Re: Struggling with Hepatitis C

[Guest guest]

Oh I see now, Sally. Perhaps a letter (or phone call) from Dr Hess

would still be helpful if Dr Scholten was open to the input.

Otherwise, I guess another surgeon is your only option. Good Luck!

Meli

BMI 47

Dr Hess

June 21,01

Summer Solstice

-- In duodenalswitch@y..., " Sally " wrote:

> Meli,

>

> It isn't the insurance company, it's Dr. Scholten who says it's a

> contraindication to the surgery and he denied me. Long before the

> insurance company even got involved. Dr. Hess, doesn't feel that

> strongly regarding it. That is why I am looking to his office to do

> the surgery now. Thanks for the respnose! It's good to know that

> others had surgery with Hep C. It gives me hope

>

>

> > >

> > >

> > > Hi all,

> > >

> > > I just wanted to up date my struggle with Dr.

> > > Scholten and my

> > > Hepatitis C. I was told by their office staff,

> > that

> > > if I had Hepatitis

> > > C, that I needed to go to a gastronentrologist

> and

> > > get released for

> > > surgery. They had the information regarding my

> > > Hepatitis since day

> > > one. Well, I went to a gastro, who, by the way

> was

> > > not supportive of

> > > this surgery. He ran a battery of blood tests

and

> > I

> > > waited. In the

> > > meantime, I had my psyche eval and my PCP send

> her

> > > files over to Dr.

> > > Scholtens. Once my doctor complied, I received

a

> > > letter from Dr.

> > > Scholtens office telling me I was denied for

> > surgery

> > > due to my

> > > Hepatitis C status. All because my doctor sent

in

> > my

> > > medical records.

> > > Now mind you, this was no secret. The day I

> > received

> > > the letter, was

> > > also the day I received my blood test results

> from

> > > the gastro. He was

> > > releasing me!. He just required a liver

biopsy. I

> > had

> > > called Dr.

> > > Scholten's office and Anne, the paitent

> > coordinator,

> > > told me that were

> > > always done during surgery. But, she didn't

tell

> > me a

> > > letter went out

> > > saying I was denied. I called the next day,

spoke

> > to

> > > the office

> > > manager, and explained that they hadn't given

me

> a

> > > chance to even be

> > > cleared for surgery. She said she thinks I may

> > have

> > > gotten the wrong

> > > information from her staff in the first place!

> > But,

> > > it's possible that

> > > they could review it again.

> > >

> > > Now, I feel like, no thanks, I will find

another

> > > doctor. Easier said

> > > than done. The only other choice I have is Dr.

> > Hess

> > > in Ohio, since he

> > > is the only other one that does the DS, which

I

> am

> > > interested in. Now

> > > I will have to have my PCP refer me to him.

And,

> > if I

> > > am reading my

> > > insurance benefits correctly, it would then be

> > > treated as " in network "

> > > and covered at 100%. If she will do it, which

I

> > > believe she will. She

> > > is supportive of me. But Dr. Hess is not even

> > willing

> > > to sign up to

> > > become a member of my insurance plan. I really

> > don't

> > > know how all this

> > > works. Does anyone else have PPOM, and have

> > > experience with this? And

> > > the kicker of all this is, that Dr. Hess

doesn't

> > have

> > > a problem with

> > > the Hepatitis C. If my blood work shows normal

> > > levels, then he's not

> > > worried about it. And maybe then, it's the way

to

> > go.

> > > This is not an

> > > easy task, getting all these details for this

> > surgery

> > > together.

> > > Please, if you can help, I would enjoy hearing

> > from

> > > you.

> > >

> > > Thanks!

> > > Sally Pre-OP in Michigan

> > > No surgeon as of yet...