TNCare Select Surgeons

Hi, I am somewhat still new to this forum, so I don't know if I'm allowed to ask this or not. If I'm not, I truley apologize. I recently have been to a WLS seminar and have been trying to get approved of WLS through my PCP. I heard through my PCP nurse that if you go to a doctor that takes Tenncare, I don't need a referral. So I was wondering if any of you knew of any doctors that performed WLS specifically roux-en-y that took TNCare Select. I thought maybe if I could schedule an appointment with one instead of having to get a referral to make an appointment, that it may be easier that way? I'm not sure how to deal with my insurance. Or what to do exactly to get started. Any help would be appreciated. I live in the Murfreesboro/Nashville area Thanks

Dr. Lindy Hruska did take my Tenncare Select. I think she still does. Her phone number is 931-552-0380. She is in Clarksville. I know that is far away but I could not find anyone out here that was 'in network' with my insurance. I like her. She requires a sleep study, dietary consult and psych consult before she sees you. She is very nice and to the point. Check out her on bariactric surgeons to the left of the board and check out insurers and you can check who had tenncare select. Lisa

Thanks so much! I'll have to give her a call. I guess I kept thinking I could just schedule an appointment and they'd do it all for me I know that's lazy but I don't know how to deal with insurances. I'm kind of a push-over.

You should call the Cumberland Center for Obesity Surgery 615-284-7960 or www.johnhusted.com I am pretty sure the still take Tenncare select. I didn't use them But I know someone who did. Good Luck, Lisa

Hi Amanda, I am still a pre-op, but dealing with TNcare and the Dr.'s, my angel gave me some great advice and it has really helped. On the back on your TNcare card is a phone number. Call the number and ask for a case manager. The case manager will contact you within 24 hours and no later then 48. Mine even gave me Dr.'s names, your manager will call you every month to see if they can help you. I gave my surgeon her name and number. Then a lot of the problems can be solved thru your worker. This person will be your worker until no longer needed. Other then that, check out the surgeons, what insurance they take, read messages from prior patients. You can't go wrong with Dr. Hruska, or Cumberland. Good luck to you, Kathy

Yes My case manager was an absolute godsend. Some ppl didn't need to get a case manager with tncare but I did. I have bluecare and was getting the run around with customer service on trying to find a surgeon to take me. They wouldn't even give me names kept telling me that my PCP would have the names and only he could get them. Yet my PCP's office only knew local surgeons and none of them would touch me because of my high BMI. Once I got a case mangager it was much easier. She got my medical info and did the calling to the surgeons to see who would take me and a month later I had a surgeon. Also case management helps expidite things. Like when I had my sleep study done. It was determined I needed a cpap machine. Normally that would have taken a cpl days to be approved and arranged for delivery of the machine. However since I had a case manager my nuero dr faxed the papers to bluecare and they auto send it to my case manager and she approved it on the spot. She also helped me get transportation to my surgeon appts in clarksville (a 4 hr drive). She stayed on my case until I was recovering from surgery with no complications. Which was almost exactly one year after she became my case manager. When she closed my case she told me should any complications arrise from the WLS to contact her immediately and the case would be reopened. Wish you well. *huggles*

HI AMANDA, I HAVE TENNCARE SELECT, AND I AM SEING DR.GLEN BIRKITT IN BRISTOL TN. I HAVE NOT HAD MY SURGERY YET,BUT I'M IN THE WORK'S OF IT. HE HAS A VERY LONG WAITING LIST, BUT I GUESS IT IS WORTH THE WAIT. HIS PHONE # IS 423-968-1861. GOD BLESS YOU IN YOUR RESERCH. BRENDA

Amanda, Call Dr. William Richards at Vanderbilt. I am sure the girls in the office there would be glad to help you. There is also a convention in Nashville the 13th of this month at the Doubletree Hotel. I have a post on here with the site to go to. They should have boo~coodles of info there. Also there is a banner on here with Dr Husted, Olsen and another at Cenntenial. Click on that and get their info. I am sure they would be able to help you as well. Blessings, Mary~ -121

Hey you guys! Thanks so much for all of you guys help. I finally got myself a case manager at TN Care. Although, she has only called me once and I've left her two voicemails. I may have to stand up for myself more and call her again. However, I do hate bugging people. But, as I was browsing some Obesity Help sites today. Someone from Vanderbilt Center for Human Nutrition called me. As luck would have it, one of my doctors gave them my number I was so thrilled. I think she is going to help me get insurance stuff taken care of. The only problem is that supposedly TNCare wont pay for the initial consultation visit. That's the most important visit. What am I going to do if they say I am not eligible, or they say I am and TNCare denies me? I'll have shelled out 400bucks for nothing. The lady at Vanderbilt should call me in a few business days and let me know something. I really do hope TNCare will pay for the visit. I'd hate to waste 400 dollars if I wont be approved for surgery. She said if I was eligible TNCare would approve me, but I'm so worried I'm not eligible, even though I am 5'4 and 260 lb's. My only mental diagnosis right now is Anxiety-NOS (Not otherwise specified) and a mild mood-disorder. I don't know if that would stop me from being approved. I also don't know if how much I eat would stop me from being approved. Maybe I'm worrying too much. Going to just take it one day at a time. I appreciate everyones responses and help. Thanks a ton amanda

If I were you Id start looking into other programs. TNcare covered all of my pre op work up. Sleep studies, nutrition consult, psych consults. The whole 9 yards. I had absolutely no out of pocket expense. They even drove me the 4 hrs to my surgeon appointments pre op, took me to the hospital the day of my surgery and have covered travel to my post op appointments.