NYC people

[kkarryall 0]

Hi--Just curious if anyone had surgery in NY with GHI (I beleive I have the GHI PPO) and get approved? I had called them back in Nov. and they stated that they would cover it; I called them again today, and they said they cover gastric bypass but not that the lap band is coming up as a non-coverable code. They told me to get my PCP to contact them for pre certification and that they might consider it on a case by case basis. I feel like I am getting the run around. I am planning on getting my surgery at NYU and just went to their info session on Jan. 22nd.

Anyway, any advice is appreciated.

Thanks everyone!!

AMY :rolleyes2:

[EliyshevaLovesYahweh 6]

Hi. I know your posted thread is quite old but I wanted to ask if you were able to resolve your situation with GHI PPO? I too have the same INS coverage. Glad to say I have a BMI of 38 with no comorbidities of obesity, but rather other common overweight-related issues. Currently, I am in communication with Dr. Garber's office in re to my surgery chances here and minor set backs. Will be seen on 10/20/10. I have heard nothing but great news about that center. Anyway, if GHI won't pay...I am off to Mexico and have my SILS with Dr. Rumbaut (Lap Banding pioneer). Nevertheless, let me know how things went with you. Hope to hear it all worked out for you in the end. Cheers.

Edited September 16, 2010 by LapBandForMe
Misspelling

[msdv 5]

I have GHI through the city of NY. I don't know whether it's a PPO. I know its not an HMO.

The only thing I can tell you is that it takes them at least a month to approve . I never heard from them that you have to be a certain BMI however, mine was over 40 and I had co-morbidities.

I had to do a 6 month supervised diet. My Dr's staff was negligent in submitting my papers on time but when I contacted GHI they were very nice and even though the surgeon's office told me it would take from 6-8 weeks for GHI to approve when me and my DH got on the case they approved in about 3 1/2 wks.

I know the OP's post is very old but when I went to NYU they did not accept GHI. They were my 1st choice.

If you need a surgeons rec that accepts GHI PM me even though his staff was horrible to me the surgeon himself was great. He did my surgery and I had no pain at all and minor gas pain I feel funny to say the word pain because it wasn't even like that. I just had my surgery 8/16/10 and I know how you feel.

Edited September 16, 2010 by msdv

[Jinky 0]

Hi--Just curious if anyone had surgery in NY with GHI (I beleive I have the GHI PPO) and get approved? I had called them back in Nov. and they stated that they would cover it; I called them again today, and they said they cover gastric bypass but not that the LAP-BAND® is coming up as a non-coverable code. They told me to get my PCP to contact them for pre certification and that they might consider it on a case by case basis. I feel like I am getting the run around. I am planning on getting my surgery at NYU and just went to their info session on Jan. 22nd.

Anyway, any advice is appreciated.

Thanks everyone!!

AMY :thumbup:

I have GHI PPO throught the UFT and they covered my lap band.

Good Luck!