I dont know where to start????

So I have insurance finally and I am stumped as to what do I do first.  I already have a referal for my pcp but I need to find doctors that accept medicaid insurance.  I lice in Central oregon and I am not super trusting of the local bariatrics guys.  I want Tersigne but he is in the process of having his hospital becaome a center of excellence.and that is what medicaid requires.  I just want to get the show on the road and start the required testing and I dont know what to do???  Do I just start the test with ohsu and then transfer if tersigne gets his hospital approved??Let me have wisdom if anyone can help.  Thanks in advance and I hope your not sick of my lame whiny questions by the time this is over... Thanks Chris

According to the Blue Cross/Blue Shield insurance page, Dr. Tersigni is certified to perform WLS as a Center of Excellence doctor.  I don't think I'd start with one program and then hope to transfer -- most places don't like that and tend to get very territorial.  Once you transfer, they are crabby about sending records, etc.  What is wrong with the guys at St. Charles?  We've got a couple people in our local group who have gone there and had good outcomes. Linda

I have had alot of mixed reviews from the local docs they really havent had as many surgerys as some of the other docs i have mentioned.  They started doing bariatric surgerys a few years ago when it became all the rage.   Also their infection rate is pretty high.  St charles is not a center of excellence but the doctors are just like tersigne is a doctor of excellence but his hospital is not.  But Doc Tersigne has started the tours and is way further along in having his hospital becoming a center of excellence where as st. charles has just gotten the initial paperwork turned in.  It is all so complicated.  I do know that ohsu is a center of excellence.  I am just not real sure i want to deal with how bad their patients get treated by staff and how busy they are.  Since i am ohp/medicaid I have to pick the doctor and the hospital that are both center of excellence.  Phew now i am brain dead it is so lame the hoops you have to jump through.  I just wish i could pick who i want and go there and get it done but not gonna happen i have to work a bit harder.  Thanks so much Chris

OHSU is not a center of excellence.  Legacy Good Samaratain is and in Portland has a really good program.  You'd be required to travel some but I do know they take OHP/Medicaid.   Oregon Weight Loss Surgery & Legacy Good Samaritan Obesity institute work together.  Here is the link to their site:  http://www.legacyhealth.org/body.cfm?id=681

OHSU IS a Center of Excellence - I had my surgery there and could not have had it there if it were not a Center of Excellence. Linda

see, now that's weird.  cuz my insurance would not cover Sacred Heart or anywhere else.  And I was told the closest one was in Montana!  how annoying.  

Sorry... my bad.

OHSU is definitely a Center of Excellence for Medicare and has been since 2006.  The other Centers of Excellence in Oregon are:  Legacy Good Samaritan Hospital and MC (since 2006) and Sacred Heart MC (since 2008). OHSU accepts Medicare and the Oregon Health Plan (OHP).
Medicare covers Duodenal Switch, RNY, and gastric lap band.
OHP does not cover any WLS as a matter of policy.

Starting in Jan. OHP started paying for wls if you have a preexisting condition of diabetes whether or not you need meds for it.  If you have any co morbiditys they cover wls.  It is a new policy of theirs that they cover it.  I have researched the heck out of it and i found the entire write up on it and to my understanding if you have that co mobitity or diabetes it is covered.

I have Aetna and although there are more "Centers of Excellence" available, there are only 4 that my husbands employer (They set the guidelines for the insurance co.) allow me to have surgery at.  It is confusing isn't it? Legacy Good Sam in Portland works with SW Washington Med. Center, but I have to still go to Portland.  I hear it is a great hospital so I don't mind, but it seems odd that I can have the tests done here, and must have the surgery done in Portland. I hope to be on the losing bench soon.  5 more pounds to go till I get my letter from Aetna to go ahead!!! Be Well, Debbie