Another step closer .. Long and winding road

GoingMobile
on 8/14/07 10:10 am - San Dimas, CA
So I FINALLY got  my second PCP to give me a referral to a surgeon. Talked to them and they ONLY do the RNY and LapBand. I know its alot easier to get either approved by my isurance BUT This isn't what I want or what i feel is best for me. Not to mention I can't get in to see them until Nov 26th. I fully 3expected a denial and appeal and legal action to get the approval I want, though BC has been covering the VSG lately, it is getting easier to get approval.   Any thoughts on how to get two part DS or VSG done if the Doctors won't do it? will the insurance co let me go somewhere else? do I have to get another referral from the PCP? what if they they won't give me one? Any help is much appreciated, as always
HerbR
on 8/14/07 8:56 pm - Upstate, SC
I do not know the specifics, but the DS forum page has a lot of discussion on one and two part DS methods and insurance issues.

Poor men want to be rich, rich men want to be king.
And a king ain't satisfied 'till they rules everything.
   
                                                                          - Badlands
NotDave (Howyadoin?)
on 8/14/07 9:25 pm - Japan

Know nothing about the DS, but my surgeon reluctantly does "VSG's" with no bypass (affectionately called the Sureevu - "sleeve" here in Japan).

He performs them mostly on people who insist they "have" to drink alcohol and on those who have a family history of severe ulcers or stomach cancer.

He has been know to perform the sleeve on super MO patients and then come back and add a ROU limb to the surgery. This gives a very unflexible long, slim pouch with it's pylori valve in tact + a ROU bypass and no remaining stomach.

I think he does each part separately for 12-15 grand and has friend surgeons in California. No such thing as insurance for that here. He's a great guy and speaks English really well. And you may have some interesting problems with your catheter, like I did!

Just chatting, not sure if this is any help,

Dave

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