anyone from Barix?
Hi everyone! I'm going to Barix for my first consult on Friday! I'm really excited, I'm just unsure of one thing. I have Capital Blue Cross and one of the requirements for approval is the 3 month diet supervised by a nutritionist. I was originally going to have my PCP supervise me for this, but now I'm not sure I would be approved since it specifically said "nutritionist." I was wondering if anyone that went to Barix had a good nutritionist to recommend that they used? Also, what can I expect at the consult with Dr. Boe? Thanks!
I would contact your insurance and see who they cover for a nutristionist... because if they aren't covered it can cost a lot...
Boe was my doc but I didn't have the consult with him lol... I like him. He is a really nice guy and very friendly and can be funny... when he wants to be lol... but no question is stupid to him which is a great thing when it comes to doctors in my eyes...
Hi Casey,
I had my RNY at Barix but with Dr Pupkova but have had the pleasure of meeting many patients who have had their surgery by Dr Boe he is an excellent surgeon as all doctors that are affiliated by Barix Clinics. I had Aetna insurance and was told by them to get approval for my WLS I had to either have a 3 month supervised nutritionist diet or 6 month doctor supervised diet. I was impatient and choose to do the 3 months diet with a nutritionist at Frankford Hospital Wellness Center in the Northeast area of Philadelphia. You can go online and search for a nutritionist in your area but most nutritionist do not take insurance. I choose to go thru Frankford since they were able to take my insurance and all I paid them was my $15 copay at each month visit. I was glad I was able to do that. I hope that helps. Good Luck with your consult with Dr Boe. You will do great. Take Care:)
I had my RNY at Barix but with Dr Pupkova but have had the pleasure of meeting many patients who have had their surgery by Dr Boe he is an excellent surgeon as all doctors that are affiliated by Barix Clinics. I had Aetna insurance and was told by them to get approval for my WLS I had to either have a 3 month supervised nutritionist diet or 6 month doctor supervised diet. I was impatient and choose to do the 3 months diet with a nutritionist at Frankford Hospital Wellness Center in the Northeast area of Philadelphia. You can go online and search for a nutritionist in your area but most nutritionist do not take insurance. I choose to go thru Frankford since they were able to take my insurance and all I paid them was my $15 copay at each month visit. I was glad I was able to do that. I hope that helps. Good Luck with your consult with Dr Boe. You will do great. Take Care:)
-Shilpa
People comment on my over 100 pound weight loss and attribute it to my WILLpower, but it is my WANTpower: I WANT to be thin and healthy more than anything else!
Hi Casey,
I didn't need a supervised diet before my surgery, so unfortunately I can't help you with that. But I wanted to say that Barix is awesome! Dr. Pupkova did my surgery, and she's great. I know Dr. Boe's patients really like him, too, so you can't go wrong with either doc. I really like the floor nurses at Barix----they're very knowledgeable and very personable. I was recently in contact with a corporate nutritionist from Barix in Michigan, and she was great too. I really had a good experience with Barix and am happy with my decision to go there. I hope you have a great experience with them too!!! Good luck with your journey!!!
Julia
I didn't need a supervised diet before my surgery, so unfortunately I can't help you with that. But I wanted to say that Barix is awesome! Dr. Pupkova did my surgery, and she's great. I know Dr. Boe's patients really like him, too, so you can't go wrong with either doc. I really like the floor nurses at Barix----they're very knowledgeable and very personable. I was recently in contact with a corporate nutritionist from Barix in Michigan, and she was great too. I really had a good experience with Barix and am happy with my decision to go there. I hope you have a great experience with them too!!! Good luck with your journey!!!
Julia
Hi! I think you've made an awesome choice - Barix really knows how to provide excellent, comprehensive support to patients, ranging from the "barix bible" (an absolutely invaluable book) to the nutritionists and nurses, facility, and support groups. I have nothing but praise for them.
If you check with CBC, ask about hospitals in your area that are participating providers. In my case, I have Aetna, and Doylestown Hospital participates. Because they do, I was able to go to the nutritional counseling center through the hospital and meet with the nutritionists - as I had a diagnosis code of morbid obesity, it was covered with my usual doc-office copay. (I was surprised, as I had been told that nutritionists are rarely covered.) This angle on it worked, though, and Aetna was happy with it. It's worth exploring if capital doesn't cover "private" nutritionists.
I would suggest that to be safe, you should also have your PCP supervise the 3-months, by going to him/her once a month and making sure that there is good, contemporaneous documentation in your file that you discussed diet and exercise at each of those visits. It could eliminate a later run-around with the ins.
Good luck and I think you'll love Barix. I've never met Dr. Boe (I had Dr. Pupkova), but have heard really good things about him.
Karen
If you check with CBC, ask about hospitals in your area that are participating providers. In my case, I have Aetna, and Doylestown Hospital participates. Because they do, I was able to go to the nutritional counseling center through the hospital and meet with the nutritionists - as I had a diagnosis code of morbid obesity, it was covered with my usual doc-office copay. (I was surprised, as I had been told that nutritionists are rarely covered.) This angle on it worked, though, and Aetna was happy with it. It's worth exploring if capital doesn't cover "private" nutritionists.
I would suggest that to be safe, you should also have your PCP supervise the 3-months, by going to him/her once a month and making sure that there is good, contemporaneous documentation in your file that you discussed diet and exercise at each of those visits. It could eliminate a later run-around with the ins.
Good luck and I think you'll love Barix. I've never met Dr. Boe (I had Dr. Pupkova), but have heard really good things about him.
Karen
There are a TON of barix babies on the boards!!!! Welcome! I'm one of 'em although I am a patient of Dr. Pupkova. I have met Dr. Boe before and he seems wonderful and the people who have him sing his praises ALL the time!
The insurance thing....I would double check by calling or something....but it sounds to me that you might want to see an actual nutritionist. Couldn't hurt to have your PCP AND nutritionist do stuff, so you have documentation all over the place. Just make sure your nutritionist and your PCP are on the same page. Barix has nutritionists ON STAFF so it might be worth your while to see if you can see them.
Oh, and I didn't read all the responses so if there is repeated info here, I'm sorry. These are the support group meetings schedule AT barix if you are interested:
SECOND TUESDAY of each month: 7pm to approximately 8:30 in the lobby PRE OP support group. Topics are geared towards pre op patients (insurance, fears, what to expect, etc) although post ops do attend to lend support, receive MORE support (cause there's never to much) and to keep "on track" Susan is the leader, "Cloesmom" here on the boards
THIRD WEDNESDAY of each month: 7pm in the lobby to approximately 8:30 although many hang out afterwards to chat for a little bit POST OP support group. Topics are geared towards post op patients, their needs, questions and answers regarding topics members bring up, etc etc Dennis Belk is the leader, also here on the boards very often! Pre op patients sometimes attend, but it should be noted some things may be a bit intense for pre op patients due to potential conversation issues (complications, emotional difficulties etc)
FIRST SATURDAY of each month 12pm - 4pm First two hours are broken into small groups based on what part of the process you are in. Then a small break, and then a large group to get everyone together. The smaller groups work out VERY well as at the Tue/Wed meetings listed above, they are pretty big and these smaller groups allow for a more "concentrated" support.
Can't wait to get to "know" you better!
Pam
The insurance thing....I would double check by calling or something....but it sounds to me that you might want to see an actual nutritionist. Couldn't hurt to have your PCP AND nutritionist do stuff, so you have documentation all over the place. Just make sure your nutritionist and your PCP are on the same page. Barix has nutritionists ON STAFF so it might be worth your while to see if you can see them.
Oh, and I didn't read all the responses so if there is repeated info here, I'm sorry. These are the support group meetings schedule AT barix if you are interested:
SECOND TUESDAY of each month: 7pm to approximately 8:30 in the lobby PRE OP support group. Topics are geared towards pre op patients (insurance, fears, what to expect, etc) although post ops do attend to lend support, receive MORE support (cause there's never to much) and to keep "on track" Susan is the leader, "Cloesmom" here on the boards
THIRD WEDNESDAY of each month: 7pm in the lobby to approximately 8:30 although many hang out afterwards to chat for a little bit POST OP support group. Topics are geared towards post op patients, their needs, questions and answers regarding topics members bring up, etc etc Dennis Belk is the leader, also here on the boards very often! Pre op patients sometimes attend, but it should be noted some things may be a bit intense for pre op patients due to potential conversation issues (complications, emotional difficulties etc)
FIRST SATURDAY of each month 12pm - 4pm First two hours are broken into small groups based on what part of the process you are in. Then a small break, and then a large group to get everyone together. The smaller groups work out VERY well as at the Tue/Wed meetings listed above, they are pretty big and these smaller groups allow for a more "concentrated" support.
Can't wait to get to "know" you better!
Pam
Instead of complaining that the rosebush has thorns, be happy that the thorn bush has roses. 
Casey, I had my surgery at Barix just 3 weeks ago. You are on the right track!
I also have Capital Blue Cross. They have very specific requirements - the journey took me FOREVER but if I can help with added info, I am glad if it paves the way for a smoother ride for you.
As far as the nutritionist-supervised diet, I worked with a program at our local hospital which was led by a registered dietitian. It was a group program and not hugely expensive, but I saved all the handouts, food logs, topics discussed, and pre- and post- body assessment from that. In addition, they wanted copies of ALL of my primary care doc's chart notes showing that I had weighed in with him at least monthly, what his recommendations were, and that we had discussed my weight problem.
In addition, Capital required the following:
Documentation of BMI > 40 or obesity related comorbidities.
Written statement that you have been advised of alternatives, risks, and benefits of surgery (this is documented by your consultation). The Barix insurance dept. will provide this.
Documentation of attendance at at least 2 support group meetings (you can get a letter from facilitators at the Barix meetings)
Sleep study. If you have sleep apnea there is a requirement of a minimum number of hours on a CPAP prior to surgery.
Letter from your primary care doc stating that he/she is aware of your interest in surgery and stating that you are a good candidate for WLS
Psychological evaluation
Cardiac clearance, which may include a stress test (I had a stress echocardiogram)
Pulmonary clearance (For me this was the same dr. as ordered my sleep study)
GI clearance if you have GIRD or positive H pylori (This is determined by another blood test. If you are positive, you need to take a regimen of antibiotics and be retested.)
Endocrine check - basically a blood test that your thyroid is normal
Vascular evaluation or consult if you are at risk for thrombosis or pulmonary embolism
Physical medicine consult if you are unable to follow an exercise program
This sounds like a lot but it's best to know up front what all is required. I'd recommend the following:
1. Get to know your insurance dept. contact at Barix. These folks will be your primary contacts throught he approval process. They are great.
2. Work very closely with your primary care doc.
3. Get copies of all results, reports, and letters from each of the above and fax them to Barix YOURSELF rather than waiting for various dr. offices to follow through. BE IN CHARGE and TAKE CHARGE as much as you can or you will wait forever.
4. Start making the appointments as soon as you can.
5. When you get approval, Barix will talk about getting a "letter" which CBC does not always send (depends on your type of policy). Get the preauthorization number - Barix can schedule you based on that number.
You may find that all of these are not discussed at your consult - they were not all mentioned when I first met with Dr. Pupkova (she just recommended the sleep study and losing 5 lbs.) - but the insurance company prevails at this stage. Once you get approval...you're rolling.
I hope this is helpful. Please feel free to send a note if you have other questions. Despite all the red tape...it's a great place to be on the other side!
I also have Capital Blue Cross. They have very specific requirements - the journey took me FOREVER but if I can help with added info, I am glad if it paves the way for a smoother ride for you.
As far as the nutritionist-supervised diet, I worked with a program at our local hospital which was led by a registered dietitian. It was a group program and not hugely expensive, but I saved all the handouts, food logs, topics discussed, and pre- and post- body assessment from that. In addition, they wanted copies of ALL of my primary care doc's chart notes showing that I had weighed in with him at least monthly, what his recommendations were, and that we had discussed my weight problem.
In addition, Capital required the following:
Documentation of BMI > 40 or obesity related comorbidities.
Written statement that you have been advised of alternatives, risks, and benefits of surgery (this is documented by your consultation). The Barix insurance dept. will provide this.
Documentation of attendance at at least 2 support group meetings (you can get a letter from facilitators at the Barix meetings)
Sleep study. If you have sleep apnea there is a requirement of a minimum number of hours on a CPAP prior to surgery.
Letter from your primary care doc stating that he/she is aware of your interest in surgery and stating that you are a good candidate for WLS
Psychological evaluation
Cardiac clearance, which may include a stress test (I had a stress echocardiogram)
Pulmonary clearance (For me this was the same dr. as ordered my sleep study)
GI clearance if you have GIRD or positive H pylori (This is determined by another blood test. If you are positive, you need to take a regimen of antibiotics and be retested.)
Endocrine check - basically a blood test that your thyroid is normal
Vascular evaluation or consult if you are at risk for thrombosis or pulmonary embolism
Physical medicine consult if you are unable to follow an exercise program
This sounds like a lot but it's best to know up front what all is required. I'd recommend the following:
1. Get to know your insurance dept. contact at Barix. These folks will be your primary contacts throught he approval process. They are great.
2. Work very closely with your primary care doc.
3. Get copies of all results, reports, and letters from each of the above and fax them to Barix YOURSELF rather than waiting for various dr. offices to follow through. BE IN CHARGE and TAKE CHARGE as much as you can or you will wait forever.
4. Start making the appointments as soon as you can.
5. When you get approval, Barix will talk about getting a "letter" which CBC does not always send (depends on your type of policy). Get the preauthorization number - Barix can schedule you based on that number.
You may find that all of these are not discussed at your consult - they were not all mentioned when I first met with Dr. Pupkova (she just recommended the sleep study and losing 5 lbs.) - but the insurance company prevails at this stage. Once you get approval...you're rolling.
I hope this is helpful. Please feel free to send a note if you have other questions. Despite all the red tape...it's a great place to be on the other side!
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