Changes in the supervised diet time for NC Medicaid?

Hi, everyone. I'm new here and I will be having weight loss surgery (hopefully the gastric sleeve) at Mission St. Joseph's Hospital in Asheville, and I have medicaid. Does anyone know if it's true that North Carolina Medicaid recently changed their requirements, only requiring a 3-month supervised diet instead of six months? I hope I read it correctly. Thanks in advance.


Writingmom

I'm not aware of the change, but that doesn't mean a thing. If you don't get enough response here, you might try cross posting to the main and RNY boards which are more active. Sometimes you can get more answers when casting a wider net... You might also consider posting it to the Insurance forum as well.

Best of luck,

I did not think that Mission would take medicaid. I would check into that closely before you get too far in the program.

I know someone that went all the way thru all the requirements and then could not get surgery because they had medicaire. Had to go to Hickory Surgical which takes medicaire


Tamara

A follow up to Tamara's comment... I do know that Medicare/Medicaid patients need to use facility that is recognized as a 'Center of Excellence.' There are now 11 COEs in North Carolina. Here is a list of the NC COEs. You can double-check this with Medicaid. I got this information from the website for the Centers for Medicare and Medicaid Services.

Facility Name	Provider Number	Date approved	State
Cape Fear Valley Health System	340028	12/16/2005	NC
Carolinas Medical Center - NorthEast	MD-341200001	02/24/2006	NC
Durham Regional Hospital	340155	05/17/2006	NC
FirstHealth Moore Regional Hospital	340115	09/01/2006	NC
Frye Regional Medical Centerq	340116	02/24/2006	NC
High Point Regional Health System	34-0004	05/02/2008	NC
New Hanover Regional Medical Center	340141	02/24/2006	NC
North Carolina Baptist Hospital	340047	07/29/2008	NC
Pitt County Memorial Hospital	340040	02/20/2007	NC
The Presbyterian Hospital	340053	06/06/2007	NC

Wesley Long Community Hospital

1477591055

06/29/2009

NC

 

Mission St. Joseph's is in the process of becoming a COE, but Barbara's right, they're not one yet.

Medicaid will not pay if they are not a COE.

Mission told me that medicaid does pay for weight loss surgery at their hospital. I'm confused now. I'm going to call the lady right now...

I just got off the phone with the insurance specialist at Mission and she informed me that Medicaid, which I have, will pay for the wls at their hospital. It's Medicare that will not pay unless the hospital is a COE.

Yeah! I'm so glad to hear that!

Wishing you all the best,

Writing mom

did not mean to scare you. I just know that they do a lot of extra things to get people into their program and I know several that have went somewhere else because of the extra charges.

Mission has applied for Center of Surgery of Excellence several times and have been denied for some reason.

I live in Clyde and work in Asheville. Was very concerned about their outcomes.

Please go to seminar and see what you think but also look at other programs and really look at the program follow up which is very important.

Mission just changed their follow up visit program I think and it may be very good now.

I hope they get their center of surgery of excellence soon.

Tamara