Dr. Schlesinger and the ERNY

 hello determined2Bhealthyandstrong,

Thank you for your post and sharing your experience.  I appreciate the openness and the frankness of your replies.  Your willingness to share helps me to feel a bit more relaxed with my decision.  I too am seeking a revision with Dr. S.  I am working thorough the insurance issues now.  BCBS of MI has finally replied stating "that the procedure is covered under my plan if it is deemed medically necessary.  This is not a guarantee of payment.  Pre-certification for the hospital is necessary....."  what does that mean!  that they will cover the hospital stay but not necessarily the procedure!!!!    I have waited 7 weeks for that reply, something they told me over the phone 8 weeks prior....Jen has asked me for a date I want to proceed with and she will call and try and get them to commit to payment.  I wonder if it is just another game insurances play to find away of not paying!  Any way good luck to you and I am glad you had a good experience with Dr. S.  I am sure you will have just as much success with meeting your goal!

THANK YOU SO MUCH FOR YOUR ENCOURAGEMENT AND KIND WORDS!   I have not had a face to face with Dr. S.  I have all my medical records and psych eval sent into him per his request
and he has reviewed it.  Since my insurance did not require (or maybe they just didn't catch it) that I meet in person with him before I start the process Dr. S is allowing me to move forward with the procedure.  They only ask that I arrive in the area 2 to 3 days before the surgery so that we can meet face to face, answer all my additional questions and concerns, and so he can finish his evaluation of my cir****tances.  Then we will proceed with the pre op testing.  This has saved me travel cost which I truly appreciate!  Seems that Dr. S cares about his patients from many different angles.  I have spoke with him on the phone and have had several correspondences through e-mail.  I am hoping that this is adequate as one of my concerns (probably unjustified) is that I will get out there and he will decide I am not a good candidate....

How have you been doing since your surgery? 
Did you have ERNY?
Can I ask how long he decided to make your common channel?
What kind of issues are you dealing with now stemming from your procedure?
Are you loosing the weight you had expected?  I understand it is slower the 2nd time around.

Sorry for so many questions.  Helps me to get a better grasp on what I may have to deal with after the procedure.

Thanks again for your support!

That's what happened to me when I had my RNY 5 years ago.  I have BCBS Federal.  They said it would be a covered procedure if deemed a medical necessity.  I didn't need pre-certification.  So my doctor's office had submitted everything proving the medical necessity and went ahead with the surgery.  Well afterward they said it wasn't a necessity and didn't cover it.  5 years later and I'm still paying for it.  I was devastated - I never would have gone ahead with it.  I desperately had wanted it but wasn't financially able.  Well, it really put me in the poor house.  It's horrible the way insurance companies do this.  I wish you luck!!  It's good you need the pre-certification - this way you'll get it in writing that it will be covered.  Keep us posted!