Question:
What if you are denied? Then what? Do you go back diets that don't work ?

My doctor flat out lied to me about sending in my referral. He said he had sent it in twice, but actually, he never even wrote it. I don't know if the insurance will approve me for surgery now. What are my recourses?    — Jean T. (posted on July 29, 2002)

July 29, 2002
I would definitely first seek out a second surgeon.It's a drag doing this all over again,but at least you'd be getting somewhere.And who wants a surgeon who lies anyway? What else is worth lying about to him??
   — Elizabeth N.

July 29, 2002
HI SWEETIE, I ALSO HAD THE SAME PROBLEM, I HAVE BEEN THRU ALOT, JUST READ MY PROFILE LOL. BUT GO FIND ANOTHER DOCTOR. MY FAMILY DOCTOR HAS BEEN OUR DOCTOR FOR 10 YEARS, AND HE DOWN RIGHT DOES NOT AGREE WITH THE SURGERY. SO I HAVE FOUND ANOTHER DOCTOR WHO GAVE ME CLEARANCE YESTERDAY. ASK YOUR SURGEON TO REFER YOU TO ONE OF HIS COLLEGUES FOR LETTER, THATS HOW I GOT MY CLEARANCE. IF YOU JUST NEED A FRIENDLY EAR, I AM HERE. BEST WISHES!!
   — Gale G.

July 30, 2002
I had the same problem! I also had Humana HMO of Illinois just like you have! Why don't you change networks to go to Rush-St. Lukes Presbytarian. Change Primary Care Physicians to Rush-St. Lukes Presbytarian. Humana HMO will approve your surgery especially if you go to a surgeon who does the footwork and all of the paperwork for you and your BMI is 40 or above or you are 100 or more pounds overweight! One surgeon who does this is Dr. Frantzides who has an office at St. Lukes Rush and his telephone number is 312-942-6511 at Suite 818. His office also has a special program where if you are uninsured they set you up at Cook County Hospital to get this surgery free of charge. Please read my Profile and if you have questions just email me at [email protected] I had my surgery on 03/04/02 and I feel great. I am down 71 pounds. Is your BMI 40 and above? Just give this surgeon a try and you will be surprised as to how soon your surgery date will come around. When I went to my first consultation my surgery date was set for 8 weeks after my very first meeting with the surgeon. I was relieved and extremely impressed. HOPE THIS HELPS! GOOD LUCK! If you want to know of other PCPs who are WLS friendly and would give you a referral ASAP then just call his office and speak to his staff!
   — Shirley M.