Sally/DS Approval VS RNY Approval

[Guest guest]

Hi Sally,

If your DS Surgeon participates in your insurance (ie: in-network)

then your approval should come as easily as your RNY approval. If he

is not in-network, things may be more difficult.

The bottom line is, what surgery outcome do YOU want to live with for

the rest of your life? Would I, personally, choose to have an

RNY/micro-pouch surgery to shave a few months off my waiting time?

No way. Not even at the risk of having to self-pay if I were to lose

insurance coverage.

The way I see it, neither the doctors, nor the insurance reps (nor

anyone on this list, for that matter) will have to walk in my shoes

for the next 50 some-odd years (hopefully). And if it happens that

I am *not* completely satisfied with my results, I want to know it

was because of my *own* choices and not because I felt I was

railroaded into something other than what I wanted.

But everyone is different. There are LOTS of folks who have chosen

the RNY and been *extremely* pleased with their results. I can't

speak if *all* of them were completely aware of the DS option when

they made their decision, but I know that some were and are glad

for their choice, regardless. I say, good for them!

So my advice to you is to continue researching and soul searching.

See if you can be put on Dr Scholten's cancellation list for an

earlier consult. Call them once a week or so to see if they have

any openings. If you can get in to see him for your consult you

will better be able to make an informed decision. First *you*

have to decide what surgery you really want, then figure out a way

to get it.

Just my opinion. Keep in touch and let us know how you make out.

Best wishes in your journey!

Terri Hassiak

BMI 60

http://www.obesityhelp.com/morbidobesity/profile.phtml?N=H980366398

Appealed " Out-of-Network " Ins. Denial - AND WON!!!

BPD/DS with Dr. Pomp on 6/25/01

email(no spaces): bunsofluff @ hotmail.com

> Hi,

>

> I was just approved to have the Micro-pouch surgery which is

similar

> to the Rouen Y. But that is not the surgery I want. It was " plan

B " .

> In case I couldn't get the DS. (Hepatitis C was a

contraindication).

> But the DS surgeon has changed his mind, after seeing my blood

work.

> But my consultation isn't until the end of September for the DS.

Then

> I have to try to get approval and then surgery. So we are looking

at

> Thanksgiving for the DS. The micropouch could be done in July or

> August. And it's already approved. And, the other thing that plays

> into this, is my job. It looks pretty shaky. I might be out of a

job

> by January, if what they are predicting is accurate. And who knows,

it

> could happen earlier.

>

> So this is my question. How many people got approval for the Rouen

Y

> and approval for the DS? Was it easier to get approval for the DS

> after having already been approved? Or harder? I know it's

dependent

> on what kind of insurance you have, but I certainly don't want to

wait

> until October to find out I have been denied and have to fight to

have

> the DS.

>

> Thanks

> Sally

> Preop in Michigan

> Dr. Scholten for DS

> Dr. Wood for Rouen Y

[Guest guest]

Teri,

I know you are right and I know that I really want the DS, but time is

such a factor, espcially since I might loose my job. Of course the DS

is the right surgery for me. And I did call Dr. Scholten's office and

they are so booked right now. Tight is the word she used. But she

would do what she could. And she said even said that with my

insurance, it could be more than 4 weeks for approval. But it did seem

hopeful from what I heard in her voice. It wasn't like, forget it. But

Dr. Scholten also does the RNY, so that is what she might be referring

to. Oh well, I will probably do both consulations, pray that things

work out at work and that Dr. Scholten's has a cancellation. That is

all I can do. Thanks for responding. I appreciate it.

Sally

> > Hi,

> >

> > I was just approved to have the Micro-pouch surgery which is

> similar

> > to the Rouen Y. But that is not the surgery I want. It was " plan

> B " .

> > In case I couldn't get the DS. (Hepatitis C was a

> contraindication).

> > But the DS surgeon has changed his mind, after seeing my blood

> work.

> > But my consultation isn't until the end of September for the DS.

> Then

> > I have to try to get approval and then surgery. So we are looking

> at

> > Thanksgiving for the DS. The micropouch could be done in July or

> > August. And it's already approved. And, the other thing that plays

> > into this, is my job. It looks pretty shaky. I might be out of a

> job

> > by January, if what they are predicting is accurate. And who

knows,

> it

> > could happen earlier.

> >

> > So this is my question. How many people got approval for the Rouen

> Y

> > and approval for the DS? Was it easier to get approval for the DS

> > after having already been approved? Or harder? I know it's

> dependent

> > on what kind of insurance you have, but I certainly don't want to

> wait

> > until October to find out I have been denied and have to fight to

> have

> > the DS.

> >

> > Thanks

> > Sally

> > Preop in Michigan

> > Dr. Scholten for DS

> > Dr. Wood for Rouen Y