Question:
BC/BS Health Options plan

don't know how to proceed since Health Options is a HMO and their are no surgeons doing that procedure in FL. How do I proceed with my PCP? Should I contact the insurance company first. My Pcp did agree to refer me to a surgeon out of county and would probably out-of-state. Any hints of what I should do? Thanks everyone. Debi    — Debi V. (posted on November 13, 2000)

November 13, 2000
Debi, if you are serious about wanting the DS then you need to go to duodenalswitch.com and study the list of the only doctors in the US (and a couple in Canada and one in Spain) who offer the DS. These are your only choices. So that is the place to start-see who is actually willing and able to offer this type of surgery. Then, check out the doctors locations and find the one who is the best match for you. That means a doctor who is close to you in their actual practice, a doctor who is close to family or friends, or someone who is easy to get to. Can you afford the airfare, hotel, taxi, meals, phone charges, etc to do this at a distance or alone? An aftercare program is nice but unnecessary-the biggest thing post op is to get your blood work done-period-even if you never lay eyes again on the doctor. You don't read much about people going back to Spain for checkups, and the importance of this factor diminishes with the reality of post op life, believe me. Then look into a lap approach or an open approach.All lap surgeons can do this open but not all open surgeons are able to do this lap. This is another factor to think about. Then when you have picked a couple of choices then the next step is to call their office and see if they accept your type of insurance-speak to the business office or finance manager-these are the people in the know about this stuff. Then check with the office nurse/surgery coordinator and find out when the next available appointments are and how far ahead the doctor is scheduling surgery-if you don't want to wait 3, 6, 9, or 12 months, keep searching. Go ahead and make your appointment if it won't be for a while-at least you will be in place-even if you have to tell the office that you will be self pay (this is if they are unwilling to make an appointment for you without insurance preauthorization-remember the scheduler does not know what you talked to the finance people about!! If indeed you do have to cancel your appointment for whatever reason, take heart, there are many, many people who want your spot-the doctor will not suffer!!!! Now that you have some of the nuts and bolts out of the way call your primary care doctor and tell him that you have made an appointment to see Dr. So and So and would like a referral to him. A lot of offices are very happy that a person has taken it upon themselves to attend to details so they don't have to-some people take it as an insult or an uppity pushy patient. So what, you will need to take care of yourself in this whole journey-no one will care as much as you will nor follow through like you will. Debi, there is no doctor who is perfect, not a one who hasn't had a problem or complication and there are unhappy patients out there. When we go to any type of check point I have found mostly all positve things written, I think the negative opinions are not posted because people are afraid of slander and libel and being accused of lying about "the precious doctor" you will not find many objective opinions publically but privately you might. There is only one doctor and operation where there is a lot of warning and out and out aversion. The DS surgeons are all highly regarded-it is nearly impossible to find a DS patient who will talk poorly about their doctor or experience even though there are some. So just listen to everyone and make up your own mind. The DS is a great operation but after you have gone through all of the actual manuvering and what not to have a DS it may not work out for you-I mean that the travel, insurance, finances (don't want to mortgage your home and life for ever nor be in debt so deep that you can't make it financialy), availability of lap vs open may not be feasable. Take heart, the RNY is also a great operation and people are doing fantstically well with it, too. (So my advise for picking a RNY doctor is essentially the same withthe additional suggestion that the doctor be a member of the ASBS) Always keep in mind the final outcome is to lose weight and get healthy. Sometimes we don't get out first choice or the second one either. Grieve and move on. This is a long process for some and you must take the first step. I do try to be a clam voice in the midst of the confusion about what doctor. operation, etc to choose. You must separate the emotional issues from the practical ones. I believe that is the bottom line when it comes to choosing a doctor. While you are in this stage of the process you see that it is a good thing to complile all of your medical records and documentation, write out a diet history and generally educate yourself. Remember you don't have to know it all at this get go, just keep moving along!!!! If I can helpo more just e-mail me!!
   — Fran B.

November 13, 2000
Hi Debi...There are some great resources out there for you... You can go to <a href="http://www.duodenalswitch.com/Surgeons/surgeons.html">DS Surgeons</a> for an ever growing list of DS surgeons world wide. If you haven't already, I would suggest you join the eGroups <a href="http://www.egroups.com/group/duodenalswitch">DS mailing list</a>. You can read & ask questions from hundreds of people who have experienced this exact thing.. traveling to have your surgery of choice. And lastly, you can look at <a href="http://www.myWLS.com">http://www.myWLS.com</a> for samples of Diet Histories, Family Histories, Letter to Insurance, Frequently Asked Questions, more Resources, and all kinds of good stuff. Traveling to get the surgery you want is very doable. I did it, as did many, many others. If you have any other questions, please feel free to eamil me! Take care for now....
   — [Deactivated Member]

August 13, 2001
There are surgeons in Fl and are on Health Options. I am seeing Dr.Rout at Shand's Hospital. Talk to PCP or insurance company.
   — KARLA S.