In July of 2009 I contacted 1-800-Get-Slim (before it
changed to Get-Thin) to show my interest in their Lap Band procedure. They took
down my medical insurance information and set me up for a consultation. On July
29, 2009 I went in for a consultation. After the info seminar I met up with a
doctor and afterward assigned a consultant by the name of Pauline Garcia. She
spoke with me and told me that my insurance would cover everything including
the exams I will need. In August I was scheduled for an endoscopy and other
medical tests. In September I was sent a letter from my insurance stating they
do not cover the Lap Band procedure. I called Pauline many times. Left messages
but there was no reply. Finally after weeks she called me back and said to fax
her the letter from my insurance. I did this and again began another round of
calling her to follow up and leaving messages with no response. Since I got no
response I filed an appeal with my insurance.
When Pauline finally contacted me
she me that they had filed an appeal. I received another letter stating again
they would not cover the procedure. I was then contacted by Pauline stating we
can now do something else. They would check me for a hiatal hernia. If I do
have it, they would get approval from my insurance to do the surgery and then I
would pay them $3500 and they would do the Lap Band at the same time. I went in
for another consultation with a Dr Madan in Long Beach. He met up with me very
briefly and asked me if they had found a hernia with my endoscopy. I said I
didn't know. And he tell me that "we're gonna go ahead and get this going
for you and get you approved. Shouldn't be a problem". That was pretty
much it and then he told me that my consultant would contact me. After about 2
weeks she calls me and tells me I have to have another endoscopy. I ask her why
I have to get another one if I had already gotten one done. She says because
"before they weren't looking for a hernia" but now "since
they're finding a lot of people have them" they are going to do another
one.
I was not too happy it especially since I would go under sedation once
again. But I figured that if that's what it takes to get the procedure done I
would do it. I also I agreed about the money. I had gotten a federal tax refund
and had no problem paying it. She told me to send a cashier's check to them.
But then I said, Shouldn't I wait until it's approved by my insurance before I
send the check? To which she replied, Oh yes that's right. Just wait. I went in
for the tests in February 2010. I thought I was only going in for the endoscopy
but they made me take all the tests all over again. This includes, ultrasound,
ekg, urine, blood tests. I asked if I would have to do all the tests again and
they told me I had to since it had been a long time since I gotten them done
eventhough it had only been a few months. Now there are a lot of claims filed
with my insurance which my insurance had refused to pay. My insurance is saying
I am responsible for all which totals up to $10,000 or more. And that is only
for the tests. I then got a call from Pauline Garcia stating they had
"found a hiatal hernia" in my tests and she said "don't worry,
that's actually a good thing". She said it would take about 5 business
days to get an approval from my insurance. But weeks passed and I received no
response. I continued to call and leave messages.
When she finally called me
back she told me not to worry because they have been following up with my
insurance and so has Dr. Madan. On 2 occasions I recieved calls from the Weight
Loss Center/Top Suregeons in Beverly Hills. One of them stated she wanted to
comfirm my email and taht was the last step before sending my information to my
insurance. I got a little annoyed and told the person that I thought I was
alreayd waitinf for a reply from my insurance. She did not have an answer and
she only told me that she would have my conultant contact me. This never
happened. I called Pauline Garcia's businness phone, which is the number I have
been calling on June 25, 2010. A female answered and stated she was not
Pauline, she was Diane and that she did not know Pauline but she only knew that
it used to be her business phone. I have called Weight Loss Center and they can
never give me an answer. You either transeffered from person to person or
stated someone will call back or you are sent to a voicemail.
I have reasons to believe that they knew
from the beginning that I would not qualify and were merely seeking to file
false claims with my insurance for their own financial gain. I also believe the
"hiatal hernia" is nothing but a scam pulled by them and when they
realized my insurance would not cover they no longer desired to work with me. I
would say I want them to proceed with the procedure but after finding out that
the reason insurance companies are not approving is because 2 of the doctors
that are the owners or president of the facility had their license revoked, I
doubt my insurance will approve. At one point when I was sitting in the waiting
room I heard 2 doctors speaking about the "hiatal hernia" exams. They
were speaking about who would pay for what and "how is this going to work
out". Unfortunately, there were so many people in the waiting area that I
could not hear what they continued to say.
2 Updates & Rebuttals
calianonymous90
United States of America
Update (07/13/10)
#3Author of original report
Wed, July 14, 2010
I called and spoke to the consultant manager and he told me that indeed Pauline did not work there anymore. That he would have another consultant call me. It's been 2 wks and no one has called me. I'm not interested anymore but I find it humorous that it's been almost a year and still they have done nothing. I wanna see for how long this will go on...
calianonymous90
United States of America
Response...
#3Author of original report
Mon, July 12, 2010
Well good for you but I'm writing about my experience.
2 Updates & Rebuttals
calianonymous90
United States of AmericaUpdate (07/13/10)
#3Author of original report
Wed, July 14, 2010
I called and spoke to the consultant manager and he told me that indeed Pauline did not work there anymore. That he would have another consultant call me. It's been 2 wks and no one has called me. I'm not interested anymore but I find it humorous that it's been almost a year and still they have done nothing. I wanna see for how long this will go on...
calianonymous90
United States of AmericaResponse...
#3Author of original report
Mon, July 12, 2010
Well good for you but I'm writing about my experience.