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New with GEHA insurance

Tabikat07x

Tabikat07x

Member
I'm a little shy so its hard to ask questions and ask the right ones. I'm having some troubles with my insurance and all the prerequisites... and I need to know the best place to buy food and vitamins. I am woefully uninformed, but I still have lots of time till surgery, I don't have a date yet. The surgeon I have comes highly recommended, but as far as pre-op and post-op support and nutrition hes only recommended chat groups and talking to my primary physician about diet. I'm looking for friends and mentors to help me on my journey :)
 
Hi Tabikat,

Have you attended the seminar that most surgeons and bariatric centers require? I got a wealth of information from that. Also you need to check and see if the center where your surgery is being done is a Center of Excellence? Try and find out the success rate, infection rate, and complications of the center. These are all legal and important questions you may ask when the time comes. My center handles all insurance questions, they are equipped to know what different insurance companies require, and since they want to get paid they should let you know what will be required of you and of them.

Remember every center and every surgeon is a bit different. Check and make sure they have a support group, a nutritionist, and check with other patients to see how well they handle any emergency that might arise or if they are available for to answer questions you might have after your surgery.

Most importantly, be an informed consumer. Look on the internet at different sites, learn the different procedures, read some blogs of people who have had the surgery, what type and why they chose that particular surgery. Ask specific questions rather than generalized ones.

This a journey to healthier you and it will pay to be informed. Good luck, welcome to the forum, and let us know how you are doing.
 
Thanks guys,

I did go to a seminar. I know what the procedure is and most of the stuff that goes along with it. I should have said that I have a hard time explaining myself sometimes... hence the horrible questioning skill.... I'm mostly uninformed about insurance lingo and policies, I have researched it but I cant find much that isn't pages of fine print that makes me want to cry :(
 
Hi Tabikat,

Welcome to a great group of people on a journey that is very unique. I too hate reading all the fine print on the policies, so I called the company and spoke with a rep. She told me that the surgery was covered and I would need to do certain things before they would approve the surgery. It took me just over six months, after they changed the requirements on me. My total time was about 18 months, a lot of it was my fault for putting things off. So give your insurance company a call and you should be able to get all the answers you need. I'm concerned that your Dr. doesn't have a nutritionist that he uses, as the dietary requirements are different once the surgery is complete. Is there another Dr or clinic you can use that provides full support, it would really be helpful, especially in the first few weeks after surgery. You need to have someone who understands what you're going through to call in the event you have problems or questions. Please let us know how things are going and ask any question you want.

:cool:
 
https://plus.google.com/102967254807098181253/about?gl=us&hl=en

http://www.healthgrades.com/physician/dr-david-martin-yg2r7

^^^ that's my surgeon. He had flyers and papers for support groups and all I just forgot to get them. but I'm still concerned that he didn't talk about them or give me any of the numbers I needed.

I've called my insurance and got different answers for some things. Like, the medically supervised visits.... can I use my regular physician or do I need a nutritionist? they keep flip flopping cuz the book isn't specific.
 
Hmmm...if he only relies on pamphlets, and has you handle the insurance questions, I think I would look for another surgeon. I read the two reviews. I think you need to look for another surgeon who specializes in bariatrics, is part of a formal program that takes you through the process (including nutrition and diet), and is a Center of Excellence. Just my opinion though. If you are having these kinds of problems and issues already, just wait until post-op phase.
 
yeah I've started looking into it. does anybody know if I can still use the results from test ive already done with a different surgeon? or am I going to have to start all over again?
 
Tabikat07x said:
yeah I've started looking into it. does anybody know if I can still use the results from test ive already done with a different surgeon? or am I going to have to start all over again?
Click to expand...
I used my sleep study results from a few years ago when I had looked into surgery. That saved me quite a bit in out-of-pocket expense.
 
I agree with Miss........My center took care of all my requirements in one day from the seminar to seeing the phyc doc, and how much insure was gonna pay.....the only thing i had to do on my own was show up......and when i got my approval letter i had to see my home town doc for the physical to make sure i can handle surgery.....like the ekg and chest xray......as soon as i got my letter i got a surg date.....not gonna lie.....i had it way simple.....but it seems to me that your center isnt doing anything!!! it is hard enough to take the plunge and commit let alone having to do it all on your own!
Angela
 
I don't know about any other centers but mine gave a list of the requirements and the number of years since you had them done that they would accept. For example I had to have a colonoscopy within seven years and they accepted that but due to my age the stress test was not acceptable so I had to have another one before surgery.

You are entitled to copies of any and all testing that you have done so always ask for copies of everything, even the surgical report. I keep a file with all my test results. When I went to my initial appointment I gave my surgeon of everything. The only two things I had to do was the EGD (look at the stomach with a scope) and the stress test.

Your bariatric center should have all this information for you and yes your tests should still be relevant wherever you decide to go. Joy
 
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