Second Appeal Denied! Dr. Hart office sucks!!!!

 Hello every one i need to vent like crazy about Dr. Christopher Harts office. While i believe he is a awesome doctor when you have staff that sucks you lose out on alot of business and you lose people from your practice you probably arent aware left because your staff sucked!!!!!. Any way i posted before on being denied by aetna. They say i needed 3 months of diet supervised diet and exercise and behavior modification. Ok so iwas told by the office i had all of that right. But i was also told that aetna always denies on the first time but approves fairly quickly on the second appeal. I was told that by everyone in the office. So like a concerned patient I called to speak with the person MS amanda Korey who was supposed to be in charge of resubmitting my stuff. I called her i am not kidding About 5 times and she only returns calls on tuesday and thursdays. After 3 weeks of no return call i was told to e-mail her after about 2 more weeks of no response i recieved and email of 1 sentence stating i will resubmitt appeal and will be in touch if the need arrives.   WHAT!! i wanted to discuss why i was denied in the first place. The doctors office told me i didnt need to see rachel the NUT every month just once and come weigh in once a month. But how were they supposed to document my behavior mod. If no one ever saw me and talked to me just broght me in weighed me and told me they would create notes. Evrytime i call the office to see what i should do if i should start over again for 3 months which i had already no one seems to know because the person i need to speak to never returns calls or e-mails.  So eventually they resubmitted i have no idea what was resubmitted becuae of course no phone calls ever. I eventually call aetna after and see that they are upholding there original denial due to the same documented reasons. Im done with this office. I cried for days about the denial sent emails and called crying the office felt so bad and said they would personally tell amanda that i needed a phone call. Dont even ask if she ever called beacuase she didnt. Please help has anyway had a good doctor in atlanta with good helpful staff that takes aetna. I feel ike they set me up to fail. I once saw dr .Maynard and his staff was so accurate about what aetna wanted they set me up with everything to succeed i just lived so far from his office it wasnt possible with my schedule to travel so far.

I'm so sry to hear your having such a hard time of it. I know, me too. I was told with me being on WellCare of Ga. that at first they would probably deny me but after all the tests and paperwork was done that it would be OK they would probably go ahead and approve. Then they send my surgeon a list of stuff that needs to be done. 1 of which was a 6 mo followed diet. Then they send me a paper saying a 12mo followed diet. When my PCP calls to talk to them about it and find out what in the world do they want from us they won't even talk to her because she's a Nurse Practitioner, Go figure! So when I call them to try and find out they tell me that they won't talk to me either! Said it was HIPPA, but that's BS you can talk to me about me geez! So now I'm seriously thinking about going to Mexico and pay a flat rate to have it done. I figure if the weight don't kill me and the surgery don't kill me then the LORD wants me around for some good reason or another. I'm desperate. Good Luck to you and I hope someone on here can help you out hun

I think that my next step would be sending a certified letter to Dr. Hart expressing my concerns while at the sametime look for another surgeon. If you are up to driving to the Johns Creek Area there is a Dr. William Johnson who is wonderful and his staff is too. They have the physc, and nut in their office whom you will see for the three months. hope this helps.

Dr. Hart & Dr. Johnson, same practice. -Elli

I'm going to Mexico, but I've heard good things about the doctors at Northside Hospital.  The two names I remember are John Daly and Paul Macik.  Best wishes!

I'm sorry you are having such a hard time. I have aetna and was approved the first submission. My surgeon was Dr. Scott in Rome which is about an hour-  hour and a half from Atlanta. Ginger his bariatric coordinator told me exactly what I needed and what to make my PCP document for three months and that I ahd to the the NUT for three months and I did. Approved. Ginger always call you back. Some people don't think she has much of a personalitly but she answered all of my questions and I got approved and was always called back within 24 hours. His nutritionist is Kristen and she is great too. Dr. Scott is a wonderful, caring man. I am two weeks tommorrow post op. You may live too far away for Dr. Scott, but I highly recommend him and his staff. Again, I am so sorry you are having such a hard time.

Sorry to hear about all your trouble. I used Dr. Macik. His is at Northside Hospital. Good luck sweetie.

I'm sorry to hear about the horror you've been dealing with.  I ended up being self pay but only because my husband's company took the option not to cover WLS, not any issue with insurance.  I had my surgery with Dr. Daly at Northside.  He is VERY VERY good and I absolutely love his staff.  When I originally tried to go through insurance, they were extremely helpful, never rude, returned calls, etc.  They were equally nice with self pay (of course since it was immediate payment!) but I really am VERY happy I had my surgery with Dr. Daly.  I had the lap-band, but he is extremely skilled in all types of surgery. Good luck!!!!

Hi.  I thought I would jump in here, too!  I am using Dr. Scott in Rome also and have found Ginger to be very efficient in returning calls and also very patient with all my stupid questions.  I am scheduled for July 14th, but still waiting on approval...it is really getting down to the wire!  I was denied on my first try and hopefully I will know today if I get my approval (prayers being said and fingers crossed).  I know Rome may be quite a distance from you but I have been very impressed with Dr. Scott and his staff at the Harbin Bariatric Center.

Hey there!  I had Aetna too but wasn't able to use them. I went through Dr. Champion and I HIGHLY recommend him!  Most of my questions are answered with one phone call, no need for them to even call me back!  The staff is great and knowledgable.  He also has a great aftercare program.   www.drchampion.com is his website I believe. I know that he's out-of-network for all insurance plans but it's worth it. I had originally talked to Dr. Daly's office but it took forever to get in and I felt like they pushed the lap band when I wanted RNY.  Also, he does other surgery's as well, I wanted a doc that did 100% bariatric.  Dr. Champion is also a Center of Excellence which is important.