medical neccessity??

Hi, had my second consult yesterday.. went well. Dr Hodges' office will submit to insurance Wed. or Thursday. Told me once they get the approval they will schedule date with in a week or two.. was excited thinking FINALLY.. THEN WHAM.. the insurance lady tells me that before they can schedule my surgery, I will have to pay the portion of the bill that insurance won't pay.. WOW.. this is alot of money and I sure didn't expect this setback! I do not understand why they did not inform me of this my first visit so I could have saved this money while going through the whole process to begin with! What blows my mind, is if this is a medically necc.. surgery, WHY do this to the patients because it delays the surgery yet again.. it takes months to get this far and then to be told you are close to getting your surgery and then yank that blanket out from under your feet, I just don't get it. I mean insurance pays 90% on our policy, once they approve anyways, so why is it neccessary to pay the last 10% up front?? I am frustrated and depressed, but guess it won't do any good to dwell on it.. just had to vent.. Have a great day all.. til later. Dawn

Maybe others had a different experience but I wouldn't like that at all. they certianly shoudl have told you up front. I would look into another doctor. Lisa Huffstetler

Dawn, Hey,Dawn.I am so sorry to hear about your insurance problem.10% is a lot to come up with, considering the average cost of surgery is $30,000.00. I think they should have informed you upfront of the cost and that you would have to have it before hand. Keep on keeping on though. It is all going to be worth it in the end. Seems like set-backs and denials are what the insurance companies want to throw our way. Hugs, Lori

Thank You to all of you *****sponded to my earlier post.. today was a bit emotional for me but tomorrow is a new day and I am sure it will work out in the end.. I have came this far and I didn't think I would get to this point so with that in mind, I am gonna keep fighting no matter how long it takes. I just wish we could all go back to the days when doctors cared more about people than the almighty dollar.. I am not saying every doctor is that way but in my experience this has been the case..in this process, I managed to get my records in hand and got to see them, I just sat and cried at the little notes docs wrote in them at times.. it is like they see the "fat" as a weekness or character flaw or something and they believe every ailment is because we are obese..when we go to them for help they dismiss us without hearing us and personally I am sick of this type of treatment. I may be heavy and have some health issues but I am just as important as any thin person.. and have just as much love and compassion to offer the world, as anyone else.. I deserve better and I think we should all stand up to these idiots who feel we are anything other than worthy of being treated like human beings! The irritating part about this money thing is that before I chose a surgeon I called and asked UP FRONT what the fees would be out of pocket so I could be prepared and make my final decision , I was told $200.. so I paid that my first visit, and was told there weren't any other fees except for my portion insurance doesnt pay.. but they DID NOT tell me that had to be before surgery! So far they have gotten alot more than $200.. I am going to go ahead and stick with them and do what I have to because all the other clinics seem to be charging $3-5000 up front anyways.. well I have probably said WAY too much.. goodnight all and thank you again! Hope youre all doing well!!! God Bless!! Dawn

Hi Dawn, I know you must be really upset with your ins. co i would be.That is just not fair,they should have told you before now but that is the way they seem to be.I am still trying to find a dr to do my surgery and take my ins. it should not be so d.... frustrateing or difficult to with.Any way best of luck to you and i pray that it all works out for you. Eva

Dawn, I will tell you why, because doctors don't give a darn if it is medically necessary or not. All they care about is getting their money and nothing else. They are afraid if they don't get it up front then they will be out that money and the doc couldn't keep up the mortgage payments on his house in the Carribean if people did that. You think I am kidding but I am very serious about this. They don't care about people, just about the money. Ok I am in a cynical mood tonight but in my humble opinion this is the case with almost all doctors. Just like at my docs office you pay your office visit copay up front before you get through the doors to see the doc and if you don't have it. Sorry don't care if you're dying we have to have that 10 or 20 or 30 dollar copay or you don't see him. I am sorry this has happened to you and I can sympathize. I had to pay my copay for the hospital up front before I could be given a surgery date. Luckily it is an HMO so just a copay and not a percentage. By the way got the Hospital bill and it was over $30,000.00 for the surgery. Good luck Dawn. Greg

Greg, How are you feeling??? How is the weightloss coming along? Hope youre feeling better and doing well. hugs, Dawn Lori, How is your appeal going?? hope you get good news soon! Have been thinking about you! hugs, Dawn

Hi Dawn. Honey I am sorry you have to go thru all this. All I was told with Hodge was $200 at the first appointment, nothing else was mentioned. One of the ladies on her gave me her Dr.'s name in Nashville, A Dr. Spaw. He will accept my medicare, but wanted his fees up front. That is close to $8000. He does not bill the insurnance for his fees. He was cash in hand before he proceeded with the surgery. It's all about the money. Good luck honey, if you change your mind and want a different Dr. contact me, I can give you a list of Dr.'s and what they want. I'm going for the record of the most Dr. denials. Hugs to you, and may this be just a stepping stone on your journey. Kathy

Hey Guys......Just a little story about Drs,Hospitals,Ins Co.and their $$$$$$$.......As a Hospital Nurse I have heard of cases where Ins People are sent into Pts rooms to "HOUND" them for "Portions that Ins won't pay".Funny these people have to back down when "HARRASSMENT LAWSUIT" is mentioned.That is the last thing a sick or post-op pt wants to be bothered with while still in the hospital. Ins Co. are out for nothing but $$$$$$. Hospital corporations are out for nothing but $$$$$$. Most Dr's(I won't say all,but MOST) are only out for $$$$$$ also. I have some horrific stories from behind the scenes,but I shouldn't get into any of those!!!!!! Dawn....I wish you the best of luck!!!! April