Question:
Should I take a chance on being turned down by Dr.Gagner because my insrance which
is BCBS may not pay DR.Gagner enough money when I really want DS Lap instead of Open RNY which would be with DR.Goodman who is a wonderful man I am so confused because both are out of network my insurance states they'll only pay what they would pay a dr. in network well also DR. Goodman gave me a call and told me he would accept what they will pay but I don't think he do lap nor do he do DS any advice will be helpful,if anyone has a reason I should not go with DR.Gagner for DS please let me know I want to be happy since this is going to be a life changing operation. — TANGIE B. (posted on September 20, 2000)
September 20, 2000
Tangie, alls I can say is do your research. Know what the pros and cons
are of each surgery and seriously decide if you can live with the cons of
your choice of surgery. I had LAP RNY on Aug 8 and there are many many
many days that I wish I had the DS. I chose the RNY b/c of dumping, bad
thing to do b/c not everyone dumps. I'm sorry if I sound bitter, but I
wish I had asked this question before my surgery. I would have had the DS.
I am an eater and so is everyone I know, I should have taken this into
cosideration when I was thinking about such a restrictive surgery. Like I
said before, when you choose the surgery that you want make sure you
absolutley postivly know that you can cope and live with the cons of that
surgery. If there is any doubt, don't do it. Like Melanie said you can
always pay back a debt, but you can't undo permanent changes done to your
body!! Don't make such a huge decision, on what money can do. Good Luck
— Alison B.
September 20, 2000
Dear Tangie, Dr. Gagner has a few associates that also perform wls
laproscopically. Gagner is at the top is his field though. I personally
used Dr. Herron (His associate, LAP RNY). His other associates are Pomp
and Inbanet (SP) These associates were choosen by Dr Gagner personally.
One or more of them may accept your insurance. As for Ivie and the staff,
they aren't the best out there BUT I didnt let that stop me. I was
constantly calling them and basically taking charge of what I needed to do
in order to have the surgery. Do not let the attitude of office staff
dictate your quality of care. Ivie and any other office help are irelevant
in the end. My advice: Call Surgical Associates (212)241-3699 and see if
any of the associates take BCBS. Best of luck to ya!
— Jeannet
September 20, 2000
This insurance thing is tricky to say the least. I have BC/BS Personal
Choice PPO and searched extensively to find out whether or not he was
within network and I was told he was not. I had surgery in June; lap BPD/DS
by Dr. Gagner.
His fee was $12K. The insurance company paid him something like $1800.00
and the bill is considered satisfied because he is within the BC/BS network
in New York. All I had to pay was the consultation fee of $260.00 and
$60.00 for pathology. I believe he is with the Empire BC/BS network. I hope
this helps. Good Luck !!!
— PrettyHotAndTempting
September 20, 2000
I know what you mean about the financial considerations because for me,
(and I mean for me personally and only me), that was the bottom line. But
the only way you will know how much a doctor will accept is if you speak
with him directly. Then you will be in a better position to evaluate the
financial aspects related to the surgery. Many physicians will be
flexible if you talk to them beforehand. Good luck. (Let me put me 2 cents
in for Dr. Gagner-I love him and he did my surgery and my sister's, too.
His associates are very competant also. And many of Dr. Goodman's speak
highly of him. You will be in good hands no matter which physician you
choose. :-)
— Fran B.
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