Sandy3 0 Posted October 20, 2005 I talked to a rep from Barix clinic. She stated they have a contract w/my insurance Co Paramount of Toledo. The insurance Co has told me that they do not pay for WLS surgery. Barix just started doing lapband surgery. Dr. Schramm reportedly has done 80 lapbands in 6 mos. I have set up a consultation....no fee. She said they would send a referral to insurance co. Any feedback from members on this clinic and physician (good, bad and indifferent) will be greatly appreciated. Also is ther anyplace on this site or another that I can get info on how patients have rated this facility or physician? Thanks sandy Share this post Link to post Share on other sites
"with the band" 1 Posted October 21, 2005 Sandy - I am also from outside of Toledo - and I went to Dr. Duckett and Dr. Oweiss of Northwest Surgical Specialists in Maumee, OH. They do lap-band exclusively. They are wonderful surgeons in their own right and are highly respected in the area. If you are anywhere near Toledo area go to them - they are top notch and specialize in this. If you need anymore info - let me know and I will set you up with a phone number, etc. Good Luck. They have the tools to use the arbitrators to help fight your insurance. They have a seminar once a month with infor that you can attend. Share this post Link to post Share on other sites
Sandy3 0 Posted October 21, 2005 Thanks "with the band." I will try to answer in the fewest words possible. I wanted to go to Dr. Duckett. For over a year the office manager "Nancy" kept telling me to "hang on" they were signing a contract w/Paramount. So I did all the stuff to prepare..psych, therapy, supervised diet etc etc. Then " Nancy" tells me that she knew all along that the contract they were going to sign was for self insured companies only (25% of Paramount contracts) She told me on a number of occasions that it would do no good to appeal "They won't pay for it: they won't pay for it. And if you have an appointment for a consultation, you had better cancel it unless you plan to self pay!!" She also said "Why would you do all those things when you were not covered? You just wasted your time". I even went to the last seminar to help me determine my next step. Same old story from my friend "Nancy". No support what-so-ever. She was very negative. So while I agree they probably are the best and it would be much more convieient, I saw first hand that the "office manager Nancy" is not going to be supportive of my need to appeal in case of a denial. So that's the only reason why Barix. There is no fee for consulation, unlike Dr. Duckett which is $150 which Nancy made quite clear would be lost once I was denied. The lady next to me in the seminar was worried because she's not sure if her insurance would cover. I gave her info on this site so she could at least investigate her options after "Nancy" got hold of her. Thanks for the reply though. Who knows, maybe it will work out in the end. I can't have my PCP send a referral to the insurance Co until after Jan. as my company may be changing insurance. Once I know who the insurance co is going to be I can start the process. Or maybe I'll get lucky and get banded before the first of the year through Barix. This whole thing has been like being in a maze. But with each set back I gain more knowledge and become just that more determined to see it through. My life depends on it. Sandy Share this post Link to post Share on other sites