New here! WV transplant to PA just for the surgery

greendragon
on 7/21/10 1:10 am - Morgantown, WV

Hello all! I was signed up with Dr. Akkary in WV, who left the hospital a couple days after I got my approval letter from the insurance... so willy nilly, I had to find a new surgeon. There isn't any others in the area of WV I'm in (Fairmont), and the closest in-program one was 2.5 hours away in Charleston. Dr. Costa, in Greensburg, PA, was taking some of Dr. Akkary's clients, so now I've started the process to get him approved. His office is only 1.5 hours away - not as bad of a trek :) So now I'm sort of a PA transplant!

I just got a call from insurance (Klais & Co) that they would pay for dr. Costa as an in-network surgeon since they had no one else close, so that's great news! Just waiting on a surgery date now. WOOHOO!

kgoeller
on 7/21/10 2:28 am - Doylestown, PA

RNY on 04/22/09

Make sure you ask the insurance company EXPLICITLY whether Dr. Costa's surgical FACILITY (and anesthesiologist/labs/etc.) are also covered in-network. I ran into the same type of thing with Aetna and ended up with a large out-of-pocket because they treated the surgeon as in-network and the facility (Barix) as out of network.

Also - make sure you have documentation in writing from them that they will pay in-network. Makes it so much easier when you potentially have to argue about it afterward.

Congratulations on the approvals and on finding a surgeon. Welcome to the PA Board, too!

Karen

greendragon
on 7/21/10 2:31 am - Morgantown, WV

VSG on 11/08/10

They are sending the documentation to me and the health group. Dr. Costa's assistant, Peggy, is making sure that all that is happening, specifically that the facility is also covered. Thanks for the advice though~! If Peggy hadn't mentioned it, I wouldn't have a clue to make sure.

This insurance company actually does it's best to work with you on everything. My agent Liz is terrific, and gets things DONE. It only took two weeks for them to approve the surgery!

Thank yoU!

Laureen S.
on 7/21/10 3:03 am - Maple Shade, NJ

RNY on 10/16/07

Congrats on working your way through the maze of WLS and landing here in PA. . . I, too, am a transplant, by way of NJ, because after my research and wanting someone close to home in case I had a need of the urgent kind, I landed up at Barix with the wonderful Dr. Pupkova and Barix nursing and staff members were just awesome. . . anyway, I also found this board much more active than my homestate board, so I frequent this one, as well as one geared towards my "age" (lol), which while I am getting younger all the time thanks to WLS, the calendar tells me I am 55 now (lol), so I am also an active member of the Over Fifty Forum, which is a great board for anyone of the golden years (lol). . .

You will find lots of helpful folks here on this forum, so feel free to ask questions and participate as you like.

Best wishes as you undertake a journey that will give you a new lease on life.

Laureen

My Mantra is that I do not determine my success by the number hanging in my closet, nor will I let the scale determine that success either. . . It is through trial and error I will continue to grow and succeed. . . Laureen

"Success is a journey, not a destination." Ben Sweetland

Nicole0216
on 7/21/10 3:38 am - Lancaster, PA

RNY on 10/03/06

Congrats and Good Luck. You will be so happy you migrated over to this board. It is very active and we are awesome!

greendragon
on 7/21/10 3:45 am - Morgantown, WV

VSG on 11/08/10

Glad to hear it! My husband is also on the surgery path, but he's only about halfway through his doctor-directed diet. I've jumped through all the hoops, and here I come!