Help! Confused In Florida!! - Page 5 - ThinnerTimes

Native2u · 04-21-2008, 07:52 PM

Quote:

Originally Posted by gina0922

Valerie,

Thanks so much for all your help! I really appreciate that it. I spoke to a lady today with my ins. I explained to her that the Dr wanted $250 for his consultation and part of that money would cover getting approval from my ins comp. I further explained that $250 was a lot of money to spend not knowing if it would even cover the surgery. Also that my handbook does not make mention of any exclusions for WLS of any kind. She told me to send her the CPT codes for both surgeries (LBS and LapGBS) and she would email me back with any exclusions or inclusions as the case may be. Now regarding the $$$. My max copay will be $300. Which will be covered between Dr Jawad and the Nutritionist
and the Psych eval. Not to mention all the office visits @$30 bucks each. Max out of pocket is $3K after that ins pays 100%.

Oh...I thought that you were going to have the same surgery that I am....RNY. I'm not having the LBS. I changed my mind the day that I went to Dr. Jawad's office for the seminar. I went with an open mind. That is great news for you on the insurance end.

astona · 04-22-2008, 12:23 PM

My husband and I went to Dr. Fusco's little lecture as the first Dr I wanted to see, and I have to agree with Val... He is a used car sales man. We left there totally shocked that he was upping his fees 4k. WOW, he said that lap band was the be all and answer to all. After doing lot of soul searching and research I decided RNY was for me, and my insurance company sent me to tri-care.

Dr Jawad was VERY professional and I had my surgery as most know March 12th. And as Val said had my G-tube out yesterday.

I was very and am very happy with how things have gone and dont forsee any issues. If anyone lives in Florida I would suggest Dr Jawad, he is well worth the travel. And he does have an office in Orlando for aftercare.

Dr Jawads office fee's are as follows, $250 educational fee, and than $25 per set of insurance paper work that needed to be filled out. That was it, and all I had to pay. Well and if you have insurance co-pays.

I did by my BA vitamins and iron from him as well.

In my opnion Dr. Fusco is just out to make money, Dr Jawad I believe really cares

gina0922 · 04-23-2008, 12:13 PM

Quote:

Originally Posted by Native2u

Oh...I thought that you were going to have the same surgery that I am....RNY. I'm not having the LBS. I changed my mind the day that I went to Dr. Jawad's office for the seminar. I went with an open mind. That is great news for you on the insurance end.

I am strongly leaning to RNY. From what I have read from others it would be the better alternative for me. I need something that will change my lifestlye. The LapBand, if not filled to the proper amount can allow me to continue to eat the way I have been eating my whole life. I know me...I am the type to say "just this one slice of pizza wont hurt" and of course that leads to 3 more. Or I just don't have the extra money/gas and/or time to travel all the way to Orlando for a fill. I need a restriction that is there all the time. Something to keep me in check. I know it is a tool just like the band. But I seriously think it would be the best choice for me but I will still discuss it with Dr Jawad. I will ultimately give him the last word as to what is in my best interest.

Native2u · 04-23-2008, 12:55 PM

Quote:

Originally Posted by gina0922

I need a restriction that is there all the time. Something to keep me in check. I know it is a tool just like the band.

The RNY will keep you in check. That is why I chose the RNY surgery. I needed something to keep me in check also. I also need consequences for my actions too.....meaning if I went to Dairy Queen and ordered a blizzard, I'd either get sick or pass it & feel sick the rest of the day. I don't want that. I was leaning towards the lap band, but, knowing me.....I'll cheat. You can eat that blizzard as long as you drink a glass of water with it.....you will be fine, no consequences.

snick1899 · 05-02-2008, 07:53 PM

I think you said you got a new surgeon, but in case you haven't, I am out of Largo, FL (About 1 1/2 hours from Orlando). I am working with Dr. Richard Gordon with Advanced Surgical Associates and I have liked him from the start. I had tons of weird questions on my initial consultation regarding scuba diving and the effects of the lapband vs RNY with the pressure of being underwater, and he made phone calls and made sure I had answers before I left his office. I really liked the fact that not only did my questions matter, but they mattered enough to him to be answered right away. I had some set backs with his office staff (took 2 months to get my stuff sent to the insurance, even after all my work up was complete), but I am glad I waited it out and stuck with him. I just got my approval from the insurance today, so hopefully I will be under the knife soon!! (Wow does that sound like a weird thing to say...lol). If anyone else is in this area looking for a surgeon, PM me and I will get all his info to you!

Native2u · 05-03-2008, 08:38 AM

Quote:

Originally Posted by snick1899

I think you said you got a new surgeon, but in case you haven't, I am out of Largo, FL (About 1 1/2 hours from Orlando). I am working with Dr. Richard Gordon with Advanced Surgical Associates and I have liked him from the start. I had tons of weird questions on my initial consultation regarding scuba diving and the effects of the lapband vs RNY with the pressure of being underwater, and he made phone calls and made sure I had answers before I left his office. I really liked the fact that not only did my questions matter, but they mattered enough to him to be answered right away. I had some set backs with his office staff (took 2 months to get my stuff sent to the insurance, even after all my work up was complete), but I am glad I waited it out and stuck with him. I just got my approval from the insurance today, so hopefully I will be under the knife soon!! (Wow does that sound like a weird thing to say...lol). If anyone else is in this area looking for a surgeon, PM me and I will get all his info to you!

Yes, I have found a Doctor.....thanks for thinking of me though.

I'm curious.....what did he say about the diving? I'm a certified diver and I plan to get into really heavy next year.

I'm going to have Lap RNY done.....NOT the lapband.

I'm waiting for my insurance to approve me currently.....I hate the waiting game!! LOL

snick1899 · 05-03-2008, 09:18 AM

Quote:

Originally Posted by Native2u

Yes, I have found a Doctor.....thanks for thinking of me though.

I'm curious.....what did he say about the diving? I'm a certified diver and I plan to get into really heavy next year.

I'm going to have Lap RNY done.....NOT the lapband.

I'm waiting for my insurance to approve me currently.....I hate the waiting game!! LOL

My main concern was with the lapband, I was afraid that when your body contracts from the water's pressure it may give the band room to slip. I have heard horror stories regarding the band slipping on its own, so I didn't want to give it more of a chance to happen. The Lapband company said it "shouldn't" be a problem. I took "shouldn't" as meaning that it hasn't been tested on divers and they were guessing. I don't know if you are a DAN member or not, but I asked a DAN medic and he said it should be fine too, (again with the "should" word) but all my instincts told me not to do it, so I decided against the lapband. The only restrictions with the RNY (I am only approved for open, bummer) is the healing time, just like any surgery. I don't know how long that time period is though, so I plan to get at least 1 more dive in before my surgery!!

doxielover · 05-03-2008, 09:18 AM

I just went to my small group seminar on Thursday and there certainly wasn't any fee! My PCP received prior authorization from Healthnet for the consult and that was that. I've talked to some other WLS friends who have used other groups here in Sacramento and none of them have ever had to pay a fee for the seminar. I wonder if this is something that is Florida specific? Good luck in your journy - I'm hoping for my lap RNY right when school gets out in the middle of June (high school teacher). Peace.

Native2u · 05-03-2008, 09:40 AM

Quote:

Originally Posted by doxielover

I wonder if this is something that is Florida specific?

No, it isn't Florida specific, at all.

The doctor that I decided AGAINST....charged a "admin. fee" of $3700 before he will even touch you for surgery. Which is CRAZY!!!! MOF...if you have read my prior posts, my insurance company wants me to turn him in because he is ripping people off (in their eyes too) and he does accept my insurance. So, at least others with my same insurance will what he is doing. PLUS I HAVE EVERYTHING IN AN EMAIL AND CAN PROVE THAT HE IS CHARGING THAT MUCH.

On the other hand, I have chosen a doctor in Ocala....and his admin fee was only $250. I far cry from $3700.....wouldn't ya say??

Native2u · 05-03-2008, 09:44 AM

Quote:

Originally Posted by snick1899

My main concern was with the lapband, I was afraid that when your body contracts from the water's pressure it may give the band room to slip. I have heard horror stories regarding the band slipping on its own, so I didn't want to give it more of a chance to happen. The Lapband company said it "shouldn't" be a problem. I took "shouldn't" as meaning that it hasn't been tested on divers and they were guessing. I don't know if you are a DAN member or not, but I asked a DAN medic and he said it should be fine too, (again with the "should" word) but all my instincts told me not to do it, so I decided against the lapband. The only restrictions with the RNY (I am only approved for open, bummer) is the healing time, just like any surgery. I don't know how long that time period is though, so I plan to get at least 1 more dive in before my surgery!!

I was afraid of slipping also. I have heard that it will slip and have heard of horrible stories of such. I didn't want that to happen to me. Actually, I have heard of slipping just from straining on the toilet or lifting something heavy. If you talked to a DAN medic and the company of the lapband, and they both say.....maybe or shouldn't.....that sends a RED flag up for me too.

I am "open water" certified also. That is one of reasons that I decided on the Lap RNY also. I don't want any problems, after I heal. That is why I probably won't dive until next year. Just to make sure that I'm healed all the way.