Pottermom88
Please login to post to Pottermom88's support wall. If you don't have an account, registration is quick and easy.
VegasDeb 22 years ago
Hugs to you, Maryalice! Good luck on your journey!! Deb
love2eat 22 years ago
good luck and I will put you in my prayers.... Hugs and more Hugs see ya on the losing side even though I am not a loser yet hee heee heeee :-) Love Rachel
GW 22 years ago
Maryalice, My thoughts and prayers are with you on this roller coaster ride we call WLS. I have also been denied and am waiting for my appeal to be approved. I know what you are going through! I pray that all goes smoothly this time and that soon you will be a "loser!"
elsa W. 22 years ago
maryalice, i pray your surgery and recovery are very successful and smooth. huggs elsa
Gilly68 22 years ago
I am praying for you.....it will all work out just fine...
Theresa W. 22 years ago
Hi Maryalice! I will be praying for you with your consult with cori. You deserve this! You have a good friend in Jennifer! Good luck!
Lois B. 22 years ago
MaryAlice I hope everything goes smoothly for you this time around and you are approved for surgery!! Keep us posted on the Michigan Board.
Wookie 22 years, 8 months ago
Mary , please don't give up so easily. I have been trying for 5 years to get the surgery. I was approved for surgery at flint hurley and one week before surgery I was told they couldn't do it because I was to high risk for them!!! Then I went to another Dr in Grand Rapids and was told I had to lose 60 lbs first. Like you I thought this was ridiculous. I then found a Dr right here in Alma that did them and he agreed to do it for me. I only had to do 2 visits with a phsycologist before my insurance would cover it . Then guess what? I got a letter from social security telling me I would now recieve a medicaid card and I couldn't have 2 hmo insurances so I had to change my insurance and start all over again!!!! This turned out to be a blessing . My aunt had the surgery with him and he botched it. She spent 7 months in the hospital and passed away in February. The day after he did her surgery, he packed up all his patient records and left town , leaving her and other doctors who knew nothing about the surgery to fend for themselves!!! What a wonderful human being!! Now I have fond Dr Woods. He is Dr Sapala's associate. He is going to do mine but I have to lose 70 lbs first. So far , following his instructions I have lost 30. I am going to continue to do as he asks because I feel it is my duty to uphold my end of the bargain if he will uphold his. And I truly believe he will. Also you should know that I have Medicaid and Medicare. I don't know why they told you at the office that there is no pre approval for medicare because I had to show 5 years of doctor assisted weightloss programs , have a phsyc test, and do a h-pylori test. I also called Medicare personally to see what the rules were for them to pay and the person read directly from their handbook to me. It said the only thing you have to prove for them to pay in full is that being overweight has caused you to have other health problems or that being overweight is aggravating already exsisting health problems. So if you are eligible for Medicare please apply now!!! Don't let the office help tell you anything different either. When i first called Dr Woods office the person I talked to told me Dr Woods did'nt accept Medicare. I said that's funny his profile on the website says he does. Then it was oh well I guess we can try it. I was then called a few days later and told that Medicare MIGHT not cover it all and that they MIGHT cover only 80% of it. That is when I called Medicare personally. I think why they try to discouage Medicare patients, ( and it's not the doctors it's The CORI CENTER!!! The doctors work for them), is because Medicare does only pay 80% of what they normally charge but usually your other insurance will pick up the rest. And even if they don't a lot of the doctors will waive the other 20% . So you see then THE CORI CENTER loses money and they don't like that!!! I guess I don't blame them because after all , they are a business and are trying to make money too, just like everyone else. But my point is you have to let them know you won't take no for an answer and show them that you aren't going to go away!! In other words be a big pain in their........ well you know!!!!!!! Anyways please don't quit now. We all care and are praying for good things to come your way. BIG HUGGGGS, KEVIN PAINTER
koogy 22 years, 9 months ago
Don't give up! I think the figures they gave you are very inflated. Those sound like "billed charges", not the rates the insurance will pay. My husband has lap RNY in Cincinnati in April, and we had to pay 90% of network rates, so all of his bills came to about $1300.00, which means everything came to about $13,000. (Billed charges looked to be about $35,000). That includes the surgeon, anesthesia, hospital, etc. For anything above the $10,000 Med Mutial will pay, I am sure you can set up a payment plan ahead of time. See if the doctor's offfice will give you the codes they bill, and then call Med Mutual to see what they pay on those charges. Even if you don't get but one or two codes, you will have a better idea of what you will actually have to cover.