Really Need Some Advice

So the IMR was decided in my favor, but although the original request for surgery was from Dr. Keshishian they are now trying to send me to someone that his name can't even be googled. I mean it can but it has no info about him and his experience. I really don't know what to do. I'm so upset because they are basically asking me to risk my life to save them a little bit of money. Has anyone experienced this? I don't know what to do. This is his profile from the California Board of Doctors

License:	A 102804 Licensee may be a U.S. or Canadian medical school graduate whose pathway to licensure was based on the FLEX (Federation Licensing Exam), USMLE (United States Medical Licensing Exam) or LMCC (Licentiate of Medical Council of Canada) written examination and has been licensed less than four years in another state OR may be an International medical school graduate whose pathway to licensure was based on the above exams or approved combinations of the NBME (National Board Medical Exam), FLEX or USMLE.
License Type:	Physician and Surgeon
Name:	AFSHIN ESLAMI, M.D.
Address of Record:	1641 CREEKSIDE DR STE 102 FOLSOM, CA 95630
Address of Record County:	SACRAMENTO
License Status:	License Renewed & Current Licensee meets requirements for the practice of medicine in California.
Public Record Action(s):	No Public Record Actions available
Original Issue Date:	February 22, 2008
Expiration Date:	February 29, 2012
School Name:	ISLAMIC AZAD UNIVERSITY, TEHERAN MEDICAL UNIT
Year Graduated:	1997

Monique.....have you asked them why they won't let the surgeon that you requested do your surgery?   Just a thought.    I am with you....I would not want anyone cutting on me who is not extremely experienced.   Tell them that if he is experienced in revisions to show you proof.   Good luck to you in your fight !!!!


Hugs and blessings ~~ Vivian

Hi Vivian
They don't want me to see him because he's not in my medical groups network. I found out that they are also just looking at procedure code and that the code is just for a revision for something other than gastric band. I ended this business day asking my doctor to submit and authorization request to my medical group requesting Dr K that way if they say no I have a right to an appeal and can go all the way to an IMR again. 

 Good luck to you Monique.   Hope that you can make them see your point of view.   After all it is YOUR life and body.


Hugs and blessings ~~~ Vivian

Monique,
Find the stats & facts as soon as possible.  Always focus on "revision" vs just DS.  ie How many revisions has Dr. Eslami done from Rny to DS.  Make sure your insurance understands that they havve to compare apples to apples and the extremely high risk surgery that you need.  Don't go emotional on them but simply point out facts.  Call Dr. Eslami's office asap and ask for the numbers.  Ask to be put in contact with any of their post-op patient's that have had a revision from Rny to DS.  Always make it the same.  Not a revision from lapband to DS or a virgin ds but the Rny to DS.  Point out the liability factor that may exist with your insurance sending you to someone who is not an "expert" in the field with proven success at doing "exactly" what you need to have done!  Don't settle!

So sorry friend!  Just when you thought it was the last  corner too, right?!!!

I'd be on a man hunt of anything wrong with this Doctor.  Who knows, perhaps he's a jewel of a doc who just hasn't made a name for himself yet?  (how can that ever happen with the DS bloodhounds that we so thankfully count on to research everything)

Has anyone on the CA state board heard of him?

Joyce I have been stressing revision from rny to ds all day to people. I've told them about the risks and I hate to bring it up but I also mentioned how someone died just a couple of weeks ago. I stressed how they need to provide some exerienced in doing revision from rny to duodenal switch. I also tried to find out if they had anyone in network how did the duodenal switch period and I think that answer was no. Of course I'm not giving up, but this is very stressful. I'm working full-time, going to school full-time and now trying to fight with insurance any chance I get. I really wanted to have this straightened out so I could have surgery during the winter break! Thanks for the tips and I'll keep everyone posted.

((((((((((((Monique))))))))))))   Hang in there!  ....  Positive thoughts for you friend!

HAve you called the insurance company to see why they are wanting to send you to a different doctor. I would call and ask for some answers. Why is he better than the surgeon you have chosen??  IF someone cant answer your question, have them call you back.  You need answers

The reason is that he is not in my medical groups network. I've been on the phone with insurance, medical group, and doctors office all day. I hope I can get this straightened out soon...

Hi, Monique.  This may sound strange, but I think one way to "research" this new doctor is to ask a bariatric (well known) surgeon.  I have gotten very honest appraisals and answers from several doctors now.  They praised some of the names I gave them, and kind of deferred on others (which of course meant that they didn't really approve.)  Just my thoughts....best of luck to you.