FIDELIS

Fidelis will pay for the surgery. It is the surgeon that I am having the problem with. The surgeon will go  where  he will get the most  $$$$$$. It is sad that these doctors are like that , but someone has to tell the truth about them. I have looked at differant doctors here and I have not seen one doctor or patient that will do the surgery or has had the WLS. I rest my case.

YOU  HAVE TO BE EMPLOYED AND WORKING AND NOT ON SSI DISABILITY AND HAVE THE MEGA BUCKS TO GET THE SURGERY.

I hear and appreciate the emotions you are sharing and overall sense of seemingly frustration.  For me the truth is to also consider directing some emotion to the insurance companies who offer such low reimbursement/almost NO reimbursement and require sometimes 10X more of a provider (that patients do not see behind the scenes in the way of coding, billing, documentation etc). The blame can be shared in many arenas I assure you, it is not all about greedy surgeons. As a provider (Psych NP) I can tell you sometimes all of the EXTRA SPECIFIC documentation that is needed, regulations to follow and 'hoops' in general that are required of providers who accept 'certain insurances' on top of little/no reimbursement exacerbates this issue truly.  Speaking for myself I stopped accepting insurance a few years ago because I was sometimes working for free or worse the cost to myself of operating a practice was so great (Long hours and no pay!)! If the biller didn't dot all i's and cross all t's claims are rejected, if you do not file in the time frame ditto no payment, insurances reject claims for no reason  and the patient you see today you are lucky to get payment in the next 3-6 months!  It is a multifactorial issue. Yes some are out for the money so to speak,/greedy but in my experience and in my practice is my livleyhood and as much as I am passionate about bariatrics passion alone will not pay my mortage, heat, lights, grocery bills, malpractice insurance, license fees or student loans that I took out to become a provider. I have empathy and compassion but again too much and I woould not be able to survive. It can not afford to be my unpaid hobby.  Also if one accepts the abuse of insurers and accepts the terms of service (that they have to jump the hoops for little benefit) then the insurance company sees no issue. I am not saying the ONLY solution is to deny accepting some insurances but I refuse to collude with what I feel is unacceptable terms of service/reimbersement *yes I know there is suffering because of this sadly*. Providers can accept/manage/provide a certain amount of probono/free care but there needs to be a balance and if only a few accept then again a problem we can not share the wealth of poverty so to speak. If providers accept this fate tehn they would only ultimately end up bankrupt and not practicing, no one wins then. The system is challenging/frustrating and stinks in general but the blame doesn't lie just with providers! That is my truth...

I have looked at differant doctors here and I have not seen one doctor or patient that will do the surgery or has had the WLS. I rest my case. That line right there tells me that it's not the doctors, but Fidelis that is being unreasonable... if all docs took Fidelis, yet one didn't, I might understand your gripe... but the fact that NONE of the docs take it tells me something else.

While I appreciate your frustration I have to agree with the 2 posters and this statement especially: For me the truth is to also consider directing some emotion to the insurance companies who offer such low reimbursement/almost NO reimbursement and require sometimes 10X more of a provider (that patients do not see behind the scenes in the way of coding, billing, documentation etc). The blame can be shared in many arenas I assure you, it is not all about greedy surgeons. 
I am was very fortuante to find a good doctor who was willing to take my insurance, knowing that the the Insurance wouldn't pay it all.  He basically said he would bill them and accept what they take and not require of me to pay the difference.  He's been GREAT with me, and I know he is struggling to get the insurance co. to pay him even half of what he billed them.  I had to sign something to allow him to dispute and request more from them cuz he only recieved a small fraction of what was billed.  That says to me that what is being shared here is very true.  Most doctors are not getting rich at our expense!  I want my doctor to recieve what he should be receiving.  I want him to be able to provide for himself and pay for all the education he had to get and will continue to get to stay at the top of his profession.  The issue really is insurance companies and the rising cost of doctors being sued unjustly that has us in this crisis. Sorry that you are hurting and so dissapointed!  Sandra

Im sorry your having problems with insurance.....{{hug}}  Positive thoughts and prayers going your way that you find a solution.

LisaMarie Nice to see you here, how are you doing? How is postop life 2+ yrs out? Check in wiht us! Jamie

Fidelis received no requests (paperwork) for the WLS to be done by the bariatric surgeons. Funny how history repeats itself. My dad needed open heart surgery and because of the lack of money and insurance he was denied the surgery. My day always paid his bills. Well to make the story short, he diefd six years later from a massive coronary. To top it off his doctor let my 12 year brother at the time stay right in the room and watch dad die. He was almost admitted himself. I don't  care what anyone thinks. People in the medical field get alot of  money from all their patients to live on. Come to Cortland and I will show you where 2 doctors live. One has an underground pool. So he was making good money. So please don't respond to this post cause I just don't give a rats behind anymore.

I'm truly sorry you're having such a difficult time with what seems to be your dr. and the insurance. By the sounds of it you're not completely thrilled with this surgeon any way. So why not, put a period at the end of your journey with him and part farewell.. Do you really want to put your life in someone's hand that you have this much distaste for? My suggestion, contact your insurance company, get a list of participating practicioners (they may or may not be conveniently located to you) and go and interview them. Find one that meets your needs as the patient and go on from there. Put yourself first for your treatment. Good luck to you...