MEDICAID AND MEDICARE SURGEONS LIST!

Hello Members,

On a daily basis we get calls from members in desperate need of surgeons that will accept Medicaid and or Medicare for Bariatric surgery.  It breaks our hearts when we have to say "we don't know of any surgeons in your state we can refer you to". 

Can you please help us? If you know of any surgeons in your state that accepts Medicaid and or Medicare, will you list their:

Name

If they accept Medicare and or Medcaid

Phone number

Facility

Address

This list will remain here for our members to access and use.

Thank you so much!!!

ObesityHelp,

Member Services

Commonwealth Surgeons in Richmond, VA takes Medicare & I think they accept Medicaid as well.  I am not sure how the Medicaid works as it is my secondary insurance but I do have Medicare and as stated in a previous post, they do not do pre-authorizations.  They require ABN's to be signed acknowledging that you will be responisble if Medicare doesn't cover.  The surgeons office will submit for payment after the surgery and then Medicare will decide.  It sucks to do it this way but...  That is the government.  LOL!  I am sure that this is how Medicare works with any surgeon that takes those insurances. If you want to contact that office, their number is 804-285-3225.  Hilary Surrat is their Bariatric Surgical Coordinator and I am sure she will be able to answer all your questions.

The information that you listed, is it for the actual Gastic surgery or is it for plastic surgery? I have medicare and would really like to find a doctor that will take the medicare as a way to remove the extra skin.

Would like some guidance. I am a Tricare Prime beneficiary. Received referral to local Gastric banding surgeon and Doctor said I was well qualified and needed weight loss surgery (Lab Band -my preference). He said we could be in Surgery in late March/early April.   His office Insurance Coordinator then stated as a Tricare Prime patient, TRICARE required all weight loss surgeries to complete: Psych eval Nutritionists eval Blood and Thyroid tests Show proof of attending a six-month weight loss program within past three-five years (this was a show stopper and meant no surgery until did six month program.  Sept surgery?). My question is does Tricare really require the six month program? RJSu

It could be true.  I know alot of insurances require some sort of attempts at other weight loss programs or diets.  My insurance required a 6 month pcp monitored diet and weight checks.  I started that just as soon as I contacted my surgeon since I knew it would take 6 months.  Best thing to do is call your insurance company and ask what they require. **Theresa**

RJSu....
From what I have heard on all the forums and I have talked to SEVERAL TRICARE reps and ...they all tell me NO...they dont require the 6 month program...but you need to get Tricare to send you something in writing stating that...Diff. Tricare reps say diff things tho..I havent gotten as far in the game as you are tho..

Hello RJSu

Yes they do. I have Tricare Prime. If you call the tricare 800 number, the rep will tell you no or no one from a doctors office has called to verify. Once you speak to a surgeon's office that  accepts Tricare they will send you to their rep. Here they will tell you six months doctor documented weight loss program. They do not accept weigh****cher, Jenny Craig, Nutri System.... it has to be with a Nutritionist ooh you must be 100 pounds over weight. I am 90 pounds with 3 comorbidities and they will not allow me to get the surgery, I have to gain 10 pounds then be in a program to loose those 10 probably silly but that is the way they do it.

Hopes this helps

S.

No, Tricare Prime (& standard) do not currently require a 6-month diet.

I am a bariatric surgeon practicing in Richmond performing both Gastric Bypass & Gastric Banding and have numerous Tricare patients approved for surgery without this requirement. 

Because of your message, however, it did raise my concern that they had changed their requirements, so I had my office's surgery  coordinator check with Tricare today, and the 6-month diet is still NOT required.  They do, however still require Psychology & Dietitian evaluations, as well certain labwork (TSH, H.pylori) and an EKG; sometimes cardiology & pulmonary consults are necessary, depending on the patient's health condition.

As a Tricare member myself, I wanted to set the record straight!
Thanks.
David Elliott, MD, FACS, FASMBS
Colonel(R), US Army
Bariatric Surgeon & Bariatric Medical Director
Richmond Surgical Specialists
Parham Doctors' Hospital
(804) 545-4925
www.richmondsurgicalspecialists.com/weight-loss-surgery.htm


PS We also take most Medicaid bariatric patients, but currently not Medicare patients.

 im also tricare prime beneficiary and i was wondering if you could tell me who your surgeon was if you already got the surgery. im stationed in alaska but wanting to get the surgery done in virginia. I dont know if you already got your surgery but im not requried to prove that i did a weight loss program, but then again a referral hasnt been put through for the surgery yet. 

If you live in the northern Va area and have Anthems Health Keepers Plus  It is the secondary Medicaid  ,  Call Dr Moazzez  703620-3211   He is located at Fair Oaks hospital in Fairfax VA. They take it and do everything to get you approved and then go a step futher to make sure they can get all your appointment for testing and classes on days that are together.  Granted you might be at the hospital all day but it bets going 10 diffent times on 10 different days.  You do have to pay a 200 registration fee but they allow you to do it in payments.   Good luck and I hope this helps