DS surgeon search update w/ info - Dr. Bonanni

[Jen-2]

I spoke with Bonanni's office. It turns out Bonanni does perform the DS surgery on patients under a 50 BMI; however, it looks like he won't be an option for me as the individuals dealing with the insurance in his office said Highmark almost never makes an exception to their requirement that the insured have a BMI of 50 or greater. I was told the only exception they had seen Highmark make was in a case where someone had wildly uncontrollable diabetes.

I inquired about his self pay rates and they were high. The surgeon's fee was slightly under $3000, but the hospital fees were $50K and she wasn't sure if that included the anesthesiologist's fees.

Given their certainty regarding the insurance requirement and me telling the intake coordinator that self pay fees in that range weren't an option for me - his office didn't even suggest that I attempt to pursue the surgery with him to see if ultimately we could get insurance approval.

Worth noting is that during my conversation with the coordinator she informed me that Dr. Bonanni is using a set common channel length of 125 cm for his DS surgeries. She said he found it didn't affect weight loss and that his patients were reporting more normal bowel movements.

Optimal common channel length seems to be an ongoing debate so I thought I'd put that information out there for anyone considering Bonanni. I'm a complete newbie to this but that seemed longer than what most surgeons I've read about are using so it made me wonder how it would affect long term results.

 

[Jen-2]

I called Dr. Greenbaum's office. His office reiterated the same information regarding Highmark's refusal to make exceptions to the 50 BMI or greater requirement. His self pay fees were surprisingly low. For the surgeon, hospital and anesthesiologist - Tina informed me they were somewhere around $13K. That fee does not include pathology, a cardiac consult or the psych consult prior to surgery. She said he requires a liver biopsy. Does anyone know anything about this? I'm in the process of emailing him all of my information and setting up a consultation.

I did a search on here and saw a member named Mike Powers was pursuing surgery with Dr. Greenbaum in May 2014. It seems he stopped posting (could be I don't know how to search correctly). Does anyone know whether he had DS surgery with Dr. Greenbaum and whether he still posts on here? I have some questions about Greenbaum, fees, the process, etc. I'd like to ask him.

Thanks!

If anyone has experience with Dr. Greenbaum - I'd love to hear it. Please share. Thank you!

 

[Munchkin]

Apply and appeal. You have to get the denial to appeal it.

 

[Jen-2]

Yeah - I know and I will through Dr. Greenbaum. I'm losing hope though that an appeal will matter. I have to finish a few pre-op requirements before I can submit for approval. Dr. Bonanni's longer CC made me think of you. Didn't you post previously that your surgeon did a kinder and gentler DS? I wonder if that is what he's doing.

 

[southernlady]

Yeah - I know and I will through Dr. Greenbaum. I'm losing hope though that an appeal will matter. I have to finish a few pre-op requirements before I can submit for approval. Dr. Bonanni's longer CC made me think of you. Didn't you post previously that your surgeon did a kinder and gentler DS? I wonder if that is what he's doing.

My common channel is 175...and last Sunday I weighed in at 135. Which, for me is a 23.2 BMI. I will be 4 years out in Jan. The up side is that I probably absorb a bit more in the way of vitamins/minerals than someone with a shorter than 100, but then again, I am not positive that is the reason. I just know my vitamin list is NOTHING like a typical DS'er. You can see my July labs along with what *I* take here. But NOTICE the statement IN RED at the bottom.

While common channel length matters...it's more of "how long is it in relation" to YOUR bowel AKA the Hess Method? And how long your alimentary channel is in relation.

If you do decide to go with Greenbaum (and it sounds like it), try and hook up with @Elizabeth N. And @jillc JUST had surgery with Greenbaum as a self pay. She was a revision to a DS but her experience is so recent.

 

[Elizabeth N.]

The insurance battle is a tough one, but certainly worth trying to fight. Diana and Larra are both insurance warriors who have helped a lot of people get coverage otherwise thought to be unattainable.

Dr. Greenbaum does have a good cash program. Let me know if you come over this way for a consultation. I'd love to get together for coffee or lunch.

 

[southernlady]

@Jen-2, is Highmark your ONLY option? I know it's a BCBS affiliate...are you insured thru your employer?

Try the insurance route first so you get the denial IN WRITING and then get @DianaCox and @Larra to help you appeal.

It has to be Highmark as I had BCBS TN (Medicare) and they paid for my DS without a squabble...their only denial was my choice of surgeon. They wanted me to stay IN STATE. Thankfully I lived in a state with, at the time, several DS surgeons. BCBS IN GENERAL has an exclusion for WLS UNLESS you qualify. I know Medicare.gov does NOT reserve the DS for just those over a 50BMI.

 

[jillc]

@Jen-2 I just had a revision surgery with Dr. Greenbaum on Dec 1 and he has made a great arrangement with the hospital. The hospital's prices have recently gone up, so it may be a bit more dear than $13K but not by much.
For my revision, I paid the hospital $11,152 and Greenbaum $4k, plus pre-op appointment fee. The hospital was good and Greenbaum is a good cutter. I had a revision from a very old bariatric surgery called a VBG.
My CC length is 75 cm. Greenbaum does not use the Hess Method but he does factor the length of your intestines in. He usually goes with 100 cm unless you can prove that you are very knowledgeable about the DS and will be ultra compliant with the vitamin regime.
He agreed on 75 with me. He gave me a proviso though - if my small all intestines were shorter than the norm once he opened me up. In that case he would have gone with his normal 100 cm. My starting BMI was under 50.
He did not require a psych consult for me, but I did have to have a cardiac and pulmonary consult to clear me for surgery, a upper GI barium series and bloodwork.
The liver biopsy, removal of gallbladder and appendectomy are all done during the surgery.

If you have any questions, feel more than welcome to PM me. Btw, I would suggest meeting with ^^^ @Elizabeth N. - she will be invaluable if you go for surgery in NJ

 

[Jen-2]

Thanks for the responses! Yes, Highmark is my only option. Thanks for the info @jillc! I will PM you. And thanks for the offer to get together for coffee/lunch, @Elizabeth N. I'd love to if he accepts me as a patient.