? Medicare and seeing Dr.Nagle

HI,

I live in Illinois, I have Medicare and am going through Dr.Nagle's office at Northwestern for my RNY.  I'm just starting out and was wondering if anyone else with my insurance has gone through the process with Dr.Nagle and can tell me what the basic timeline was like?  Like how long did it take from your first visit to the actual surgery date?

Thanks for any info!

Hi there, Carol! I'm just starting out at that office too, although I have Cigna, so can't help on the Medicare front. I am learning that it's important to drill down to the most extreme detail available from my insurer about the criteria I must meet for approval for RNY. The general info says: "6-month doc-supervied weight-loss program." But the deep details list that ALL these elements must be DOCUMENTED in my program: my weight, my nutrition program, and my physical activity program. Had I not learned about the detail of the exercise element, I would have neglected to ADD it myself to each meeting with the dietician, WLS educator, et. al. Folks at these OH boards have taught me already to be hyper-prepared to meet the insurer's requirements. BTW, Roseann, the insurance coordinator in Nagle's practice can tell you about Medicare, or at least guide you in your search for info.

Hi Carol,
I am a nurse analyst and review Gastric Bypass surgeries for Medicare. If you have had 6 months supervised weight loss, nut counseling, psych eval and BMI over 35 w/co-morbs or above 40 and using a Medicare approved doc and facility, it should go through the 1st time.  I love to send out letters to approved patients. Just know if it is denied, it usually is just some missing paperwork, in my experience. I call the MD office and let them know what I need and have them send it to my attention.  Good Luck!!

Thanks for the info! I have done all of the above and am working on my nut counseling and will have my psych eval on Monday.  I'll just triple check that all of my paperwork is getting done!

I was wondering if you have an update on whether Medicare covered it?