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I just wanted to introduce myself. My name is , and my surgery date is

scheduled for June 29. I am nervous, scared, excited, worried, anxious, and a

multitude of other things.

It's been a real journey for me to get here. I first started the process over a

year ago. I got insurance approval with no problem whatsoever almost

immediately.

Then I wasn't happy with the first surgeon I had talked with. It all boiled

down to money, and the way he ran his office. I am Blue Cross/Blue Shield and

he told me he accepted them. Then when it came time to schedule the surgery, I

found out he wasn't " in network " and he wanted another $8,000 above and beyond

everything I had paid up until then and on top of what the insurance was paying

him. I had to pay a lot of coinsurance, and extra fees to get him to accept me.

He also would not accept any nutritionist, psychologist, trainer, etc. but his

own and they were not " in network " either. And he insisted I pay this huge fee

to access his support program after my surgery. Anyway, to make a long story

short -- his office had told me in the beginning I would not have to pay more

than $3,000 out of pocket -- which I had already done at this point and he

wanted another $8K, I told him I wanted on paper what this $8,000 was for. His

admin sweetly told me, " oh we don't do paper. " They still claim I owe them

$1,200 for what I don't know since they don't do paper. I figure they can just

tell that to the collection bureaus if it gets down to that. I still have not

gotten an itemized bill from this guy. I was going to have a lap R & Y. This

doctor also told me that he was the " ONLY " doctor in Dallas who was doing

laprascopic R & Y which I have learned since is just more B.S. A lot of his

patients love him, but...

So then my PCP recommended another doctor for a lapband. I went to him and

again, he was not in network, and he said he could accept my insurance but on

top of that he wanted another $3,000 give or take. I figured at this point I

could cough up that much money. However, after chasing them for three months

trying to get a call back or an answer, I gave up. Turns out this " surgeon " did

not do the surgery, he just made arrangements for other surgeons to do the

surgery. It was wierd. Surgeon Number One called him a pimp.

This whole thing was getting very disheartening for me. I had spent years

working in medicine and had never run across so much b.s. So I decided to try

and find someone myself! Wow! This surgeon was " in network " but only for

medical visits. He was not " in network " for the surgery. He wanted about

$2,200 above and beyond insurance.

I felt like I was trying to buy a used car... This is a hot surgery and these

docs want to make as much money as they can...

Then I got sick -- real sick -- in the hospital, intensive care type sick.

So they sent another surgeon in -- first thing I asked was -- are you " in

network " ? Again, not for surgery, but for consults and office visits. I said

forget it. He was lapband too. He sat there for an hour trying to convince me

that the lapband was identical to the bypass.

At this point, I didn't want to mess with the lapband. I had done my research

and I feel the bypass is the best for me. And to be honest, I have not seen the

success with other patients with the lapband as with the bypass. I weigh 385

lbs., diabetic, asthmatic, thyroid stuff and I have a huge incisional hernia as

a result of two C-Sections. More on that later.

So I went home and stewed and stewed and felt sorry for myself. And then I

decided to take this dang bull by the horns. If I had to fly to New York, I

would to get this taken care of. My insurance is out of BC/BS out of New York,

and I knew there were surgeons in New York would were in network who would do

this, so I figured there must be someone in Texas, Oklahoma, Arkansa, NM, or

Louisiana that would. So I went online and I searched and sent email stating

what was going on and asked point blank if they were in network for the surgery.

I got a lot of surgeons that said no, but I did find several surgeons who WOULD

do the surgery, who WERE in network as surgeons for this surgery and who were

incredulous at the problems I have been having, and who WANTED to help.

I opted for the program at Baylor College of Medicine at St. Luke's. I went in

and felt immediately at home and comfortable. They have no issues with my

insurance or anything and they are TOTALLY in network. I am hoping I don't have

any surprises when I show up on June 29. The only thing he is wanting is that I

stay in Houston for a week after my surgery rather than drive back home to

Dallas, and he wanted to make sure that I understood that he would want to see

me for follow-up. NO PROBLEM for me on either of those accounts. He also said

that as soon as I hit a stable weight, they could then take care of my hernia

(which I kid you not hangs down to my knees). The other doctors all said it was

fluid or fat, but when you touch it you can tell there is something else going

on.

So that is my story... I got down to Houston again on May 24 for tests, and

then June 29 surgery time. They would have done it earlier, but the surgeon is

taking a two-week vacation the first part of June. (Can you believe the

nerve???)

That's my story (nightmare).

W.

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