PHCO covering fills?

[gkeyt 0]

Hi everyone,

I have a question about coverage for fills. I had surgery in Portland, OR in March 2007. At the time everything was covered by my insurance. I just moved to Spokane, WA, and it looks like bariatric treatment is excluded from my new PHCO plan (through Sacred Heart MC). I was referred to Dr Pennings in Idaho by my surgeon, Dr Emma Patterson. I will need to be seen again in March for my 1 year visit, and I was curious: has anyone ever gotten anything POST OP paid for by PHCO? Just wondering. I'm looking into the cash costs for everything and just trying to sort it all out. Thanks.

Gwen

[kodiakdiabetes 0]

Hi Gwen,

After speaking to both the Rockwood Clinic billing office & Dr. Penning's office, I am under the impression that ALL weight loss related procedures are excluded with PHCO coverage. I too have PHCO and am very discouraged with my progress thus far with obtaining consent for any bariatric surgery or post op care if I self pay for the surgery. My frustration is heightened knowing (as an ICU nurse & diabetes educator) how beneficial to myself, my job and the insurance providers pockets this surgery would be! The service is provided in our system @ SHMC, however we as nurses and employees are all excluded from receiveing this life saving, risk lowering surgery. Has anyone taken PHCO on legally? Any advice out there?:thumbup:

Thanks!