Initial Consult Scheduled: Dr. Elariny

 So wow!  This was all much easier than I had anticipated!  I met my new PCP yesterday. Covered the typical new patient stuff. She asked if I had any particular concerns. I told her that I was working my way toward Bariatric surgery and would like to be referred to Dr. Elariny. Without even batting an eye she said "Sure, I can definitely do that for you."  Cool!

Called Elariny's office yesterday to see what kind of wait there would be or an appointment. They said he could see me on Oct 10th. Dang!  Impressive. So I had to check with my work that I would be able to have that off and amazingly, no problem there either. I called back today and confirmed my appt for the 10th. Called back my PCP's office to be sure the referral would be faxed over. They said it was being faxed today. 

I also found a psychologist in the area that does preop Bariatric psych evals.  Interestingly, he has had Bariatric surgery!

Such a productive day!  Don't want to jinx it!

Moving right along. Good for you!   : )

--gina

 Absolutely!  Knocking down one domino at a time. :)  Thanks Gina!

Excellent!  Let us know how your visits go.

Fun when things work out, good for you.

All checked and waiting. Will update with how things go!

How is Baltimore treating you?  Im in Catonsville!

Overall, the appointment went very well. My tentative surgery date is 12/14 or 12/17. We'll see if insurance goes smoothly. Dr E wants me to have a cardiology consult and an echo for clearance. He also wants me to have an endoscopy and colonoscopy - not thrilled about that but better safe than sorry!

The finances I was a bit shocked by. When I had talked to his nurse on the phone about the surgeon fee (the DS surgery is out of network) she said his surgical fee was between $5-8k depending how much insurance covers. Well, she showed his total cost would be ~$33+k! My out of network coverage is 80%/20% so at best I'd be responsible for ~$6,600. That's not too bad (certainly cheaper than self pay) I'm just a bit nervous if the insurance company only pays a fraction and then being stuck with the rest!

I'm scheduled for my psych eval this Friday and my cards appointment is next week. Moving right along! It all definitely seems more real now!

Bugirll: Good to meet you! Baltimore is a pretty cool city. I like being so close to water!

Get your insurance pre-approval and prior authorization in writing in advance so you have proof down the road. Dr Elariny's office 19 months later is claiming that my insurance didn't pay anything, and that pre-approval/prior authorization isn't a guarantee of payment and it didn't pay anything. My insurance policy explicitly covered the DS. It also had 80/20 out of network coverage and I had prior approval, prior authorization, everything lined up. The total cost for surgery was 33k, but they said everything was covered except the surgery. They said I would be responsible for about 7k also, but required 12k upfront  and they said I should expect a refund depending on the insurance. So now they want me to pay another 20k. 

They forgot about my paperwork for months, had to resubmit the whole claim due to their billing department losing paperwork, then they just forgot until I called/emailed them asking what's up for the 5th time in a year. Their billing department is notoriously terrible after surgery. Alex will help you before surgery, but not much after it. You have to be careful with them, document everything, get everything in writing. I'm not the only one that this has happened to. As much as I like Dr. Elariny himself, his billing department is a nightmare. On top of their incompetence, they are also rude and incredibly shady.