Hey -- Wondering about Blue Cross coverage & Dr. John Rabkin.....

I'm in San Francisco, Cali and I just found out that the site I was hoping to have surgery at doesn't accept my Medi-cal/Medicare coverage.  I'm now in the process of changing to Anthem Blue Cross Medi-cal and I'm wondering if Dr. John Rabkin might be an option for me.  I feel so let down right now.

Dr. Rabkin doesn't accept Medi-Cal or Medicare. The hospital accepts Medicare so that part of the cost (which is the biggest part) would be covered if you have Medicare, but not the surgeon's fee.

Dr. Keshishian in SoCal (glendale) does accept Medicare, so he may be a better option for you financially. Both are excellent surgeons.

More info in a pm.

Larra

Call Dr Rabkin's office. If there is a way that it can be done, they will walk you through it. I have Kaiser (through MediCal) and they walked me through all the appeals processes. I'm not saying that they will accept Anthem Blue Cross MediCal but if you're in San Francisco it's worth a phone call. Good luck to you- I know how discouraging this whole process is.

Sue

Hi Sue,

Thank you for your reply.  I've been down these past few days and just fired up my computer, finally.  I called Dr. Rabkin's office and they're sending me some paperwork to fill out.  The staff I spoke with on the phone wouldn't give me a straight answer as to whether or not they take Anthem Medi-cal -- she just emphasized "fill out the paperwork."  I guess we'll see what comes.  Thanks again for reaching out.

You may end up having to file an Independent Medical Review (IMR) with Dept of Managed Health Care (DMHC).  If you do a search for DMHC and IMR, I had several posts where I talked about my experiences getting approval for the DS with Kaiser (2007 & 2008).  Not sure if Medi-cal is the same.

Hi,

I'm in the same boat as you, I have Anthem Blue Cross/Medical and I sent in my insurance card and info to Dr. Rabkin, just on the off chance that it would work. IT DID!

Matt (the financial counselor) told me that it would all be covered, so no out of pocket cost. The hardest part is waiting for Axis Community Health to send in a prior authorization to Dr. Rabkin. Feel free to message me and I can send you some tips, but take a chance and send it in to the office!

Lorraine

Hi,

I had blue cross for a while through my husbands work. We went to see Rabkin. He charges 300 for the consultation.

His staff negotiated with the insurance co and the initial quote would  have meant I paid 15k out of pocket. The surgery was over 30k.

He is expensive. I ended up doing self pay with Dr Esquerra at Mexicali Bariatric.

The experience was positive and only 11k.

Check out their website for comparisons.