Pending RNY surgery approved - want to change to DS

jacq0122
on 10/30/10 3:45 pm - TX
Hi Everybody,
     It took nearly a year but I finally received an approval from BCBS for the RNY.  I hadn't talked to Dr. Barker in nearly a year.  Since I had originally visited with him I had learned about DS.  Since my BMI is over 55 I would really prefer to go with the DS.  Has anybody had any experience with getting BCBS to change their approval from RNY to DS prior to the surgery?
     Since I had such a long, tiresome battle to get approved, I don't want to do anything to mess it?
Thanks
Jac
    
bookfaerie
on 10/30/10 4:32 pm
 I would wait another 5 years to get the DS, rather than let them give me the RNY. JMO.
 "Mediocrity knows nothing higher than itself, but talent instantly recognizes genius." Sir Arthur Conan Doyle

"What your heart thinks is great, is great. The soul's emphasis is always right." Ralph Waldo Emerson    
Rena H.
on 10/30/10 4:34 pm - Spokane, WA
Hi Jac,

I changed my mind from an RNY to a DS before my surgery as well. I am sooooooo glad I did! My life is amazing! As a matter of fact i am just getting ready to have some ham and eggs fried in butter.

With that said, the DS is definitely the better choice for you since you have quite a bit of weight to loose. There are lots of people who know the insurance thing better than i do... and i am sure they will be along anytime.

My point is that you shouldn't let your insurance company decide what you end up stuck with for the rest of your life. You are the one that has to live with it not them.

Good luck! I don't think doctor Baker does the DS. You might want to check out DSFACTS.com and look for a doctor in your area that is qualified to perform your procedure.
HW - 395 / SW - 358 / GW - 150

nightowl
on 10/30/10 5:02 pm - Topeka, KS
If I were you, I think I would get with Dr. Darryl Stewart's office in Denton, and see if his staff can help you deal with your insurance company to get the DS approved.  I went to your profile and read the area where you reviewed the doctors you have seen already, and how frustrating that has been.  The fact that you have already gotten the RNY approved is a big step in your favor.  You are also in luck in that I have read that Dr. Stewart has just started dong some DS surgeries in Dallas!  Woo-hoo for you!!!  Many people travel a lot further to see him.  He is pro-DS.  For your office visits, I am thinking you will still have to go to Denton (I'm not sure on this).
NancyBluEyes
on 10/30/10 5:13 pm - SouthOfTheCities, MN
I don't have any real content to add but I just want to say good luck and encourage you to stick to your guns and get the surgery you want and feel you should have. In my opinion, the DS is better than the RNY but again, that is just my opinion. However, I started with a BMI of almost 58 and I know I wouldn't have made it to where I am without my DS.
Nancy  Remember what you deserve. Be good to you. Do good to you. 
5'11"    HW 419 / SW 382 / CW 205 / GW 180


    
Valerie G.
on 10/30/10 9:45 pm - Northwest Mountains, GA
I'm not sure how TX is, but BCBS gives different answers from state to state, and keep in the back of your mind that you can appeal an unfavorable decision.  Several have been successful with this and are here to help.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

(deactivated member)
on 10/30/10 10:42 pm
mspppants
on 10/30/10 11:36 pm - Leicester, NC
woo, boy, do you ever want the DS!  Here in NC I had BCBS and once refused once, and fought with an appeal, and won my DS. I coulda had the RNY with no problem whatsoever, thank god I didn't.  Fight for the DS, but with a BMI of 55 you'll prolly get approval pretty easily. 

Best of luck, keep us posted.

pp

and p.s. my BMI was barely over 50

leslieanne729
on 10/30/10 11:53 pm
Please please please listen to what the others have said. With your BMI being that high the DS is really the way to go. The RNY is NOT
levittown_loser
on 10/31/10 12:00 am - Levittown, PA
On October 30, 2010 at 10:45 PM Pacific Time, jacq0122 wrote:
Hi Everybody,
     It took nearly a year but I finally received an approval from BCBS for the RNY.  I hadn't talked to Dr. Barker in nearly a year.  Since I had originally visited with him I had learned about DS.  Since my BMI is over 55 I would really prefer to go with the DS.  Has anybody had any experience with getting BCBS to change their approval from RNY to DS prior to the surgery?
     Since I had such a long, tiresome battle to get approved, I don't want to do anything to mess it?
Thanks
Jac
Jac,

The ONLY thing you could do to mess anything up is to let someone cut you and do a surgery on you that you really don't want and don't think you can be successful with long term!   PUT ON THE BRAKES and make sure the DS is what you really want.   Find yourself a great DS surgeon and work with them to convert your approval to another doc and surgery type.  

Good luck!  It can and is done everyday by others.  You can do it.

Tom

HW 341/SW 309/CW 169/GW 190   172 lb. loss with my DS -  Subscribe to me on YouTube!
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