Another insurance question

[Jules02]

Hi everyone,
I've been a lurker for a while, getting closer to surgery. There are no ds surgeons in FL, not any that I would trust anyway. I am less than 2 months from completing my 6 month supervised diet and all my pre-op requirements. Having listened and learned (I hope) from the vets I don't know what's next. I know that I have to go out of network (AvMed), do I have another surgeon submit my paperwork even though I have no intention of having them cut me? I will travel out of state and I will have a vetted surgeon. Any advice is greatly appreciated.

 

[DianaCox]

I would submit directly to the insurance company with a request for out-of-network referral for a procedure that is not offered by any bariatric surgeons in-network.

Be prepared to be referred to a bariatric surgeon who actually does NOT do it - or is Hoddinott, whom I wouldn't let touch me with a 10 foot pole. THEN you will have an interesting fight on your hands. You may have to do some research to see how many times he's been sued, who died, etc., or to demonstrate that some other bait-and-don't-switch surgeon does not have even a minimal number of DS surgeries under his belt, did not proctor with a qualified DS surgeon, etc.

 

[Jules02]

Thanks Diana, I will begin my research now as part of my pre op. I have heard of Hoddinott and others, including a new group in Jacksonville (Webb) who offers the ds but have never performed one.

Thanks 4kids.

 

[JackieOnLine]

Hi Jules! everybody gets a

 

[DianaCox]

Thanks Diana, I will begin my research now as part of my pre op. I have heard of Hoddinott and others, including a new group in Jacksonville (Webb) who offers the ds but have never performed one.

Thanks 4kids.

"Offers the DS but have never performed one." This is an oxymoron - how can they "offer" what they are unqualified to perform???

 

[Jules02]

Thanks for the warm welcome!

I went for a consult and one doctor told me to
Stay home and have the sleeve. Wow! Bmi 49, with comorbities? Although they advertised the ds, his staff said he hasn't actually done one, but should by the time I would be scheduled. No sweat, I'm still running.
My employer will remove the wls option on our insurance at the end of this year, so timing is vital. I am preparing to self pay, but hoping I won't have to.

 

[Larra]

Sounds like the "offer" of the Ds is designed to get people in the door and nothing else. Keep running!

 

[DianaCox]

Good for you - keep looking.