Help: Waiting on insurance to approve.

I am waiting on the staff to call the insurance company, and i can't stand the wait. who knows if all the Dr's have an out of pocket fee other than deposit for surgery?

Some do not amazingly. If you are going to look at cash pay I would check out Dr. Aceves in Mexico. He's a mega sweetheart. You'll see staff of US docs 'downing' Mexican surgeons but remember, it is the Mexican surgeons that trained many of the US docs in the procedure. It was approved in Mexico long before it was ever approved in the US. They've been doing them many years longer than US docs. If you look at stats for US complications they are very high. The reason is there are a lot of new surgeons doing the procedure and they have yet to fine tune their skills. If you look at the track record for Mexico it is much better. Cash pay in the Phoenix area is (cheapest I found) $16,500 for the band. There is a place in TX that charges $12K. Both are for a surgi-center vs. a real hospital where you are monitored for a couple of days. In Mexico it is $8200 out the door, two days in the hospital.

"Staff" of of U.S. doctor's understand the term "board certifications" and patient "follow-up care". ..... I appreciate your passion for your Mexican surgeon and understand that your cir****tances warranted escaping the health network of Phoenix but please cite your statistics and their sources if you are going to make such accusations. And, it was approved in Mexico long before U.S. because we have a standard of medical excellence that must be studied and proven safe before implementing. Mexico has no such (enforced) guidelines. BTW - Simpson does LapBand in the AZ Surgical Hospital as well as the Biltmore and Maryvale Hospital. Juarez and Fang do their LapBands at Phoenix or Tempe St Luke's, and Blackstone does her LapBands at Scottsdale. (All of them are hospitals with full service care). In fact, they have all met the standard of "Weight Loss Center of Excellence" which has such strict criteria that many many programs do not qualify in. $8200 is a great price. But, what about the additional expenses you had to return to Mexico for your complication? How about future follow-up care expenses? Who is giving you group support, post wls education, nutrition counseling, fills, etc? I think it's great that people can choose their own destiny in regard to surgery but let's get some facts straight. stats for LapBand in the U.S. are unsurpassed in any other country. Check out the Inamed LapBand site. Check out azlapband.com with stats. Check out the ASBS stats for weight loss surgeries site. Sometimes you get what you pay for and if it's just the basics you're after and you're fortunate enough to have surgery without any complciations; then you'll more than likely be fine! I don't doubt that Aceves or any other doc is a mega sweetheart. I've met many mega sweethearts in my life but I'm quite sure I wouldn't want to risk my life in their hands.

It was not the insurance, it was the Dr's Office, they told me the Dr. was in the network only to find out he was not. I was upset due to a waste of my time and money. Now i find out that i can go to either Dr's. Dr. Fang or Dr. Newhoff. Can anyone tell me which is the better of the two, or which is better in writing up my paper work for Mercy Care Insurance.

Joyce... To be very honest your response was a bit edgy and I didn't want to respond in kind so I did not respond right away. Amazingly, it isn't difficult for 'non staff' members to understand board certification, too. There is no need for sarcasm. Just because a doc isn't in the US does not make him or her a dolt that doesn't know how to do surgery. That is insulting to doctors all over the world. My doc has done 1200 procedures, no deaths, no serious side effects. His follow up is free, unlike US docs. That's free for life, btw. Fills are free for life, the hospital radiology department charges $70. I have my doc's Mexico cell phone and his US cell phone. I can reach him 24/7 without the need for going through an answering service if that is how I choose to reach him. My doc has trained US docs in the Lap Band procedure as he has been doing them a great deal longer than US docs. It was approved in Mexico many years before the band was approved in the US. His track record is better than ANY US doc I researched, his experience exceeds any US doc, he requires more than a surgicenter, he requires 2 nights in the hospital after the procedure. How many US docs require 2 nights in the hospital? Joyce, obese people have more risk for complications than your standard surgical patient. They need more supervision, especially the bigger they are. When I was in the hospital (a hospital not owned by the doc, btw) he came to see me three times daily. The asst. surgeon came to see me two times daily. The head nurse came to see me 1-2 times daily. The RN hospital coordinator came to see me 2-3 times daily. That doesn't even include the hospital nursing staff. That was JUST Dr. Aceves' staff. If I have any complaints it is that I was tempted to lock the door so I could sleep. If that is my biggest complaint I do believe I don't have much to complain about. These standards you refer to regarding the US FDA... this is something you might wish to research a little before using them in a disagreement on line. It is highly political and an extremely failed system in many ways. This is why the cost of drugs is as high as it is, or one of the reasons. Perhaps you should know that I went to battle with Pfizer a few years ago, I have the front page, feature story in the Wall Street Journal to prove it. I won. I worked quite closely with the FDA and I'm here to tell you, they are not all cracked up to be what you make of them. Most people don't really understand the failures of the FDA and they wouldn't unless they worked with them as closely as a drug company or someone battling a drug company. Actually, Mexico does have guidelines. Are they enforced the same as the US? Probably not, but that doesn't necessarily make the US superior to Mexico either. Both have their good points and bad. For example, one failure of the US that comes to my mind is a pedophile pediatrician that is still in practice in Maryville, AZ. You know, next to Phoenix? His psych records and court papers were all over the medical board's website for two years before they scrolled off. He totally disregarded the boards instruction to have a licensed person with him during ALL physical exams on children and what did the board do? Nothing, absolutely nothing. He's still a pedophile (there is no cure) and he is still treating children and disregarding board instructions after these years. Is that the standard for US docs? Yep, it sure is. Are we still superior to the rest of the world? How many examples would you like? I can point out docs (with proof) that have killed patients due to sheer idiocy and carelessness and they received a letter of reprimand from the medical board. Essentially they were told not to do that again. What is superior about that? How about medical facility inspections by the board of health? Yeah, totally depends on who is doing the inspections. Some are good and some are not. Some care and some don't. So please, let go of the mentality that the US is soooo superior to other countries because we may have guidelines but it does not mean we follow them. Please understand, I have been in medicine for 24 years now. I have seen this first hand for a great deal of time. Thus, it would appear it often times depends on the doc in question. Does he want to maintain a safe medical practice? Just because one is from Mexico does not mean they are an idiot that doesn't care. I had issues with my band. Serious issue... I was totally stressed out over something and I couldn't keep anything down. I went back to Mexico and sat and talked to my doc for the most part of a Saturday. He explained that my stress was causing inflammation and inflammation was causing vomiting. Vomiting was causing more inflammation and it was a cycle that needed to be broken. He gave me IV fluids, IV Decadron for inflammation, IV Zofran for nausea, but most of all he spent time with me. I'm not kidding, it was most of a Saturday. We just kicked back and talked about everything you could imagine. Of course, it was mighty expensive, the fee was ZERO! No charge for IV fluids, no charge for drugs, no charge for his time. He explained that we are all a family of sorts and we need to be there for one another. He told me if I wanted to repay him for that Saturday to do something to help someone else down the road. So follow up care? Yeah, I think it is pretty darn amazing. I don't know of a single US doc that would do the same and for the same fee. Well, there was the cost of gas for a 3.5 hour trip, but it was still cheaper than had I gone to a US doc. Group support... there are plenty of groups here in Phoenix that I could go to if I wanted. I choose not to for a variety of reasons. There is on line support, I can go back to Mexico if I wish just to visit with the doc, his staff, other patients, and you know what? I plan to do exactly that. Stats for lap band in the US are not really all that great. Been to the Inamed site lately? Yeah, I'll choose Mexico. Reason is, the surgeons there have been doing the procedure longer and they have more experience. Would I go to just any Mexican doc? Of course not. But I wouldn't go to just any US doc either. It requires a little common sense and research regardless of what doc one goes to. Their credentials need to be verified, their background needs to be verified, you need to know that you can deal with the staff as well. There is a great deal that needs to be researched regardless if it is done in the US, Mexico, or any other country. As for settling for the mere basics by going to Mexico... I am sorry but you are just wrong. Had I gone to a US doc, I would have been settling for basics. I did what *I* needed to do. I had a choice to have the surgery done in the US or Mexico. I had it narrowed down to five docs between the two countries. I did not choose Mexico because it was cheaper (a LOT cheaper), I chose Dr. Aceves because he had the track record I required. It turns out I may have some gallbladder issues. That is not a final determination at this point. I have already called him and asked him if it is indeed gallbladder, can I go back to him to have the surgery. He said yes and that is exactly what I would do. And finally, yes... Dr. Aceves is indeed a mega sweetheart but your comment about not wanting to put your life in the hands of a sweetheart is misleading. Just because someone is nice and treats their patients like gold does not mean they are not an excellent surgeon. I think we have gotten used to bad standards in the US. We put up with waiting for 2 hours for a 7 minute appointment, we are not always treated well by the doc or the staff, we are treated like cattle being herded in and out of the office, we don't always have the opportunity to ask questions, we rarely get the doc's 24/7 cell phone number in case we remember a question, and you know what? We accept this. We are used to it. It's the standard of care in the US. Not so in Mexico. I'm here to tell you it is a whole different world there vs. here. There is something that we seem to have lost in medicine (and I include myself as a nurse) and it is simple respect for our patients. We don't see them as people but too many times we are so rushed to get those 50+ patients in and out the door we get a little too overwhelmed to treat them as they deserve. Mexico gets down to the basics. The basics we seem to have lost here. If that is a bad thing, I'll take the bad, evil, idiot docs in Mexico ANY day over US docs. I realize you work for a US bariatric surgeon and you are clearly supportive of your employer. But Joyce, com'on... that doesn't make non US docs horrible and your doc is not necessarily superior to all non US docs. It's simply not accurate. Each person is different and the real goal here is not to chase away people from any specific doc, the goal is to do what is right for us. For me, Dr. Aceves was the best choice and I still stand by that. For you, someone else was. Cool beans! The goal here is not to insult people but to work together and find what is right for each individual person so we can all reach our goals in a healthy manner. Right?

Dear Chunky RN, You are right. Our goal here is NOT to insult people and that is why I responded "edgy" to your original post. ...... Being loyal to a surgeon; whatever country he or she is from is one thing but to do that at the expense of others is wrong. Many of us are loyal to our surgeons but do not blast other surgeons or programs. The U.S. verses Mexico debate can rage on and on and on.......I'm declining to engage with you further. I'm glad that you have had incredible treatment and wonderful experiences. .... Bringing up some story of some pedifile doctor? What's that about? An equal response would then require me to list all of the crummy things that have ever happened to someone in Mexico. That's just lame. It is over for me.........Post what you feel inspired to post but should I get the chance to encourage anyone in the future to choose a full comprehensive, board certified program in the United States, I will.

Joyce... Sorry, I just can't let this one go without a response. Feel absolutely free not to respond but some of your comments are simply inaccurate. Just because a doctor is Hispanic does not make him a bad doctor. Just because a hospital is in Mexico does not make it a bad hospital. I'd put the care I received over ANY US hospital or doc when I had my band. I think it is quite unfair to claim that one must be a US doc to be any good. Why did I bring up the pedophile pediatrician? Because you essentially made claims about how superior the US medical system is. Do you realize that countries outside the US laugh at our medical care? It is expensive, impersonal, and not always good. Yet we have the belief that we are the best. We have systems in place just like Mexico does but that doesn't mean we follow those systems. Does that clarify? It isn't a claim that nothing bad happens in Mexico, it *is* a claim that sometimes bad things happen in the US and Mexico and sometimes our systems we have in place simply to not work for a variety of reasons. Being board certified does not mean one is good. It means nothing of the kind. It means the doc jumped through all the right hoops. You know what? Mexican docs do the same thing. It doesn't mean they are good either. You are free to encourage someone to choose a US doc. I, on the other hand, will encourage each person to do what is right for them, not my personal bias. Cheers.

Chunky RN, I was just reading that your DR gave you Zofran for free. Wow! How awsome that is. I'm taking that right now for my nausea and vomiting. It is $50.00 a pill. Outrageous! I am considering traveling outside of the united states when it comes time to do my plastic surgery because I am hearing there is such better patient care and cost.

He did give me all the IV meds for free. He said it was part of follow up care and that is included in the original lap band fee of $8K. Before I decided on a surgeon I really needed someone to help me with the decision. I went to a guy here in Phoenix and before I knew it his staff was telling others I had been there for an appt. It wasn't something I wanted shared! So when I was trying to decide if this was the best option for me I drove to Nogales and met with a family practice guy. He was a gem. For TWO hours we discussed my medical history, what I have tried and failed, various options, the works. For two hours he charged me $30.00. Amazing. He didn't know the surgeon I had in mind (Dr. Aceves) since they are in different parts of Mexico but he realized he might know some folks that do know him. He made some phone calls while I was there and talked to three docs who know Dr. A. All three had nothing but great things to say about him. He also helped me verify credentials and such. Again... for all that, $30. The medical care in Mexico is a world different from here. They aren't trying to cram in as many patients as possible in a short amount of time. They take their time with each patient, get to know them, and they sincerely try to help. An MD appt is usually at least an hour for a new patient, rarely less than 30 minutes for a regular patient. Doctors are not little mini Gods as they are here. They aren't typically in the profession for money. The average doc in Mexico makes about $1K/month and the average nurse makes $500/month. Money doesn't seem to be their goal as much as it is here. They are far more humble, it's just something you have to experience before you can really understand. I did my work, I did my research. It paid off, I had the best possible experience one can have when they have surgery! I guess my point is that if you really take your time and do your research it will pay off. Don't rush into anything. Each person has to do what is right for them.

I dont remember the exact amount for the surgery but it was out of pocket because the insurance wouldn't cover it. However all of my presurgery bloodwork and testing i had ran through my primary care physician. That way my insurance covered it. So there is ways to get around some of the cost. All of my follow up blood work I have done through my primary. Also if you self pay through Dr. Blackstone your follow up is then covered for a year. (not the testing, but your appoitments)