BS Access+ HMO Bakersfield, Ca

[Happy Loser 0]

Hi Lauralee, I actually went to a seminar by the doctor you mentioned way back in January. At the time she mentioned that she did not have the staff to get pre-authorization from insurance companies so it would be up to me as a patient to do so. That really overwhelmed me. But, I still don't have insurance and thus have yet to have my surgery. I am with a new employer and will have insurance benefits starting the 1st of March. So, maybe then I can revisit Dr. McKenzie. Regards

[lauralee08 0]

Hi Lauralee, I actually went to a seminar by the doctor you mentioned way back in January. At the time she mentioned that she did not have the staff to get pre-authorization from insurance companies so it would be up to me as a patient to do so.

You might want to try again now, they've changed a lot about the way they are doing things and may have time to do the preauths now. The preauth doesn't have to be overwhelming, although it can involve some time. I used to work for a health ins. company, which helped me out quite a bit. If you ever need help, just let me know, maybe I can guide you through the process and translate the jargon. Every insurance company and every policy is different, but the best advice I can give you to start is when you get insurance, call them and get all of the exact steps and qualifications you will need to be approved for surgery - in writing. And always get the full name and extension # of the person you talked to. You may be surprised, I called on my BC policy and they literally did not ask for a thing, even told me that if they had given me the auth for the consult that I would be approved for the surgery. Way different than my Cigna policy where I had to jump through hoops and document everything, before finally giving up.

[mzreeda 1]

Geez, I've just started thinking about WLS and just got insurance and the runaround has already started.

I called the 3 bariatric centers in the closest city to me so I could attend a seminar and none of them accept my insurance. One accepts Blue Shield PPO, one Blue Cross, but no HMOs. I'm guessing I'll have to go to LA or Fresno. What if there are no providers around that accept BS HMO?? How can they cover it if there is not a provider??

I called BS and they said I am not covered UNLESS medically

necessary....HA, DUH. It's like she's been trained to discourage it from the start. The way she said it. Anyway, when I asked her who they use she told me I have to be approved through my medical group!! Geez, I just want to attend a stinkin free seminar, I may not even WANT to be approved. This has already been too much for my stress level:unsure:

I guess from here I'll see my PCP, start a 6 month diet and ask him where we go from there.

Cindy T

well if your willing to go to fresno then try visaila 1st its closer i have a great MD she did my band on the 5th of may she can help you and so on if you want her number let me know and see what can be done for you she very formil' with your insurance.:thumbup:

[taylormomto6 0]

Thank You, but I think I have to go through Crowne Bariatric in Corona, Ca. because this is the one my medical group has a contract with.

I'm in the 2nd month of my 6 month diet and am really struggling because I've just quit smoking as well.

Thanks!

Cindy T

[Dani25 0]

Just wanted to say hello to everyone. I live in bakersfield and have been looking into being banded seriously now for about a year. I too have been shot down by my insurance co. even just for a constult that me and my pcp both agree I need. By November we are going to have new insurance with kaiser and and hopeing for the best with them but, haveing a hard time keeping my hopes up and really have no one to talk about any of this with....So I finaly just joined here hopeing for a little insight or just someone to talk to about all it all.

hopeless in bako,

Dani

current weight 270

goal 150

[Nnrush 2]

What doctor in bakersfield do you go to?

[Cindy vsg 7]

I am taylormomof6 with a new user name.

I had gastric sleeve 10/24/2013 at KMC, paid for by Kern Family Heath Care, Medi-cal. I did have to pay $1000 program fee and $65 for the nutritionist, the rest was covered, including all tests and the psyc. Kelly runs the program and is great dealing with insurance. I was approved within a week of submital.

I'm thrilled with my decision and have lost a total of 111lbs and counting. I still have 34lbs to get to my goal.