Guest guest Posted June 21, 2001 Report Share Posted June 21, 2001 Hi. I'm in the midst of trying to get Kaiser to approve WLS. After much research I want the Duodenal Switch procedure. Unfortunately, I live in Virginia and the Kaiser general surgeon says that if I'm approved for surgery I'd have to go to a specific Virginia surgeon who does the RNY. There is a physician that deals with Kaiser in land who does the procedure and who I've heard wonderful things about. I'm going to fight to get referred to the land guy. If anyone has ideas about effective arguments and tactics, I'd love to hear them. Thanks in advance for those kind enough to answer. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2001 Report Share Posted June 22, 2001 --- karentecott@... wrote: There is a physician that deals with > Kaiser in land > who does the procedure and who I've heard wonderful > things about. , Just wondering who your land surgeon was? I spoke with Dr. Marcus' office in Silver Spring and he is dropping " ALL " insurances as his contracts with them expire. He will be totally self pay at some point, and accepting no insurances. __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2001 Report Share Posted June 22, 2001 OMG!!! What is he thinking??? Stupid insurance companies.. gotta love 'em... Siiigh, Liane > There is a physician that deals with > > Kaiser in land > > who does the procedure and who I've heard wonderful > > things about. > > > , > > Just wondering who your land surgeon was? I spoke > with Dr. Marcus' office in Silver Spring and he is > dropping " ALL " insurances as his contracts with them > expire. He will be totally self pay at some point, > and accepting no insurances. > > > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2001 Report Share Posted June 22, 2001 Hi, everybody. My name is Jodi and this is my first post. I was scheduled to have a lap BPD w/DS (robotic) with Dr. Sudan in Omaha, NE on June 13th, but at the time I was there to do bloodwork, ect. the week before, I found out I was going to have to be rescheduled and I would have to wait until July 27. A week later I spoke to Dr. Sudan's nurse and she told me there was a problem with the insurance. I had been approved in January by BCBS/Wellmark of Iowa but apparently there was a mix up. It was sent in for preapproval under a general code that sounded like a description of BPD w/DS but they actually did not cover this surgery as they consider it to be experimental. The doctor's office is trying to negotiate with them, but my surgery date is approaching and I am concerned that if I am able to get approval for the BPD that it will be after my surgery date and I will have to wait months again to get a new date. I don't think the doctor's office has a strong hands-on approach with further appeals if this first one is denied. I'm hoping you all might be able to give me some input as to the steps to take if I have to try to fight the insurance company so I can have the BPD. It seems so overwhelming and I'm wondering where to start. Also am wondering if there is anyone else out there who has been approved by BCBS/Wellmark of IA for this procedure. Any suggestions would be greatly appreciated. Thanks. Jodi Quote Link to comment Share on other sites More sharing options...
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