Dr. X's Nurse

After years of struggling, my wife has decided to go ahead with gastric by-pass surgery. We started the process last November when we met with Dr. Mabin. He found my wife to be a good candidate and we started the process of getting the psychological and nutrition workups. Because my wife had pulminary embolii last summer, she also needed to see a pulmonologist and a cardiologist. She completed all of that by February. By that time, Dr. Mabin had retired so we were informed that Dr. X would be the surgeon. Because my wife's insurance through her employer, Coventry, does not cover weight loss surgery, we put her on my Aetna policy. At the end of February, my wife turned all the insurance information over to Dr. X's nurse, in Dr. X's office. My wife is very patient, but finally contacted the nurse at the beginning of April. The nurse was very rude to her and said, "I haven't submitted anything yet because I know that Aetna won't pay unless you've been on a diet under Dr. supervision for the last year." My wife told her that we had already contacted the company and were told the surgery would be covered. We even had the name of the person we talked to at Aetna and her contact information. We then went to see the nurse to take her the information. She wouldn't see my wife. She said she was too busy trying to get insurance claims approved for other patients. My wife is going to wait another couple weeks and then call the nurse again. My wife actually works for a Dr. who is a good friend of Dr. X. She's about ready to talk to the doc she works for to see what's going on. She's heard nothing but good things about Dr. X and his staff. She's wondering if things kind of went sour when Dr. Mabin retired and the nurse had to pick up that work load as well. We'd really like to get this straightened out with the nurse. We're sure there is just some kind of misunderstanding. If we could only talk to her, we could explain that the company I work for has an insurance advocacy program so that if we were denied, the advocate would help us through it. But the claim has to be submitted first. So we're frustrated. *edited by OH Staff to meet the terms of service*

That's too bad! I've never heard of someone having this sort of problem before. My husband originally wanted Dr Mabin to do his surgery, since that doctor had done 3 previous surgeries on DH and we 'knew' and liked him. However, we've been very pleased with the nurse and doctor we ended up with and we do feel that this is the best doc in Lincoln doing the surgery now. I do know, from attending the pre-op and post-op meetings that this nurse leads that if you call for a consultation now, you are told SEPTEMBER is the first opening! So I know they are very busy. (but since you did that part already, you wouldn't wait that long) She is generally very nice, so when you do call her again I hope that you get her on a good day. I know that he does surgeries on Mondays and Tuesdays... Wednesdays are 'fill days' for the band patients. Sometimes he has part of Thursdays 'off'. So... if I were you, I'd call on a Monday or a Tuesday when she is less likely to be TOTALLY SWAMPED with patients, etc. since she does not go into surgery. GOOD LUCK!!! I'm sure that once you get this misunderstanding straightened out that you will be very happy with the office. Sally

I know what your going through and I hope things work out and I'm sure they will. Talking directly to the DR. is a good thing...Beth