Re: Struggling with Hepatitis C

[Guest guest]

Hi Sally:

> 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.

HUH? What do you mean he's the only other one who does the DS?

> Does anyone else have PPOM...?

What is PPOM? Is it one of these?

PacifiCare PPO/HMO

Pacific Health Alliance

Pacific IPA

Pacific Physicians Services (PPS)

Pomona Valley Medical Group

Planned Behavioral Health Care

PPO Alliance Plus

PPO CompAlliance (work comp.)

Preferred Health Care, LTD.

Preferred Health Network

Presbyterian Intercommunity Hospital

Private Health Care Systems

ProHealth, Inc.

Provident Life/NME

Prucare HMO

Prudential PPO

[Guest guest]

Hi Sally:

> 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.

HUH? What do you mean he's the only other one who does the DS?

> Does anyone else have PPOM...?

What is PPOM? Is it one of these?

PacifiCare PPO/HMO

Pacific Health Alliance

Pacific IPA

Pacific Physicians Services (PPS)

Pomona Valley Medical Group

Planned Behavioral Health Care

PPO Alliance Plus

PPO CompAlliance (work comp.)

Preferred Health Care, LTD.

Preferred Health Network

Presbyterian Intercommunity Hospital

Private Health Care Systems

ProHealth, Inc.

Provident Life/NME

Prucare HMO

Prudential PPO

[Guest guest]

Sally, My very good friend who is Hep C had the Rny and is doing

great. And yes, they did her liver biopsy durning surgery. Hep C

shouldnt make you ineligible for the DS. Remember that insurance

companies will use ANY excuse to deny you. Try getting a letter from

Dr Hess stating that Hep C isnt a problem for this procedure. Then,

if they still stall, contact Walter Lindstrom, perhaps he could use

the approach that they are discriminating against you based on a Hep

C diagnisis. Best of luck,

Meli

BMI 47

Dr Hess

June 21, 01

Summer solstice

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

>

>

> 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...

[Guest guest]

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...

[Guest guest]

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...

[Guest guest]

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...

[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...