DENIED!

HI Kathy! Good to see you posting.. How are you these days?? I am sooooo happy to see you're perservering through all the junk you've been going through! Yes Hodges was the one I went to but am having some reservations.. not sure about changing YET but at one time I spoke with colquit's office and the money was an issue and also a long waiting list.. like 9 mths.. I need this asap.. in 9 mths I may be in really bad shape.. plus dont want to have to go do all the tests all over again.. costed me 700 plus for last visit to Jc for upper gi and galbladder ultrasound.. But then again I would rather pay a doctor who I feel confident with too.. so Ill pray about it and decide later.. Love ya, Keep pushing! and stay in touch! Dawn

HI Dawn. Good to see you too. Been thinking about you. I didn't go to JC for the GI, I saw Dr. Maves right there in Knoxville. I really liked him. A very pleasant person, but then I can't do swollows, just the scope. I was asleep for it, and a good thing, as the back of my throat had to be dialated for the scope. Hopefully, I will be able to have mine either in Knoxville, or Huntington, WV. That would be more favorable, just a greyhound bus ticket, have wheelchair will travel. LOL. Plus mom and dad live there, why should I have to go thru all the expenses when I'm a veteran? I've had all the tests required, even saw another psych for a second opinion eval. He would prefer after we talked, to have the Surgeon refer me to him, so he will have a better understanding of what the dr. is looking for. Fine, whatever. I can even do that at the VA in Nashville. Only $55 round trip bus fare. Plus cab. That's $12 to the VA hospital, and back to the bus terminal. Best of luck to you. I'll be in Knoxville this Thursday evening at 6pm, Blount Memorial Hospital for Dr. Colquitts seminar. Look for my electric chair. Would love to meet you. Kathy

Dawn, don't mean to butt in but Dr colquitt is my Doctor. I had my testing done else were and all I had to do was take the reports to him and I didn't have to repeat any tests, it had been a few months too. I was approved and got my date all in the same day !! He is not backed up now, My date is August 9th. Beth in his office has been great never put me off when I call and done everthing when she said she would !! What ever you do I hope it works out for you !! I'll keep you in my prayers. Best of all things Linda

Hello Linda, Thank You for responding to my post. I might check into colquit again.. he is closer to me I do think..but one thing I MUST be certain about is that IF- when we try to get surgery approval from insurance that thier office will care enough to help me FIGHT FIGHT FIGHT because of medical need. I am not feeling very confident about the ones in Hodges office so far..I am not trying to be mean or ugly about it, I just feel when it comes to something THIS important you have to be certain and very very confident in your choices..after all this is our lives we are talking about, not a case of the flu! right!? Thank You again Linda! May God Bless! Dawn knoxville

I am new to all this and have been reading the messages to pick up good pointers. Working on the paper work, have had the initial meeting back in June, got the packet on the "how to's" . Have primary doctor working on the blood work, have appointment with the recommended psychiatrist tomorrow, my first support meeting on the 13th. My insurance company also says there is no an exclusion and will pay 70%. Something I can live with. I think I have gleamed from you post that that has been ironed out for you, good for you. Sneaky, aren't they. I also read that you had a negataive psych evaluation. How does one get that. Or avoid it. Of course, we have medical problems, caused by the weight. Duh, we are jumping through loops to get the tool to start on the road to fixing some of those physical problems. Now I understand the mental thing will not necessarily make life rosy, but a long way on the road about feeling better about ourselves is GOOD in my mind. I have tried calling the office today, but it is part of the holiday, so no wor****il tomorrow. I am trying to figure out this: just at what stage do you call your surgeons office to get the first?? appointment to be seen. This is the $300 job? Did I read you have to have a second one? And The $3000 is the program fee, is that due on one of the visits? Maybe I can get this kind of information you get from the office manager when calling for an appointment. Is this correct? As all of us know, we have to keep the ball rolling once we start this or we may be FOREVER getting to that surgial date. So I guess the question here is how does one do to get a negative psyschologial clearance? Here I was going in thinking it was going to be a breeze, not realizing there were pitfalls! My insurance co. is United Health Care and I am looking at Dr. Steven Boyce for the surgery. Thank you for ANY help coming this way, I sure need it and thankful for this forum to help out. Donna

Dawn, Don't give up on this. Call them again and ask about the exclusion and if they tell you there is no exclusion, tell them you want it in writing and then go from there, Does sound like you need to look around at surgeons though. Anyone on here ever use your surgeon?

Thank You Anne..not giving up .. Feel fresh and rarin to go this morning about this. As far as surgeons, I have read and heard alot on here abou****son being good etc but haven't heard a whole lot about hodges and they have not registered on here either.. I spoke to him about it the first consult and he just smiled and never did anything about it so don't think he cares to. I have posted before asking if anyone used him and dont recall getting any responses to that post tho.. He is very sweet and soft spoken as a person I just don't want to chose THIS doctor because of personality alone.. I can't.. my life depends on it! Dawn

Dawn i am trying to email you personally but i can not i want to tell you something but not post it... My email is [email protected] please end me your email well send me a email and i can reply to it

What insurance do you have, you didn't put that on your profile, the reason I ask is because there are some insurance companies that will pay for the surgery but it depends on the way you company has it written in the policy. For instance, I have UHC now I have heard the people were denied because they don't cover it and they don't in some states and it really depends on where you live and who you work for too. My hubby's job is based in TX and in that state UHC will cover the surgery but not in Washington state. But because my hubby's job is based there they will cover it everywhere the company is such as washington state, las vegas to name a few. Sorry if it doesn't make sence but the people who told you it was covered may have been thinking about other policies in other states and they can't denie you over the phone til they read and get all the info and read the way your policy was written for your company. Did you ask then why they denied you? Maybe the Doc didn't give them enough to determain your benifit coverage, I really couldn't say for sure on that one. I hope all works out for you!! Take Care Christina

My insurance is: Tennessee laborers health and welfare fund southern benefit administrators, inc (local union insurance) I realized what was denied was the office visit not the surgery, so I will be sure to meet all of thier requirements exactly before we submit anything more to them.. Dawn Knoxville