your physician an In-network doctor for UHC? They may bill under the physician and not True Results. Good question though, I'm scheduled to have my band surgery on August 23rd but my hernia repair will be the only thing billed to UHC as my plan excludes weight loss surgery. Companies can choose whether or not to cover and of course my company won't cover it. I better make sure my physician is In-Network, I certainly don't want any Out of Network charges as I'm already going to be responsible for the lap band portion of the surgery. Share this post Link to post Share on other sites
tflemon67 88 Posted July 10, 2012 I just checked and my physician is an In-Network physician for UHC with a totally different address from True Results more than likely they will bill under your physician but definitely have them confirm this with you. You don't want any surprises. Share this post Link to post Share on other sites
mufasas-mom 170 Posted July 10, 2012 Yes, the doctor (Richard Benavides) is in network. So it they bill that way, I guess it makes sense. Just wish they'd confirm it with me....really irritating me. Going to call again.... 1 tflemon67 reacted to this Share this post Link to post Share on other sites
bluetigereyes 95 Posted July 10, 2012 The physician my be in network, but make sure the facility, anesthesiologist, assistant surgeon, etc are in network as well since that is where the highest charges will come from. Share this post Link to post Share on other sites
mufasas-mom 170 Posted July 10, 2012 just spoke w/insurance person and she is getting the info together from the person who actually does the billing and will email me. we shall see.... i did ask what brand of lapband and they use the one made by Allergan - also it's low profile port - and no single incision - still 5 little holes.... 1 tflemon67 reacted to this Share this post Link to post Share on other sites
tflemon67 88 Posted July 10, 2012 I never even thought about the actual brand of LapBand good information to know. I'll also be checking whether or not all the other folk involved in my surgery are In Network!! Share this post Link to post Share on other sites
MandaElaine 20 Posted July 13, 2012 I have UHC and also used Dr. Benavides. As far as them covering your surgery that is correct they will be billing through the dr office so all that is covered BUT and I repeat BUT, for your after surgery care it is not covered and they will not take care of it. They billed my insurance $600 for a FILL which I am now responsible for. I have been fighting with my insurance on this because I was told that everything would be covered. Now they are telling me I need to find a different facility in my network if I want my fills covered. It's a huge mess. Dr. B is a wonderful physician but if you want to save yourself some hassle I would definitely find a dr and facility that is in network. Share this post Link to post Share on other sites
tflemon67 88 Posted July 13, 2012 I have coverage through UHC but my employer excludes weight loss surgery so I'll have my band done via a hernia repair. I'm responsible for the cost of the band which is $5500 and True Results is financing this at $235 per month which includes fills. I wish I had coverage but I'm willing to do this to get healthy. Good luck! Share this post Link to post Share on other sites
MandaElaine 20 Posted July 13, 2012 I have coverage through UHC but my employer excludes weight loss surgery so I'll have my band done via a hernia repair. I'm responsible for the cost of the band which is $5500 and True Results is financing this at $235 per month which includes fills. I wish I had coverage but I'm willing to do this to get healthy. Good luck! That's how my boyfriend had his done as well. He also has UHC and they covered the hernia and not the band. All and all is cost a little over $5500. He paid the $5500 cash that day. He has had a few things trickle in but nothing extreme. Definitely well worth the money. I just now wish I would have paid cash because fighting the insurance, after them saying it was covered has been a hassle. Share this post Link to post Share on other sites
