Dr. in Houston - Accepts UHC for fills

[Terez 0]

I was banded February 15th, 2006 by Dr. Spiegel in Houston. Because of some recent incidents that have occured, as of June 1st UHC will drop him from their plan. My question is....Should I check with my insurance company and see what other Doctors are in the network? And if I find one, will that doctor give me my fills if he didn't perform the surgery? I've been told that if that doctor didn't do your surgery, they will not fill your band. Is that a crock? From everything I have read, it seems to be...

[SusanP 0]

Hi Terez,

I am in the same situation that you are in. I called UHC and got a gap exception from Care Coordination. I told them that in the documents I signed for Dr. Spiegel, it states that I must see him for follow up appointments and he won't be held liable for any problems if I go to another doctor. They gave me a gap exception that will allow me to go to him until Dec 06 and just pay my deductible. That at least gives me some time to find a new doctor. Let's hope we get some good recommendations from our Houston area bandsters! You can email me at sphillips@matagordaisd.org if you have more questions or find a doctor!!! I just hate having to leave Dr. Spiegel.

Susan

[Terez 0]

Thanks Susan for the information. I called Spiegel's office to up my "Fill" date and she told me to bring $100. Is this what the insurance does not pay for? I was a little confused....

[Terez 0]

yes, I'm with you too, I hate to have to leave him and find someone else especially when I signed the same documents as you. When I go see him on the 17th I'm going to find out as much information as I can....I'll keep you posted

[SusanP 0]

I don't think the $100.00 thing is correct. UHC's contract with him isn't effective until June 1st. You should only pay the deductible on your card. I have done some research and found a couple of doctors that have good reviews...

My favorite: Garth Davis M.D. at 713-528-0597 He is also the Medical Director for The Weight Loss Program at Methodist Hospital

Dr. Carlos Ferrari (had a friend use him for bypass and she loves him)

713-864-5487

Dr. Adam Naaman at 713-468-2449 He's done over 1100 Lap Bands and is a surgeon who has been involved in the development of new laparoscopic equipment.

When's your appointment? I might try and get one on the same day so we can meet!!! Susan Phillips

[SusanP 0]

I meant what time is your appointment on the 17th? Goofy me, Susan

[Terez 0]

I'm familiar with Dr. Namann, my friend used him for Gastric Bypass and really likes him allot. I'd love to meet you too!! My appointment is at 5:00 Wedensday, May 17th. Yeah, the girl told me bring $100 - Huh??

[SusanP 0]

I just left a message with Elizabeth. Hopefully she'll call me back today. I told her that I wanted to get in before the end of the month because I was a UHC patient and I wanted to take advantage of my co-pay at least one more time. I also said that I had been given a gap exception until Dec 06. I will let you know what she says. My last fill was on April 25th, so they may not see me so soon, but the 17th would work with my schedule. I'll let you know. Thanks and nice meeting you!

[Terez 0]

Yeah - keep me posted. Nice meeting you as well. hey are you on IM? My email address is terez_urbani@yahoo.com and my aol IM is terezrea, my yahoo messenger is terez_urbani......

[SusanP 0]

I haven't ever really signed up for IM. I might ask my hubby how. I'm about to leave work for the day, but I will contact you after their office calls, Susan

[SusanP 0]

Terez,

How did your fill appointment go? Did they really charge you 100.00 or was it a mistake. I am confused about what to do. I just read a post about Dr. Spiegel and UHC. It said even with the gap exception, his office won't take any UHC. I haven't started calling the other choices that I found. This is a bummer. Let me know how your fill went, Susan

[SusanP 0]

I live in Bay City. It's over a 2 hour drive to Tomball. I need someone closer. Thanks for the info.

[barbara465 2]

Try Dr. Matthew St. Laurent. He is not In Network, but he is very reasonable and uses the same facilities as Spiegel. His office is located at Methodist Hospital at Willowbrook. His number is 281 921-1890. Explain your situation and they will probably work a deal with you. I switched my surgery from Spiegel to St. Laurent mostly because of UHC.

[Terez 0]

Hi Susan

yes, i got my fill and they charged me $100. I'm going to call Dr. DeMattia in Tomball and see if they will see me? Worth a shot otherwise it looks like I'm going to have to pay $100 everytime I go there...eeeeek! I have to tell you....while I was in Dr. Spiegel's office waiting to go back, the phone rang and the nurse answered it, then she said "Dr. Spiegel is not accepting new patients, just the current ones he has." I thought that was kind of odd??

[Terez 0]

Hi Barbara

Thanks for the information, I'll try them as well......what a mess this is!