Jump to content
×
Are you looking for the BariatricPal Store? Go now!

I Am Really Ticked At Dr. Speigel



Recommended Posts

I have wanted to have the Lap Band for 3 years. However the place where I worked was self insured and did not cover the procedure. So when I got this new job, I was relly happy to find out that they did cover it.

I went to Dr. SPeigle's office on Saturday for a consultation, they had a sign that said he was no longer taking UHC for fills, nothing about the surgery. Well they called me yesterday and said that I was approved, however since he was no longer in net work I would have to pay him $4500.00 (that may as well have been the $15,000.00 cash price).

When I got home I immediatly came here to ask for help, however I found a message from back in March, about asking UHC about a gap exception. They said they would pay his bills at in-network prices. Well when I called his office today to talk about it, I was told that he was not taking any UHC in network coverage. That was when I got :) mad. How can a doctor refuse a patient when they have insurance coverage.

Can anyone let me know if there are any doctors in Houston that is taking the gap exception from UHC?

I really want to have this procedure, so any :help: would appreciated :kiss2:

Also does anyone know the doctors are getting out of UHC, they are one of the largest health care providers?

Share this post


Link to post
Share on other sites

Dr. Collier, Dr. Wilkenfield, Dr. Spivak, and Dr St. Laurent all use the same SurgiCenter as Dr. Speigel...did you ask if any of them take UHC. Dr. Collier was my Doctor and I just love him to death!

Share this post


Link to post
Share on other sites

This has been a pretty common complaint lately. I suspect you will get a lot of responses on this one. Keep searching the old threads about UHC and houston doctors. I will look to, and if i find it, i will bump for you.

i was selfpay, and know NOTHING at all about insurance coverages.

good luck, and i hope it works out for you!

Share this post


Link to post
Share on other sites

Mini Me

Thanks, I did look in the old threads and got the name of Dr. Turnquest, called his office and he is still in-network for UHC. Got an appointment set to see him next Thursday. I really wanted to have the procedure on the Friday of Memorial day weekend, but as ling as I can get it done soon I will be real happy.

Have a blessed day ! ! !

Share this post


Link to post
Share on other sites

Stupid question, but why are you ticket at the doctor? They had the sign up when you got there, so it doesn't sound like you received any contradictory information...?

Share this post


Link to post
Share on other sites

Well I can be pissed because I started with Dr. Spiegel before the change. I was approved, surgery date set, and then the phone call. Not only did he want $4,500, but the surgicenter wanted $2,900. My out of network out of pocket maximum is $6,000. Dr. Spiegel's office offered me no alternatives. I called UHC, but they would not do an exception.

UHC gave me names of doctors I had never heard of as In Network. Rather than take that chance I called Dr. Matthew St. Laurent as I heard good things about him. His office was so very helpful and before I set foot in the door we agreed on a total price, including the surgicenter. I am paying $3,000 to him and $300 deductible. They are writing off everything else and taking what UHC gives them. When I went in to their office it was such a world of difference from Spiegel's setup. I finally felt comfortable in what I was doing. I didn't feel like a fat cow in a mass of people. I felt like a human being.

Now UHC told me it would be just a few days to switch doctors. WRONG. It goes back through the approval process and they are allowed 15 days to make the change. I hopefully can make my June 13th date, but I don't think you'll make Memorial day weekend. Just my experience and maybe you will have better luck than me. UHC says its a simple change, but then they hide behind the red tape.

Sorry to vent here, but Dr. Spiegel's setup just gets me going. They are all trying to go after the money and make money at the expense of human misery. Climbing off my soap box now. :second:

Share this post


Link to post
Share on other sites

I'm ticked because yes I saw the sign about the fille, but when I asked about the procedure, the lady behind the glass told me that I would find out after they made the call to the insurance company. I seems that they already knew that they would not be accepted by UCH, but wanted to collect my $35.00 for 45 mile trip I made on a Saturday mornning. I mean when I called and set up the appointment, they took my insurance information at that time, they should have told me that they were no longer in network at that time. It would have spared me a lot of gas money

Share this post


Link to post
Share on other sites

I feel the same way. It seems like Dr. Speigel is making plenty of money. His billboards are all over town and when you Google lap band in Houston, his is the first name to pop up. He must me making plenty of money. To me it just speaks of greed on his part, and not wanting to help the people that honestly need what he can do..

I had a really nasty message I wanted to post, but realized that it not hurt him, and make me look bad ! !

But I am going to see Dr, Turnquest next Thursday and hopefully have the procedure not long after that

Share this post


Link to post
Share on other sites

Dr Spiegal did my lap band April 25. I have UHC. I was approved within 10 days. I have a friend who worked there at time !!! She filled me in with alot of information about there screwball setup.. She doesnt work there anymore. I think I just made it under the wire!!!but what I know now I wish I would ve found a more compassionate office!!!!! I know he is probably the most experienced Lap Band DR..but to this day I have really only seen him 2 minutes total!!!

Kim-

Pearland tx

banded April 25 2006

lost 15 lbs

Share this post


Link to post
Share on other sites

YellowRose,

I hope all is well for you. Is everything approved with the new surgeon yet? I know how important this is for you. I waited 2 years trying to decide if this was right for me and how in the world could i get it done. Once i decided i wanted to do it, time stood still.

Rest assured that if you are committed to having this done, it will happen. I am losing very slowly, but definitly NOT gaining. This is the best thing I have ever done. All the trouble will be worthwhile once you are banded.

Share this post


Link to post
Share on other sites

Speaking of Dr. spiegel, what happened to his nurse, the one on the billboards??? Is she still there?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BlondePatriotInCDA

      I'm officially no longer "obese" and now classified as "overweight!" Years ago when I was 108 lbs (my old adult holding weight until the last 10 years) would I have ever thought there would come a day that I'd celebrate being "overweight!" 
      I hit my one year surgery anniversary next Wednesday (August 21st, 2023) and just so happen to have my final bariatric clinic check up on the same day. I'm looking forward to seeing my surgeon and being officially released into the wild! 😋
      I'm curious as to what my labs will say, especially since they told me to not take my vitamins a few days before the labs. To be honest, I find this confusing since the whole point of taking vitamins is to keep your stats within normal ranges - to assure they're working as intended, yet since I quit taking them it will show I need to take them..so I'll hear "make sure to take your vitamins!" A vicious circle. Who knows why?!
      Anyway, I have 40lbs to go to meet my goal and I'm really hoping I can do it in the next 6 months (for a total of 18 months post surgery). At my starting weight the charts show only 20% reach their goal within 18 months with a starting weight of 259 the day of surgery. I'd like to add that to achieved goals. Fingers crossed!
      I'm amazed and thankful for everyone here on these forums who've supported me, answered my questions and understood the plight! Thank you all, you know who you are.
      · 1 reply
      1. NeonRaven8919

        Well done!

    • BlondePatriotInCDA  »  Crayon

      Welcome to the bariatric forums!
      · 0 replies
      1. This update has no replies.
    • juliie

      Good morning all, how long did it take insurance to approve you?
      · 5 replies
      1. NickelChip

        Once it was submitted, not long at all. Just a few days, I think. But my surgeon's office didn't submit it until all my requirements were met, which included psych eval, dietician meetings, a certain number of visits, bloodwork, etc. As long as you've checked all the right "boxes" they require, the approval process should be very standard and easy. Your surgeon's office should know exactly what you need to get approved.

      2. juliie

        good morning , I just need one more clearance from the insurance requirements which is my basic nutrition class , and that's on the 26th of this month. I have BCBSMI insurance. my surgeon said it usually takes 4-6 weeks for them to approve but can be sooner

      3. BlondePatriotInCDA

        Once I completed all the insurance/program requirements - about a week. It seemed fairly quick, but I also contacted my insurance company several times to confirm all the requirements I needed to satisfy there paperwork machine and also nudge (nag squeaky wheel) them 😋 ! Also, my bariatric clinic is/was on top of it.

      4. juliie

        @BlondePatriotInCDA thanks, I have BCBSM hopefully it doesn't take them long to approve me, i just need one more clearance from their requirements. wow a week ? that was fast ,have you had yours yet?

      5. BlondePatriotInCDA

        Yes, my one year anniversary is this Wednesday. It will go quickly, it may not seem like it now..but trust me it will. I have BCBS as well. Good luck, you can do this!

    • rsmith2593

      I has my Ru &Y July 7, 2013.  I was 389 lbs on surgery day.  I am now 198.  I feel so much better ! I can keep up with my grand kids ages 3,3,4,8 and 13
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Long whine alert - I'm really disappointed! I saw my primary Dr last month and told her I wanted WLS and she was all for it. Said that I had to do the 6 month supervised diet for my insurance and a boatload of other tests. Ok. I understand. She started my 6 month diet last month and sent a referral to the bariatric surgeon. MY plan was to do the supervised diet, then at the end of the 6 months in January, do all the other tests...sleep study, endoscopy, ekg, psych, nutritionist, etc. because all of that would get my insurance deductible met, then have surgery in February or March. Since my deductible would be met, I'd only be paying my 20% coinsurance by then. Got the call from the bariatric surgeon's office on Friday and was told that THEY are the ones that will do my 6 month supervised diet. I explained that my primary Dr already had me on it for a month but they said everything will go thru them. Ok. I understand. So I explain about wanting to complete the diet first, then do all the other testing (because I don't want to have to pay my deductible twice by paying for all that stuff now, & then it starts over in January) but she tells me that they do the testing while I'm doing the diet. That means that I cannot even start their bariatric program until January! They made my first appt for Jan 9th & that's when the 6 month diet will start with them & they'll submit to insurance for approval in June & I would have surgery in July. Man!!! That's almost a year from now! All because I don't want to pay $4500 now, than have to pay it again in January. I don't understand why they won't let me diet now & do the other tests at the end.
      · 1 reply
      1. NickelChip

        Before you assume that the testing will take your full deductible, I would make some calls to your insurance. I have a 3k deductible and my portion of the bloodwork was nowhere close to that even though I assumed it would be. I think my copays ended up being around $1k or less for all the preliminary tests. And remember, you will have extensive bloodwork multiple times after surgery, so there may be no way to get it all into one calendar year. Also, you might look into financing options through your hospital. Mine allowed me to put the $3k I owed after the surgery (because yeah, that did max out my deductible for this year) on a 24-month no-interest payment plan. Depending on your options, it may be affordable enough that you can book your appointment sooner and get this whole thing going instead of having to wait almost a full year to have your surgery.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×