State of Georgia - UHC - Dr. Macik

lerkhart
on 3/22/09 8:29 am
Does anyone know if State Health - UHC will pay for the vertical sleeve as a WLS?    I put a call into Faith(behavior nurse)  last Thursday, but she has not called me back yet.

I have completed my six month supervised weight loss and am working on the 6 months of counseling.  I have completed 2 months.  I was thinking of having lapband surgery, but am looking into the sleeve now.

I am thinking of using Dr. Macik at Northside Hospital.  Does anyone know how many sleeves he has done?  Does anyone know when the next seminar is scheduled for?

Thanks

Linda
CColeman
on 3/22/09 11:18 am
I asked about the vertical sleeve and was told that the procedure is still considered experimental and not covered by the State Health Benefit Plan.

talksoupslp
on 3/22/09 12:39 pm
No, the SHBP insurance plans will not cover the vertical sleeve gastrectomy.  Dr. Macik started doing the sleeves in the middle of last year (give or take), so I don't know how many he's done.


Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
izzy2008
on 3/22/09 1:18 pm
HELLO LINDA!  I TOO HAVE UHC AND I AM ON MY 5TH MONTH SUPERVISED WL DIET. I ALSO WANTED YOU TO KNOW THAT YOU DO NOT HAVE TO ATTEND THE COUNSELING SECTIONS ANYMORE. EVERYONE COMPLAINED SO MUCH TIL UHC AND SHPB CHANGED THE REQUIREMENT TO 6 MONTH OF SUPPORT GROUP MEETINGS. THE CHANGE CAME INTO EFFECT FEB 6,2009. THIS IS PER THE DIRECTER OF UBH. IF YOU HAVE ANY OTHER QUESTIONS READ MY BLOG OR PM ANYTIME.

OH AND THE SLEEVE IS NOT COVERED JUST LIKE EVERYONE HAS PREVIOUSLY STATED.  ONLY THE LAB BAND,DS AND RNY.

Wanna know about my type of surgery? Visit www.dsfacts.com 

IZZY
HW/338 SW/321 CW/205
GW/185  (20 lbs from my goal!!! YaY!!)

Ally61
on 3/22/09 8:48 pm - Naperville, IL

Dr. Macik is my doctor and I'm having VSG on Wednesday...I personally know one person that also had Dr. Macik and he too had the VSG...He's doing just great and if I'm not mistaken has lost 100 lbs. since January 2009 when he had the surgery...As a matter of fact, he was at support group two weeks after he had the surgery and had lost 23 lbs.

You can look Dr. Macik up on here and it will answer all of your questions in reference to how many surgeries he's done and go to his website at: http://www.atlantaobesityanswers.com/ to find out when the next seminar is.

I've met him and although he comes off very shy, I feel confident that he knows what he's doing...Also he's not afraid to answer any questions you may have...

Hope this helps!

"... For unto whomsoever much is given, of him shall be much required: and to whom men have committed much, of him they will ask the more." Luke12:48

 
lerkhart
on 3/22/09 10:42 pm
Thanks so much everyone.  I guess I will rethink the type of surgery I will have since my insurance will not pay for the sleeve.  I don't think I can get past the side effects of the lapband and so many people changing to something else.

If you have to attend a seminar at a center of excellence for State Health I will just finish the counseling sessions because I am over 2 1/2 hours south of Atlanta.  I hope the psy. I am using will be accepted by Dr. Macik. 

This has been a long time coming.  I've been working toward the surgery since last May.  Studied it several years ago but backed out.  Wish I had done it then.

Good luck everyone.

Linda
talksoupslp
on 3/22/09 11:11 pm
I don't have UHC, so I don't know the process and requirements, but you need to speak to your case manager/nurse that they provided you with.  If the requirement is changed to attending 6 bariatric support group meetings, they may not accept the 6 counseling visits in lieu of that.  VERIFY this information with UHC.

And I think you will be very happy with Dr. Macik.  He's a good guy.  Some people say he seems quiet or shy.  I didn't get that from him.  I think he has a quirky sense of humor - mom and I got him to laugh during my initial consultation. 

Good luck!


Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
Ally61
on 3/23/09 12:55 am - Naperville, IL
On March 23, 2009 at 6:11 AM Pacific Time, talksoupslp wrote:
I don't have UHC, so I don't know the process and requirements, but you need to speak to your case manager/nurse that they provided you with.  If the requirement is changed to attending 6 bariatric support group meetings, they may not accept the 6 counseling visits in lieu of that.  VERIFY this information with UHC.

And I think you will be very happy with Dr. Macik.  He's a good guy.  Some people say he seems quiet or shy.  I didn't get that from him.  I think he has a quirky sense of humor - mom and I got him to laugh during my initial consultation. 

Good luck!
You're so right about Dr. Macik, he is a good guy...He is quiet and somewhat shy but if you talk to him a while you'll definitely see his quirky sense of humor come out...I'm still laughing about something he said when I first met him and it's been almost four months, lol!!!
"... For unto whomsoever much is given, of him shall be much required: and to whom men have committed much, of him they will ask the more." Luke12:48

 
LaShelle2
on 3/23/09 1:18 am - STOCKBRIDGE, GA
Did UHC add any new surgeons. I recall Cigna adding some from Savannah?  When did you last check the surgeon's list?

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

Hello,  I would  also suggest you followup with both Case Manager and UHC because I have the same UHC, but I needed none of those things for the band and now none of them for my revision.  Our plan only requires a surgeon to send a medically necessary letter.

It is so starange and a bit wrong that they all require such different processes.  However, I do know they haven't approved the sleeve as of yet.  Says it is experimental.

Terri

Terri D.
Certified Life Coach with Specialization in Weightloss and Bariatrics
Working towards Bachelors in Exercise Science with specialation in Bariatrics
Revision to Gastric 4/9/2009 from Lapband

  At goal at 7 months.... thanks to lifestyle change, exercise, & an acai berry drink.  Inflamation in body-Gone, Headaches- Gone

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