New Ins. Jan 1st-no coverage

[jmschnapf 0]

Help! I have been preparing and going to the Dr and Nutritionist since April 2007.

I fulfilled all of my requirements Sept 28th. My Dr was out of the office until Oct 3rd to sign the letter requesting pre-cert. Anthem PPO of Indiana took over 3 weeks to enter the request, then approval came Nov. 3rd.

I called the office that Monday morning and they got me in to see the Nutritionist and the regular Dr on Nov 7th. At the end of the appt they scheduled me to see the surgeon on Dec 7th-telling me there was no way I could be scheduled for surgery before Jan 1st.

I had let them know back in September that my insurance was changing, and the urgency of the matter. Of course the new insurance does NOT cover lap band surgery.

I am beside myself! The surgeon also practices at another hospital in town, but the nurse told me that he is actually booked up.

If...I could find another program that would take me, I would have to go thru the pre-cert approval again!

Am I just out of luck??

Feeling down....

Jodie

[kaninag 35]

I talk with the surgeon himself...and explain your problem...trust me if hes a good doctor he will try his absolute best to get you in. If not he may have a partner or know how to get you thru before Jan1...I am running into the same prob except my 6mo doesnt end until dec 15...so i will really be pushing it. good luck

[jmschnapf 0]

Thank you--that is a good idea, maybe his partner could do it. the partner generally does all the YnRue (SP?) and mine does the lap band, but I believe the partner was the first in Evansville to do a lap band originally.

jodie

[KD8888 0]

Ask to be put on a cancellation list.

[jmschnapf 0]

Well, today I called the surgeon's office direct, not the weight loss clinic. They also said nothing could be done, they were already scheduling into Dec. and they couldn't put anyone ahead of others. I hung up very very discouraged, and decided to go on line to see if I could find another clinic that could help. Within an hour a very nice girl from the weight loss clinic called me at work and said she heard what was going on and she spoke directly to the surgeon, and he told her they would work on getting me worked into the schedule!! She scheduled me to see him Monday afternoon (working me in, he is on call that day) but if that one doesn't work we will try for another. I should get a surgery date scheduled when I complete a visit w/him. Hopefully Monday!!! Bless Tracy, and Thank God for being in my life. Thanks to all of you for your support too. My emotions have run the gamat this week!!!

Jodie

[Lynn43 0]

Jodie - I'm from Evansville and going through the Deaconess Weight Loss Clinic. I hope that everything works out for you! I have to wait until the first of the year to have my surgery done..because my current policy doesn't cover the lapband..so I switched from the EPO to the PPO. Please let me know how it goes for you. Good Luck!!!

[jmschnapf 0]

Lynn-that is too wild!! That is where I am going. I got a surgery date yesterday!!! December 13th. I go tomorrow for an upper GI, Thursday morning for a meeting w/nutritionist and exercise specialist. See Dr Haughn Dec 7th ---then surgery! Good luck w/your insurance and surgery. Have you been to any support meetings? I have only been to 2. I plan to go pretty regularly. Keep in touch.

Jodie

[Lynn43 0]

Congratulations on your surgery date!!! That is soooo wonderful! I've only been to one support group meeting so far. I need to get to another one. Please let me know how everything goes.

[buttercup76 0]

Hi jmschnapf

I am currently going through the same thing you were. Was your original surgeon able to get you in or did you have to go another route? I meet with my surgeon on next Wednesday and i pray that he can fit me in before December 31st. My insurance changes at the first of the year as well and doesnt cover lapband.