New here - some questions...

hello! i'm new here, just signed up this morning. i called to make my consultation appointment with Dr. Bauman on monday. i just have a few questions on my mind before i get there (apt isn't till sept 14th). does anyone here have anthem blue cross blue shield for their insurance? if so, is the psych evaluation covered by insurance? i asked about it when i called insurance company to find out if the surgery was covered and didn't really get a straight answer out of them. anyone here get their surgery done by Dr. Bauman? I picked him based on 2 things, how many procedures he's done and his location. i would love to know what others who have seen him have to say about him. also, i've researched gastric bypass alot but i haven't come across much about life AFTER the surgery. i mostly just find stuff about the surgery itself. the scariest part about this atm is not knowing how it will be afterwards. thanks in advance to all that reply! Donna

I have bcbs of nc and it did not pay for mine or the nut...

Just the hospital and doctor... I did not pick Dr. Bauman because he couldn't see me for months. The doctor I picked could see me that week.  You made a wonderful choice.........

Hi Donna and welcome to OH, the land of the losers!

It's not surprising at all the insurance company didn't give you a straight answer. Rarely do they. Unless, of course, it's NO. There is a forum on OH just for insurance issues and other's experience with them. Check that out and see if you can find an answer or maybe try posting there also. Anthem is out of NY, isn't it? If so, try posting on NYs board, too. More people to likely have that insurance.

I have a different surgeon but you can a look him up on here also. You will find other patients on his. You can send them messages directly to ask about there experience.

I'm six months out from surgery of a RNY bypass (lap).It is without a doubt THE BEST THING I have ever done for myself. I've lost about 85 lbs. I am very healthy. Have had no complications. Find it very easy to follow all the suggestions (ok, well, maybe I don't exercise enough). I had some reflux the first week but Carafate took it right away. I dumped one time only (Grits-the first week of soft food. I didn't cook them soft enough and ate too many). Anytime I don't feel good it's because I've not done what I've been taught. You'll learn all this as you go along but ask anything anytime. This is a very safe and non-judgmental place to be.

Again, welcome and best of everything on your new journey.

Karen

 

 

Donna -

First of all, welcome to the NC forum. Please ask plenty of questions and post your experiences. We all learn so much from each other that way.

Regarding Dr. Bauman: Contact shesellsflowers ... aka Sheila. I know that she used Dr. Bauman and I'm sure she would be able to give you some information and insight.

Hope that helps.

And again ... WELCOME!

Barb

 

I had bcbsnc ppo - they paid for the psych eval. The NUT eval I paid for upfront.. but when you get approved you can tell the NUT to submit a claim and give you your *full* money back.  The insurance company should very easily be able to tell you if the surgery is covered... its either  "not covered" or "not covered, unless medically necessary". If you have a benefits booklet its listed under the "not covered" section... if you do not have one, ask HR... make sure its current with you benefit year because the benefits can (and do) change if they renew the contract. "Unless medically necessary" are the magic words you want... if it says that then you just need to get approval to have it covered. I had surgery with DrMelkonian so I cannot speak about DrBauman :-) As for life after surgery... here at OH you will get any and all the answer you want about it!

Hi Donna! Welcome to our NC group!  We have a great bunch of folks here that will help you anyway they can!  My name is Diane and I live by Burlington in Haw River.  Dr. Bauman is one of the best.  He was my first choice, but too far for me as I live alone.  Gastric bypass is all over the news lately as having a 92% cure rate for diabetes, 60% less cancer and extends our longevity by a minimum of 10 years!  Life is fantastic for me now.  I was 275 lbs and suffering every day!  I had my surgery on March 28, 2007 and I've lost 80 lbs and feel better than I have in over 20 years. Enough about me.  I am so glad you asked about Anthem BCBS.  My very dear friend from church has that ... needs the surgery and they won't give her a straight answer either.  Your best bet would be to call Dr. Bauman's office and ask the insurance girl there. Again, welcome to our group.  Please keep posting... ask us Anything.... someone will have the answer.   Blessings, Diane

Welcome Donna!  The insurance part of this journey is usually the hardest part.  Lots of folks here have used Dr Bauman and I am sure will be happy to share their experience with you. As for life AFTER surgery, I have just begun my journey and it is a day at a time learning process.  I read others' profiles and take what I can use and leave the rest.  There is lots of help available here.  Your surgeon and your nutritionist will have lots of suggestions and guidelines as well. Good luck in your journey!

Hi Donna and welcome aboard! This is a great group of people with tons of info and insight. I am 6 mo post op today and I might as well be Dr Bauman's walking/talking billboard!  ( I'm a LapBander and have lost 56 lbs so far!!!!)He is awesome- kinda quiet, intense and very direct with his questions for you and what he expects out of you. As you already know-his surgical numbers are impressive! I truly no of no one who has had a complication requiring readmission among his patients. Dr Roc ROCKS- he knows his stuff and makes you comfortable with his competence. I practiced medicine for 18yrs and was willing to drive 4 hr each way to be his patient. Nancy (silverfox ???sp) lives in Jacksonville and she too decided to use him and is 4 weeks post op. You have made a very good choice. My 1 piece of advice- gather copies of all your pre-op testing results and hand deliver them in 1 complete package to Dr Bauman's office- makes life MUCH simpler, instead of waiting for reports to be faxed, or mailed or simply lost.....Good luck and come see us often! Sheila

Hi and welcome, I have Dr. B but have not had surgery. So far he is great and I think he is the best judging from talk and track record. I have BcBs fed. and it paid for Pshyc. eval. but only $30 on nutrition visit. Ihad to turn in the later myself. Can't say for the rest but the word is mine will becovered for the most part. The girls in his office are very nice but I agree about turning the stuff in yourself if possible. I spent a lot of time playing phone tag. But with my work I could not keep running things over. My first visit was on June 8 and I will see him on tuesday( not sure why) hope it is good news not bad. Good luck with wls and I hope yours moves faster than mine, he does a lot of surgerys for our area and people come from far away.....even out of state to use him. See ya Myrtis

I have BCBS Anthem PPO as my secondary and they did not cover Bariatric Surgery.  I WILL attest to what Sheila says, Dr. Bauman is the best.  His office staff is SOOOOOOO friendly and helpful, they dont make you feel like a typical patient, rather the #1 most important patient they have ever had.  He is a somewhat quieter man who is very sincere and is very professional, and expects you to be educated also.  All of my calls (and there have been mannnnnnnyyy) have always been answered asap, if not immediately.  I drive 4 1/2 hours to see him, but it's worth it to have a surgeon I feel totally confident in, and would recommend him to my Mother! My Husband was also very impressed with him, and how he took time to thoroughly answer all of his questions immediatly after my surgery.  I also second what Sheila said about having all the testing ready to go.......they are very quick with submitting and it will speed up the process. Best of luck to you, you have made a wondeful choice!!! Nancy