CAUTION for self pay

sara3
on 11/28/11 10:23 am
Hello all,

Firstly, I wanted to say that all of my pre op tests came back normal, I am thrilled and hope the next stage in my journey will be booking my flights and hotel for surgery in 3 weeks.

I also wanted all of the new folks out there, who are self pay patients to be aware of the extra cost involved in pre op tests, if you like me, do not have great insurance  the cost can be extensive. It has run into the thousands. I saved for 2 years to be able to get the DS with Dr Gagner and I was not expecting these extra costs.

I had to get a chest X-ray, blood work, upper GI endoscopy and a thalium/nuclear stress test. However, some of these may have been an extra precaution for me as my BMI is 60...

I hope this helps someone plan accordingly.

Sara
Renee2007
on 11/28/11 10:33 am - Central, FL
 I was self pay and my pre op tests were all coded due to my co-morbidities. Due to that my insurance covered them without any knowledge of my upcoming surgery. I think the diagnosis codes used are the key as to if your insurance will cover them or not.


Renee
 My DS   
SW/263  CW/136 GW/150



fullhousemom
on 11/28/11 12:13 pm
 I was a self pay. My PCP ordered most of my blood tests required, and they will be covered under insurance. I was surprised that my insurance covered my chest xray!    I, too, think that coding has a lot to do with it.   And because I was a self pay, my surgeon didnt make me complete all the insuranc required tests before surgery. Had he required everything, I probably wouldn't have had the surgery. My BMI was 40 with no comirbids, so I was lucky. 
gak
on 11/28/11 2:51 pm
Revision on 06/21/13
Please check with the doc who ordered them and see if they can be re-coded and re-billed to the insurance. They should be covered as preventive or something of the like as the others have mentioned. Good luck.. It will be worth it in the end.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

timetodance1989
on 11/29/11 2:51 am

I am new to DS forum. I was interested in the cruise information I read on one of the posts. How can I find out more information?

gak
on 11/29/11 3:01 am, edited 11/29/11 3:05 am
Revision on 06/21/13
 I will send you the info 

Edited to add:
I sent it, but OH is acting wierd. If you did not get it, please let me know. 

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

NoMore B.
on 11/28/11 8:06 pm
 Just wanted to echo what the others have said.  My insurance covered my DS, but I had extensive plastics this year, all self pay.  The plastics required pre-op labs, and imaging studies, all covered by my insurance because my PCP coded and ordered as part of my annual exam.  See if they can recode and resubmit to your insurance.
AllieInOntario
on 11/28/11 10:39 pm
I had mine in June/2011 with Dr G and I didn't have to have a GI or the stress test.  Might have to do with your BMI or other medical history.  He's VERY thorough, even with the extra cost you are in great hands.
Pick your surgery first, then your surgeon. Not the other way around.  
PS:... Potato chips should be a food group.

I'm tired of screwing with that damn health widget.
 I've lost 125 pounds to date!!!!
   And I'm UNDER 190 now!!! 
 
             
sara3
on 11/29/11 2:48 am
Hi to a fellow Dr G patient.

I am a band to DS revision so that is why I needed the GI and you are right the stress test was an extra precaution as my bmi is so high. I am very confident in my choice of surgeon and I know I am in good hands. Well done or your loss, hope I am as successful as you.

Sara
sara3
on 11/29/11 2:45 am
Thanks for the advice everyone.
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