OXFORD- LIBERTY HMO

Does anyone have this insurance? What are the pre-requisites or conditions for getting the surgery? I dont think i will have a problem getting approved based on BMI alone, however, i know that other insurances, for example, Aetna, needed a psych eval, 6 month doc supervised diet, echocardiogram, etc etc. Does anyone know if there are less tests with Oxford, or about the same amount.?? Please let me know if anyone has any experience dealing with them. thanks.

Some of the tests are required by the surgeon, not the insurance. The psych eval is mandatory. If your surgeon is thorough, you should have an echocardiogram and an exam by a cardiologist (if the cardio is any good at all, he/she should get a stress test), an exam by a pulmonologist, and an exam by a gastroenterologist. Personally, if your surgeon does not require an upper endoscopy, I think you should find another surgeon - if you are carrying the bacterium that causes ulcers (Helicobacter pylori), it can't be treated once the RNY is done, so it ought to be ruled out beforehand. The supervised diet is the only thing that is insurance-driven, and therefore may or may not be required.

Hmm. good point. i would rather have a clean bill of health and my surgeon to know what exactly is going on with my body, before he starts cutting it up. Thank you. I had an echo in Jan, do they "expire"? Like, hypothetically speaking, if i had my surgery in May, would i need to get another echo? I know you are not my doctor, just thinking out loud i guess. lol. thanks for the response though.

The echo is generally good for a year, as is the endoscopy. You will need an EKG within 6 months, and a chest x-ray and blood work within 30 days of your OR date.

I had Oxford. I did not have to prove any weight loss. I told them what I had done for weight loss and they took my word. My Dr. (Dr. Ibrahaim) take Oxford and it is the only insurance he takes. I had a bunch of tests but they were all covered by insurance. Good Luck, Donna

hi Ana either call the surgeon and ask them what the pre-requisites are -- they handle the insurance companies and should know what to expect from each insurance company or call the insurance company and ask them -- but you might get the run around aetna only required me to do a 6 month diet -- it was over in no time good luck roberta

Thanks Roberta! Shirley, the intake receptionist for Slotman wasnt sure about Oxford. She said that its been a while since she had the deal with them. But she was sure that they were easier to deal with. I was relieved to hear that. I got my scripts for the diff tests i need to take, and until my Oxford kicks in, i cant schedule the last test which is the Upper GI.. which is the most important. lol. but thats fine..