revisions

If I get a rny can I have it revised to a DS? My insurance will not cover DS. I thought if they ever did I would have it done. Or how can I fight the insurance to get them to let me get a DS? My insurance is Triwest. Dr. Schlesinger is my surgeon. Is there a posibility of paying the difference  between the two? Thanks for any help




Wanda T

Wanda,
I just want to say that you need to ask these questions of Dr. Schlesinger.  Have him explain it all to you in a language that you can understand.  If you want a DS fight for it now and wait for your appeal to see if they change their mind, hire a lawyer if you want to and fight to the end.  Having it revised to a DS is a very complicated surgery and going into a surgery thinking you will want a revision later is not an approach that you should be thinking about now, fight for the right surgery you need.  You need to do more research and then decide what is best for you before you have any type of surgery.  You have to go into this surgery fully prepared mentally and physically.  You are in good hands with Dr. Schlesinger and have confidence in him to do the best surgery for you.  Remember he tailors the surgery for each person.  As a revision patient take it from me, I sure didn't want to do a revision to my surgery, I had every confidence in my first surgery getting me to where I needed to be, but I did not get the proper surgery. 
Good Luck in your research!
HUGS

Thanks for the info.  I will discuss it with him.

Wanda T

Wanda,

Deeann is so right. If you want the DS to begin with I would have it done in a heart beat. You don't want to have 2 surgeries. Really research all your options on what kind of WLS you would like. Get a piece of paper out and list the surgery's and wright pro's and con's down. Maybe if you see it in black and white you will be able to make a better decision. That's how I make alot of decisions. I have to have them stare at me. You have picked a good surgeon. He is mine also. Dr Schlesinger also attends his own support group which is the 3rd Saturday of the month. Everyone is welcome to attend. You can also be another surgeons patient. I think first off you found a good doctor. Next you have to make the decision on what type of WLS you would like and bring it up to Dr Schlesinger the next time you see him. I forgot to tell you that Dawn T has a DS. I bet you can ask her a bunch of questions. I had a ERNY done but would be happy to answer any questions that you have. You can PM me.  Good Luck and keep us posted.  


Dawn

You need to decide which surgery will work for you FOR LIFE, and then do what it takes to get it. 

If I understand correctly, Triwest is a version of Tricare, and Tricare does NOT cover the DS.  Schlesinger is likely to tell you the RNY will be "good enough" -- because otherwise, he won't get paid.

You are going to need to decide for yourself what you want.  You CANNOT rely on having an RNY now and "just revising to a DS later" -- revisions are DANGEROUS, some insurance companies limit you to one surgery per lifetime, and to get a revision you have to qualify for bariatric surgery all over again -- which means you won't get it unless you have utterly failed your first surgery -- do you REALLY want to go through that?  What you chose now is likely what you are going to have to live with for the rest of your life -- are you worth getting what is right, or what is convenient?

Think twice, cut once.

Dianna,

How in the heck do you know if Dr Schlesinger is going to say that ? Maybe this person is going to be a self pay if Tricare won't pay for it and than want to get the DS with Dr Schlesinger. Have you you ever had a appointment with Dr Schlesinger ? Well I have and I know him. Here we go again.

I said he is LIKELY to say that -- do you have reading comprehension problems?  I have been in the WLS community for a LOOONG time, and that's how surgeons like him roll.  Had it done to me when I was interviewing surgeons myself (Jossart at LapSF -- he did the DS at the time, but I had Aetna which was excluding the DS, and he told me exactly that -- the RNY is good enough for you -- when my BMI was 49).  What the surgeons DON'T want is for you to walk out of their door without SOME surgery they can perform.

I didn't say she couldn't self-pay with Schlesinger, although if you read her post, she seems to indicate pretty clearly that if she can't get insurance coverage for the DS, she will have to have the RNY.  I was pointing out another option.

Hi Wanda

 Welcome to the AZ board.  sounds like you have some good questions. But I ( my opinion) think your ahead of yourself on this one.  Dr Schlesinger is not like a lot of surgeons here in Az that do  majority of the RNY surgeries  laproscopically.

 He tends to really talk to his patients and find out a lot about their family history  concerning the weight issue. He may even decide  to do an open procedure  so that he can do a shorter  common channel  allowing a much greater opportunity for  weightloss.  ( wish I had this choice the first time around) 

Dont  loose faith in yourself or the surgery and be thinking about revision, Hopefully  you will loose all your weight the first time around - when the appropriate surgery is done the first time/ only time.

The D.S. is a great surgery - if you can get the insurance company to pay for it..   

Good Luck and keep us posted ..  

Hi Wanda,
I had DS with Dr Schlesinger almost 6 months ago.  My insurance covered it so I can not really address that part.  He did not suggest I have RNY over the DS, he told me DS from the first question I asked him.  Now My BMI was pretty high so that could be why.  My insurance states my BMI had to be over 50 but that was not a problem.  I think you should fight for the surgery you really want.  Can you get another insurance? 
I do not regret my DS at all!  I have lost have of me already and am so greatful to Dr S & Jen!  They really will help you get what you want.

Good Luck and I hope to see you at a support meeting soon.