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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 10-27-2009, 02:32 PM   #1 (permalink)
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Red face I am going to give him a 2nd chance to make a 1st impression...

So it has been a very stressful day with my insurance company. I found out that the 3 surgeons that my medical group refers patients too use's a hospital that is not contracted with my medical insurance. So I had to call my medical insurance Health Net and see what hospitals they contract with. The guy on the phone was so nice and gave me that info along with a surgeon I could request to be referred to. Well the name he gave me was Dr Horgan. At first I was hesitant because I went to Dr Horgans seminar last week and I didn't really care for him. My family liked him but I thought he was kinda smug and wasn't vibing with him. After pausing for a few mins on the phone I took down all the info and called my PCP. I had to speak to the referral dept since they had already submitted the referral for another surgeon to my medical group. I then had to call Dr Horgans office and get the ok to use them. The girl who answered the phone was so nice and helpful. She told me that they deal with my medical group and Health Net all the time. I also asked her about the 6 month diet and she said that my medical group has yet to ask them for that on any other approvals and I should be fine. OMG I was so excited. So I am going to give Dr Horgan a 2nd chance to make a first impression..lol I did really like his staff at the seminar and to his defense he is really educated and does alot of surgery's. So now I wait...My PCP had to resubmit the referral request and now 5-15 days I should have it. The other thing I did like about Dr Horgan and his staff was that the day you see him for your 1st consult you also see the pshyc, and nutritionist at the same appt. It is like a 4 hour Dr appt and I like that they get that all out of the way. So here I go starting again on this wonderful life changing journey....
Thanks for letting me vent...BTW if I am placed on hold one more time today I might just lose it..lol Luckly no more insurance calls..for today at least.
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Old 10-27-2009, 03:01 PM   #2 (permalink)
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Hi Cynthia
Good luck with your journey. Often times a doctor is a lot different in a one-on-one situation rather than speaking in front of a large group, so let's hope for the best!
It sounds like you will be moving along quickly--wow, all your appointments in one day. My surgery is coming up in November--can't wait!
Take care,
Robin
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Old 10-27-2009, 03:05 PM   #3 (permalink)
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Second chances are wise - Dr. Horgan may have been preoccupied about a patient or family member when you first met him at the seminar. Maybe he doesn't do well speaking in front of a large crowd. The most important thing is "is he a good surgeon who does his best work for his patients?" I would take that over all the friendly smiles and jokes by a surgeon. When he is operating, you are asleep. You see him for a matter of a few minutes at the hospital then on follow ups. Its the rest of the team - psych, nut and nurses that you deal with much much more. Just go by the doctors professional ability and reputation.
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Old 10-27-2009, 03:47 PM   #4 (permalink)
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Second chances are wise - Dr. Horgan may have been preoccupied about a patient or family member when you first met him at the seminar. Maybe he doesn't do well speaking in front of a large crowd. The most important thing is "is he a good surgeon who does his best work for his patients?" I would take that over all the friendly smiles and jokes by a surgeon. When he is operating, you are asleep. You see him for a matter of a few minutes at the hospital then on follow ups. Its the rest of the team - psych, nut and nurses that you deal with much much more. Just go by the doctors professional ability and reputation.
My Mom said the same thing about seeing his TEAM alot more than him too, and I really liked them. I am going with a open mind and hoping it all goes well.
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"Instead of giving myself reasons why I can't, I give myself reasons why I can"
10/16 Started 6 month diet
10/30 Denied Consult with surgeon
11/20 2nd weigh in with PCP
12/1 New Medical Group takes effect resubmitting ppwk for surgeon consultation with Dr Callary
12/8 Psych appt with Dr.Doroski
1/8 Gyno Appt
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Old 10-27-2009, 03:48 PM   #5 (permalink)
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Originally Posted by MonkeyMom View Post
Hi Cynthia
Good luck with your journey. Often times a doctor is a lot different in a one-on-one situation rather than speaking in front of a large group, so let's hope for the best!
It sounds like you will be moving along quickly--wow, all your appointments in one day. My surgery is coming up in November--can't wait!
Take care,
Robin
Thanks. November is so close. It will be here before you know it. What a great start to a new year you will have. Good Luck. How long did this process take for you?
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"Instead of giving myself reasons why I can't, I give myself reasons why I can"
10/16 Started 6 month diet
10/30 Denied Consult with surgeon
11/20 2nd weigh in with PCP
12/1 New Medical Group takes effect resubmitting ppwk for surgeon consultation with Dr Callary
12/8 Psych appt with Dr.Doroski
1/8 Gyno Appt
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Old 10-27-2009, 04:04 PM   #6 (permalink)
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I started in June with the doctor seminar, then went to a support meeting and nutritionist meeting also in June. July was my psych appointment, and there was a delay getting that report in to the surgeon's office, so it wasn't until August that my surgery was approved and scheduled. My surgeon is in high demand, so the first available time slot for surgery was November. I had my CXR, UGI, and labs in September/October, and I just had a cardiology consult, EKG and stress test this week (this is not done for all RNY patients; I have a history of high blood pressure so my cardiologist wanted to make sure all was well for surgery).
The time has gone by quickly. I am now on a liquid diet and my surgery is on Nov. 9th!!
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Old 10-27-2009, 04:19 PM   #7 (permalink)
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Originally Posted by MonkeyMom View Post
I started in June with the doctor seminar, then went to a support meeting and nutritionist meeting also in June. July was my psych appointment, and there was a delay getting that report in to the surgeon's office, so it wasn't until August that my surgery was approved and scheduled. My surgeon is in high demand, so the first available time slot for surgery was November. I had my CXR, UGI, and labs in September/October, and I just had a cardiology consult, EKG and stress test this week (this is not done for all RNY patients; I have a history of high blood pressure so my cardiologist wanted to make sure all was well for surgery).
The time has gone by quickly. I am now on a liquid diet and my surgery is on Nov. 9th!!
Every one says it goes by really fast. Hows the liquid diet going? The surgeon said that it varies from 2-8 weeks before surgery. I hope I am closer to the 2 weeks then the 8 weeks but I am ok with his decision either way.
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"Instead of giving myself reasons why I can't, I give myself reasons why I can"
10/16 Started 6 month diet
10/30 Denied Consult with surgeon
11/20 2nd weigh in with PCP
12/1 New Medical Group takes effect resubmitting ppwk for surgeon consultation with Dr Callary
12/8 Psych appt with Dr.Doroski
1/8 Gyno Appt
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Old 10-27-2009, 05:34 PM   #8 (permalink)
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The good thing is you will be asleep during the surgery so you don't have to like his personality. LOL And, in all likelihood, you really won't see much of him at all. You will see his staff A LOT. So, even if you never grow to like his personality, I would still go to him as long as you are confident in his competence as a surgeon. I hated the bedside manner of my last OB, but she was considered one of the best for high risk pregnancy and I knew I was gonna have a c-section and I had 100% confidence in her ability as a surgeon. So, ultimately, I stuck w/her and was glad I did. She was really ultra cautious about everything and that made me feel secure even though her bedside manner was bleeeghghghhgh!
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Old 10-27-2009, 07:22 PM   #9 (permalink)
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I just wanted to say I hope everything goes well, and your approval comes quick. I also wanted to welcome you to TT. Please keep us posted, and ask away thats what we are here for.
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