RE: Re: coverage research continues

[Guest guest]

Ooog...I was Dr Elariny's second DS, and his first done lap....I knew before

the surgery that he was an excellent surgeon, so that was reassuring....but

how do the surgeons get the 75 surgery experience if no one wants to be

among the first?

Ford

Re: coverage research continues

,

I would also add that I would never let a surgeon who has done less

than 75 DS surgeries practice on me even if I could convince them. It

is an extremely complex surgery and even experienced surgeons run

into serious problems! Ok?

Hugs and good luck with your journey, sounds like you are in the

process of convincing yourself!

Theresa

Surgery date: DS Nov. 19, 2001

Dr. Gregg Jossart

Highest weight: 293

Surgery weight: 251

Current weight: 221

Height: 5' 7.5 "

> The RNY is not the DS. If there is no DS surgeon in network, your

insurer

> should provide one for you, even if they are out of network. The

RNY is a

> poor choice of surgeries and will leave you with problems for the

rest of

> your life. Don't fall for this.

>

> Best -

>

> Nick in Sage

>

> coverage research continues

>

>

> > Hello,

> >

> > As I continue my insurance coverage research, I reread my

exclusion

> > for my insurance plan to see exactly what was covered and not. I

read

> > that anything for weight loss or control is not covered EXCEPT in

the

> > diagnosis of morbid obesity. For my circumstances that is good.

> >

> > Then I wanted to search for doctors in my netwoek that may do the

DS.

> > I found a few doctors that do WLS, but all fo the do the RNY. I

> > emailed on of the, a Dr. Kamelgard in UMDNJ, and he says that they

> > have performed the Duodenal Switch, but prefer the RNY. He also

says

> > the total cost for the RNY would be about $20,000 out of pocket.

Now

> > if he is a good docotr, and willing to do the DS, then this would

be

> > great for me. It would all be covered it seems.

> >

> > Have any of you had any experience with Dr. Kamelgard? I am

hesitant

> > to pursue the DS with someone that really doesn't prefer it. And

of

> > coruse, I am speaking way ahed of myself because I do not know if

I

> > am even going to go through the surgery, but I do know that I

have to

> > have it covered or I wouldn't even consider it.

> >

> > Thanks,

> >

> >

> >

> >

> >

> >

> > ------------------------------------------------------------------

----

> >

[Guest guest]

I have Amerihealth POS which ha both in and out of network abilities. I

did research and chatted with several people. My best recommendation is to

make several consult appointments so you can make informed decision on the

doctor you feel most comfortable with. I was fairly clear I wanted the DS

from the begining but explored the RNY. In fact I have a tentative surgery

date of 2/25 if I want the RNY and I am still completing the requirements for

DS surgery with Dr. Herron in NYC. Not any of the Drs. I interviewed

accepted in network benefits of Amerihealth. I also supposidly have approval

from insurance for the surgery but have yet to see it in writting.just

verbally from my PCP office staff.

By the way what part of Jersey are you from? I am in Burlington County

between exits 4 and 5 of NJ Turnpike. If I can be of further help let me

know either through the board or email me privately....

Best Wishes

Liz

[Guest guest]

,

No problem with the private email. I grew up at 160 on GSP in Paramus.

Parents still there so I drive NORTH regularly....I will honk the next

time....

LIZ

[Guest guest]

,

I am also from NJ. I have Aetna PPO and I am going to Dr. Macura in Staten

Island if all goes well. I just don't get to post as much as I'd like, I

have such a hard time keeping up, by the time I read the messages they are

days old!! I have all my pre-op done except my psych consult, which I hope

will be this week or next (long story). Then the surgeons office will submit

for approval....say a prayer for me everyone! I am hoping with all of Chris

Hull's wonderful research and hard work that I can get at least somewhat

approved. Even though the office keeps telling me with Aetna I'm just going

to have to have the RNY. NOT!!!! They did say if I could even get a partial

approval from Aetna they would do that, and would be happy because they have

so many patients with Aetna that are denied for the DS. I'm shooting for

surgery late January to early February according to Dr. Macura's office. I'm

keeping my fingers crossed.

Believe me I'm scared to death to, but then again want to do this in the

worst way and wish it was tomorrow!!! Soon! I'm sure as it approaches I

will be bugging the life out of everyone on this list. This group has been

so helpful, and people have had all the same questions as me, so I'm lucky

most questions have been answered before I ask! If you have any questions or

want to talk feel free to email me anytime!

-Tami

Pre-op Dr. Macura

[Guest guest]

Liz,

I used to live in NJ. I lived in Gloucester County. I still have family

there and my brother-in-law is planning to have a DS in the spring.

However, he is going to travel to MS to the same surgeon I had. Maybe when

I come that way to visit them, I can drop in on you also.

M. in KC

Re: Re: coverage research continues

I have Amerihealth POS which ha both in and out of network abilities.

I

did research and chatted with several people. My best recommendation is to

make several consult appointments so you can make informed decision on the

doctor you feel most comfortable with. I was fairly clear I wanted the DS

from the begining but explored the RNY. In fact I have a tentative surgery

date of 2/25 if I want the RNY and I am still completing the requirements

for

DS surgery with Dr. Herron in NYC. Not any of the Drs. I interviewed

accepted in network benefits of Amerihealth. I also supposidly have

approval

from insurance for the surgery but have yet to see it in writting.just

verbally from my PCP office staff.

By the way what part of Jersey are you from? I am in Burlington County

between exits 4 and 5 of NJ Turnpike. If I can be of further help let me

know either through the board or email me privately....

Best Wishes

Liz

[Guest guest]

Hi Let me know when u may be in Jersey...I am around now hoping for

surgery in middle to end of Feb.2002. Happy Holiday to everyone and a good

New Year.

Liz Hershey