INSURANCE

Okay all. Here is living proof. When you get on obesityhelp's main page look for this bariatric surgeon: John Mecenas.  click on either the lap band or rxy.  then scroll down below his picture and look at the insurance carriers the elite patilents  even out of state ones have. not anywhere do you see any patient with fidelis care of new york listed. dr. mecenas is a very discriminating son of a gun. and i just don't care about anything anymore except my little guys here (6), my daughter and 3 grandchildren. i have said it  before. if you get any type of surgery you better have some type of insurance and not fidelis care of new york because 3/4's of these surgeons will refuse you if you have it. and now off to pogo to play some gin and canasta.  fidelis care will approve the surgery too, so it is not them that say no to the surgery  it is  the doctor. 2 shrinnks gave the go ahead for the surgery.  just think this doctor had a patient from florida and also massachusetts  he did the surgery on and i live in new york and he says no. money talks.

forgot, at the doctors last thursday scales had me at 300+. .  i guess meals on wheels didn't follow doctors orders. on the restricted diet i was to be on. legs are also wrapped  up like mummy's too, because of the ulcers on them.

I'm sorry that the insurance company is playing such games!  I can't imagine with all of the hoops you've jumped through this is happening.  Does Fidelis partake in ANY WLS procedures?  RNY or Lap band?  (or the others?) I think in an earlier post you mentioned being refused in Syracuse? 

I am sorry to hear your frustration. I am unaware of the whoel story- but is it the insurance of the DR- ? If its the DR- (can you go to a different one?)  i live south of buffalo so about 3 hours from you!!! We are here for you- so keep us posted- good luck-- I will keep you in my thoughts and prayers..

If a doctor's office chooses not to participate in a particular insurance plan, there's usually good reason for it, and usually due to some fault of the insurance company.  Either the insurance company puts too many restrictions on the Dr as to what they will and won't pay for... or the sort of discount the insurance company wants to get.  It's a business decision and you shouldn't really get mad at the doctor.  It's kind of like getting mad at a store because they only take Visa or Master Card.... and you want to pay with Discover or AmEx.  There's different terms the cards want and maybe the business doesn't find them fair when compared to Visa and MC. What I would do, is call Fidelis (or if they have available on their website) and ask them for a participating provider in your area.  Most insurance companies have a policy that if there are no in-network Drs within a certain distance, then they will pay an out-of-network doc at the same rate they would normally pay the in-network doc. Good luck.