Has anybody had their surgery paid for by Medicare?

[sghatl 2]

I am 65 and will be banded in December. I do not have a date yet but will have one by mid-week. My doctor performs surgery in one of Medicare's 'approved' bariatric centers. So far he has not had Medicare pay for 20 of his patients although Medicare paid for their other surgery charges (ie, hospital, anesthesiologist, labs, etc). His insurance clerk said they just haven't figured out how to bill Medicare properly yet. Anyone else experience this? Also, Medicare doesn't pre-approve. They just approve or disapprove after the surgery. My secondary has given me approvall though.

[sharon160 0]

Did Medicare have any pre-requirements....I bet not, if they don't pre-approve. Who is your secondary, and what approval was needed from them. They usually pay after medicare pays. I have AARP for secondary, and just hoping to get the lapband. Will have to travel to Vegas, as surgeons here in Reno don't accept Medicare. Really would like to know what you had to go thru to get things all set up.

Thanks

Sharon in Gardnerville, NV

[sghatl 2]

Medicare did not have any prerequirements. My secondary is BC/BS Federal Employee Program. They required the usual but did not require the 3 or 6 month diet documentation . I had to see a pulmonologist, a psychiatrist, a cardiologist and my PCP. I sailed through all the tests and BC/BC sent approval in less that a week from when the paperwork was presented to them.

I have been on a doctor's supervised diet on my own. I have been doing the Optifast program because I needed to lose weight before they would do the surgery. My BMI had to be below 60. This was a requirement when I was thinking of pursuing surgery at another hospital. But I changed when I found out the first one was not a Medicare approved center. They are in the process of getting approval. I am thankful for that though. It made me go to another consultaion meeting at the second hospital and I liked their doctor's so much better. I am very pleased with whom I have chosen.

[2bthinagn 3]

Just posted this on another thread. Medicare wouldnt pay my hospital stay because on lapband they only cover the hospital bill if it is an overnite stay. The hospital says they are writing it off. I hope they pay the surgeon bill!

[sharon160 0]

That's good information to have, but wouldn't you be covered as outpatient use of the hospital if you didn't stay overnite. Well you say this is special for lapband....glad they are writing it off for you.