Doc Referral help

Hi! I am new to this board and new to this whole process! I found out yesterday that my insurance just denied me for an out-of-network referral to Dr. Joseph Caruana in Buffalo. From what I understand, they are referring me to a Dr. Forbes, Dr. DiBennedetto, Dr. Posner, or Dr. Sax. I have never heard of any of them and I do not have any information. I am trying to decide if I want to do a POS with my insurance and only have 70% covered with Dr. Caruana or get better coverage (about 90% to 100% covered) with one of these doctors listed above that are in-network. I really want someone that is very experienced and very good (I'm not saying that the physicians listed above are not; I just don't know what experience they have). Any help would be greatly appreciated!!! Thank you so much!!! Brandi

I have been in contact with Dr Posners office, the woman i spoke with answered my questions and was very nice, i am in the process of getting the paperwork sent to me. I havent heard any of the docs above, besides posner and Caruana. Posner is a good experienced doc, and gentle, my cousin just had the surgery witgh posner 3 weeks ago, went very smoothly, he does the Laproscopic procedure and it took him about an hour my cousin said. he is however very busy the nurse told me he wouldnt be able to see me till end of summer at earliest! So i am thinking of a diff doc but havent seen any or heard of any other in the Buffalo area. Why did you get denied by ins? they dont think your deserving or "big enough"? what ins company? where are the docs you have listed above, located?

I was just reading the profiles of the different physicians in the area on this website and noticed that Dr. Posner has about a 6-8 month wait to get an initial appt. I was reading information about Dr. DeBennedetto (he is located in Lockport). I also just finished reading information about Dr. Sax (he is located in Rochester). My insurance denied an out-of-network referral to Dr. Caruana (he doesn't participate with IHA). If I still want to see him, I would need to use my Point-of-Service plan, which only pays 70%. I prefer to have it covered. From what Member Services at IHA stated, they said that as long as it is medically necessary (which I know it is from my weight, BMI, and probs I have), then it will be covered, but only according to what they are supposed to pay. I guess we will see!

Do any of the other Doc's do Laproscopic? i would rather have that and not wait for Posner as you said. Also what is IHA?

I KNOW MY FRIEND HAD DR.HARRY SAX AND HE IS LOCATED IN ROCHESTER AND HE ONLY DOES OPEN. BUT HE HAS DONE 1000 ARE MORE SO HE IS A VERY GOOD DOCTOR. IF YOU DECIDED TO GO THE STEPS ARE GET A REFERRAL FROM YOU PCP FAX IT IN THEN THEY WILL SENT UP AND APPT FOR YOU TO SEE THE DOCTOR THEN HE WILL GIVE YOU A DATE AND YOU HAVE TO GET A PSYH EVUAL AND NUTRI EVUAL..HIS PRETTY SIMPLE BUT VERY, VERY, GOOD. IF YOU WANT OPEN AND YOU ARE NOT TO FAR FROM ROCHESTER AND YOU WANT YOUR SURGERY WITHIN 2-3 MTHS HE WILL BE A GOOD DOCTOR.. HOPE THIS HELPS..

Thanks i will write his name down, I really want this done and overwith but i am so scared in general the bigger the ut the more worry! what i really need to do is see the scar and or talk with more people who have had it done.

Thank you all for the information!! Good luck on your journeys Brandi