TEXAS AMERIGROUP MEDICAID PRE-CERTIFICATION answer needed badly

Hello. My name is Karen. Sorry for the brief introduction (first post here) but I really need the answer to this very badly and soon.

 My Endocrinologist is the one advising, happy and willing to refer me for Gastric Sleeve. I have type 2 Diabetes, High blood pressure, high cholesterol, thyroid issues among other problems, with BMI of almost 36. I have researched and I meet all of Texas Medicaid's requirements to have the sleeve due to health. I've been seeing her for 10 years, but she is not my Primary Care Dr.

I was told by someone that in Texas with Medicaid only your Primary Care Dr. could refer you for Bariatric. Now the Endo says she will fill the papers out but can only answer for me with anything endocrine related, not general health. I may need him for that.
 

The big question is: Has anyone here had Bariatric done on Texas Amerigroup and were you referred by a Endocrinolist, or Primary care Dr? Will I qualify with my Endocrinoligists backing alone? Thank youi for anyone that can help me quit worrying, lol! Warm regards, Karen

Karen.....I didn't but my niece did have surgery last August with Amerigroup Medicaide.      She used Dr. Wright in San Antonio. He is just about the ONLY ONE she found in Texas that accepted that type of Medicade.   You might want to call your insurance co. and address them with the question about the doctor referral.   Her PCP did refer her to Dr. Wright.    If you need any information on him let me know and I will get it for you.   You will find that there are not many ( In fact he's the only one if I remember correctly ) that still accepts Medicade.   Good luck to you.

Hugs and blessings ~~~ Vivian

thank you so MUCH for replying Vivian! Here is how it stands now.   Trinity Mother Frances Hospital  (Dr. Beall, etc) takes NO Medicaid. However, Dr. Hugh Babineau, East Texas Medical Center in Tyler does. Dr. Hugh Babineau My Doctor is going to refer me to Babineau and i can have it in Tyler. The only question I really have is can an Encodcrinologist refer for Bariatric on their own, or does it have to be a Primary Care Dr.

I think you need to call Dr. Babineau's office.   My niece was going through him in fact had lots of things already done for him for surgery and as of Jan. 2013 he no longer was accepting Amerigroup Medicaid unless he has changed and is now accepting it again.   I helped her call the bariatric surgeons and Dr. Wright in San Antonio was just about the only one who was accepting it and he did the sleeve on her last summer.   I hope your right but I doubt it....Dr. Babineau's office did fax Dr. Wrights office some of the things she had already done so that wasn't going to have to be repeated.    Good luck to you and I hope your right but I doubt that he'd accept Medicaid after dropping coverage on it.    

Hugs and blessings ~~~ Vivian

Vivian I'm not sure about the past with your niece but he does take it. He is the only one in Tyler that does. I called him this morning and also found this on his website. I did find out that my Endo can refer me. Thanks for the help, Karen

Hi, I'm going through the same process with Dr. Babineau. my question for you is how did the process go ? My process isn't going so smooth, its like they don't want to put too much effort into your situation if your on Medicaid. I'm frustrated with this office and don't have the transportation to travel all the way to San Antonio.

I have Texas Star Plus Amerigroup. What steps did your niece have to take to get the bariatric surgery?

George 

Do you know if he still accepts this Medicaid. I am looking for a doctor to do mine. I need this bad.an how was her experience with him?

Karen,

Hi!

1.  Dr. Babineaux did my ex-wife's RNY almost six years ago.

2.  You refer to your endo is a "her".  By chance is she Dr. Sylvia at TMF?

3.  What part of E. TX are you in?  I'm in Trinidad on the west end of Henderson County.

omgosh YES YES YES!!!!!!!!!!!!!!!!!! It is Dr. Babeneaux and Sylvia I'm referring too! Finally someone who knows! I'm in Frankston, Lake Palestine, about 25 miles from Tyler! I would love to talk more with you! I have found out today that..... No one affliated with Trinity Mother Frances (my choice) accepts Medicaid for Gastric surgery, in fact, not one specialized bariatric surgeon IN ALL OF  Texas accepts Medicaid.  (Medicaid told me this today) Except for Dr. Babineau, who is ETMC. I found out today that Sylvia can indeed recommend the surgery on her own to Medicaid. The red tape atmosphere of it all has really gotten my excited dampered First I can have the surgery, then no one takes medicaid, etc.

It looks like, if I want the surgery, and need Medicaid to pay for it, I have to use Babineaux. I was very enthusiastic about this until earlier today when I read some really scary reviews about him Here:  Reviews of Dr. Babineaux and here:  More reviews  My best friend tried Babineaux and didn't care for his lack of bedside manner, so she chose someone else. I don't care if he has bedside manner as long as he is safe. Can you tell me of your wifes experience, and were you perhaps using Medicaid? Thanks so much for writing! Karen