Can anyone let me know about surgeons

Hi all,
I am new to this forum and am desparately looking for a surgeon in my area who takes Aetna HMO for the RNY surgery.  My sister went to Brian Boe in Langhorne and he did a great job but the Bariatic Center does not have a contract with Aetna yet...can you imagine their medical director has a contract with them but not the hospital...OMG!!
I live in Upper Bucks County so can easily go to the Lehigh Valley area.  Going to Philly is just too far for me right now...it would be a last ditch effort if you know what I mean.
So the question is, does anyone know of any program, doctor and hospital that takes Aetna HMO in my area?
Thank you all for you help and good luck on your journey.  Both of my sisters had RNY and have lost 86 lbs and 70 lbs so far.  My neice had the LapBand and has lost 70 lbs so far...it makes me wonder why I waited.

P

WElcome aboard!!

I'd send you to Dr Alan Brader at Lancaster General Hospital. You aren't too far from me - I am in Easton. I go down to see him for all of my follow ups (He did my surgery 2 1/2 years ago at Barix and has since re-located) LOVE LOVE LOVE the man and everyone in his office!!! It is a bit of a drive but so worth it.

Other people I know have had surgery at Westfield Hospital in Allentown and LVH and have all done well.

Liz
PS - I run a support group / cooking class in my home once a month. You are more then welcome to come - keep your eyes out this week for more info!

Hi and welcome!

You can call Aetna and talk with their member relations department.  I was specifically told, on 3 separate occasions, that because of "network deficiency" they would cover Barix as in-network.  That's because there are no bariatric surgeons/centers that are in this region that are in-network with them.  My surgery was at the end of april.  So far, I've got most (but not all) of the exp of benefits back and they have covered at in-network rate for me.  The one that they have not covered at in-network was SOME (not all) of the hospital expenses, which has now been appealed based on what I was repeatedly told by them.   So Barix may not be out of the question for you (in which case, I can COMPLETELY recommend them - Dr. Pupkova is just awesome... I have absolutely nothing but the highest praise for her and her staff). 

The other advantage of going with Barix is that the support system they've built around their care is outstanding.  From the "barix bible" (a book given to all patients at their pre-op testing... literally everything you need to know about the experience, including recipes and meal plans for post-op) to the hospital setup itself to the support groups and the nutritionists on staff, the facility is designed for the most positive experience possible. 

Hopefully, this will help you navigate through some of the insurance hoo-ha!

Karen

LVH has the 6 month new you program that meets all the requirements any insurance needs.  Then the Nut. and psychologist are yours for the rest of your life.  You pick from one of 3 docs.  I had Dr. Rovito and I adore him as well as everyone who ever speaks of him.  Dr.  Harrison assisted on both my and my husband's RNY and he was great too.  It's a good program, the hospital staff is amazing from pre-surg to letting you go and its a very clean place!  ;)  Rovito has now performed 2 surgeries and he does a beautiful job.  He is also a real person and does not make you feel like "I am a dr you must listen to ME"  He actually listens to us. 

I have Aetna and while Barix was out of my network they still covered my surgery - I just had a little larger co-pay. Keep working on your insurance company - I had Dr Boe and loved him and the entire Barix experience, so if your heart is set on Barix I would definitely pursue it with your insurance company - I had to go thru 3 different reps at Aetna before I got someone who actually KNEW what they were talking about. They sent me this huge packet of information regarding RNY and I had no problems at all.

Best of luck to you!! Keep us posted on how it all works out.

Dr Clarence Holland at St Lukes. great Hospital, excellent team, and a surgeon that has some of the best statistics in the business.

http://www.mystlukesonline.org/find-doctor/doctor-detail.asp x?doctorID=1876&sid=290180&sort=3&pg=1

http://www.mystlukesonline.org/conditions-and-services/st-lu ke-s-bariatric-services/index.aspx

Hi to all who answered my question about surgeons and centers.  It can be depressing and daunting to go through all of the "stuff" the insurance company wants to put you through.  For those of you who have gone to Barix with Dr. Boe pr Pupkova that is where I really want to go...but I am willing to check out every place everyone has recommended. My sister had RNY done in December and is down 86 pounds!!  She looks and feels great.  My other sister had it done in RI and is over 75 pounds since March and she looks and feels great too...I want this so badly now that I have seen the success my sisters' have had.
Again thank you all and I will let you know how things go as I begin the journey through the "Insurance Maze"!!

I would be remiss if I did not suggest my amazing surgeon. Dr. Neil Marymor, formerlly of Barix who has now started his own practice out of Crozer in Chester, PA.

http://www.obesityhelp.com/morbidobesity/bariatric+surgeon+profile+Neil+S+Marymor+MDFACS+dtf.html

i have no idea if he works with Aetna, but certianly wouldn't hurt to call his office and ask.