It was the best of times; it was the worst of times.

[m&nsmama 0]

Best of Times: I had my endoscopy today and my NINE ulcers from last year are healed.

Worst of Times: My insurance is now telling me that they will not pay for my procedure because my doctor (Dr. Carson Liu) is not a contracted provider. I have UHC, 90/10. I have excellent insurance. We have never had a problem with contracted/noncontracted before. My husband is on the line with Human Resources at his company in hopes this is all just a misunderstanding.

Back to the drawing board, I guess. :omg_smile:

[RestlessMonkey 7]

Get a surgeon who IS on your PPO. No reason to quit! :omg_smile:

[m&nsmama 0]

Yeah, but in So-Cal I sometimes feel like I can't throw a rock without hitting a bariatric surgeon. Tonight I will be researching no less than 9 in my zipcode alone. It was nice thinking I had all the researching behind me (Dr. Liu was the perfect combination of high numbers, good outcomes, good bedside manner).

No biggie, just frustrating and not what I want to do after an endoscopy. :omg_smile:

[RestlessMonkey 7]

At least you weren't denied and can still get the band...! :omg_smile:

[GratefulHeart 0]

I am in So Calif also and have UHC with the 90/10 insurance. My doctor is not in the preferred network. For me I just have to pay the 30% instead of 10%, and my dr. said that would be $1700. I don't know if that will include anything else (like repairing a hiatal hernia, which I know I have), but my family practice doctor recommended him to me, saying that he's never had a bad report from his surgeon. So it may be that your insurance will only cover 70% of it instead of 90%....it may still be affordable. My husband is in agreement with me that the cost isn't that bad, and the surgery is too important for my general health to forego because of the extra cost.

Hopefully you'll find that either the cost isn't awful with 70% or that another surgeon will work for you...keep us posted!

[m&nsmama 0]

Thanks, Grateful Heart.

I have a call in to my husband's HR department and I'm going to call UHC again tomorrow because I always thought that when you see someone who is not contracted your coverage drops to 70%, so I'm confused. I was ready to pay $1700-$2000 out of pocket, but for my insurance to not cover any of it? Something just doesn't seem right.

Dr. Liu's office says he is not on ANY insurance plans. He does not accept insurance--period. (He'll bill for you, of course) This allows him to balance charge the patient the remaining balance, rather than accept the reasonable fee dictated from the insurance.

[m&nsmama 0]

Grateful Heart--can I ask who you are seeing for your lap band?

[GratefulHeart 0]

I am seeing Dr. Milton Owens. He has a terrific web site at

Coastal Center for Obesity, Gastric Bypass and Lapband Weight Loss Surgery in Los Angeles and Orange County, California

My regular doctor said he would recommend him over anyone because of the great experience his patients have had with Dr. Owens. I haven't seen him yet, so cannot vouch for him yet myself. But I have researched him on this site and on others, and can find no negatives and lots of positives. I also found his office staff to be more personable than the ones I talked to at St. Joseph's Hospital. St. Joseph's program has had some complaints too, though I can't remember where I saw them. Maybe it's my own preference to see a smaller practice than a big hospital, but Dr. Owens is (I think) head of the bariatric program at one hospital and practices at four others. His web site has all that information. They also have an online form you can fill out with your information, and they'll get back to you with what the surgery will cost you based on your insurance.

So far I'm happy with what I've experienced but I've only been on this journey for maybe 1.5 weeks! When I saw my doctor my blood pressure was 160/100, so he checked my heart. We both decided it is time to do the weight loss thing, and he recommended Lap Band and Dr. Owens to me.

If you'd like to keep in touch with how it's going, let me know!

[truediva 1]

I had Dr. Liu and I was completely covered. Me and my husband didn't pay a dime (blue cross of california)

[m&nsmama 0]

That's great! According to the person I spoke with today on the phone, that won't be the case for me. I don't think it sounds right, which is why I called HR and will call the insurance tomorrow (again) but this time speak with a supervisor.

So then Dr. Liu refunded your $2000?

[truediva 1]

No, there was no cost to me at all. My insurance covered it

[m&nsmama 0]

Well, that's just weird. The woman handling billing, Claudia, told me that they collect $2000 up front for every surgery--regardless of what is covered. If there is a credit, they return it to you after the insurance has paid. You can't schedule your surgery w/o paying, and if you cancel 10 or less days from the date of surgery, you don't get the money back at all.