Guest guest Posted November 21, 2003 Report Share Posted November 21, 2003 1. Dr. Oh in Washington state does not accept Medicare patients. Period. I just went thru this with his office a week ago. 2. Yes, a stoma can simply relax. It can also be a combination of factors: simply relaxed, and made too large to begin with as well. Dr. Oh told me this is the case with my stoma. 3. Almost ALL the docs think we should be able to exercise the control to lose weight thru sheer willpower. If that actually worked, we wouldn't need the surgery in the first place, would we? I wouldn't let this guy touch me again, EVER. Or ANY doc whose knee-jerk reaction is to blame the patient. 4. Find someone who will accept Medicare, first of all. Medicare will not give any prior approval, though, so you will have to make sure the doc writes it up really well as medically necessary, and then be prepared to fight the bureaucracy if necessary. That is not easy. I've been fighting them on a totally unrelated issue for several months. In frustration, I asked HOW do I get someone to do something about this? And they said " write to your Congressman. " Sheesh. 5. I have contemplated withdrawing from Medicare, just so that my secondary insurance would become primary and I would have at least a slim chance of getting prior approval. Before doing that, tho, you should make very certain that your secondary would in fact pay. Some of them will. Others will not if they know you're eligible to receive Medicare and don't have it. Your doc AND the hospital can give you the UCR (usual and customary rate) so that you'll have some idea what would have to come out of your pocket. 6. If it's important enuf to you to pay on your own up front, ask the doc and hospital if they have any financing or payment arrangements. Other ways to pay: go back to work (if you're retired and able still); take out an equity loan on your home (if you own one). Also if you have a home, there's the reverse mortgage route. Perhaps an elder care consultant (available thru your state health dep't, I believe) could come up with some better ideas. I SO understand where you're at, Ruby. I'm in pretty much the same boat myself; but I don't have the reflux except on rare occasions. Two docs besides Oh that have been recommended to me are Dr. Marema in Fla and Dr. Gagner in NYC. The latter accepts NO assignments whatsoever; I haven't yet contacted Marema. Carol A ------------------------------------ In a message dated 11/21/2003 9:22:43 AM Central Standard Time, pam@... writes: > Is this the same doctor who gave you a " too large " stoma to start with (or > did > it simply relax - that is a possibility)? I don't know who accepts insurance > up there, but I wish you luck, Ruby! I know that if I were to have a > revision, > I'd use Dr. Oh in Washington state. > > Pam in Niceville > > ----- revision scheduled > > >I talked with my doctor who is very hesitant to do a revision, > >thinks I should have sheer will to lose weight, though my stoma is > >large. I am managing my blood sugar, and have my diet in control. > > I have joint problems and trying to avoid surgery and also have > >reflux which is burning, possibly the stomack. Dr. said my > >insurance (Medicare and Oregon Federal Regency Blue Cross) will not > >cover revision. I told him it was up to him to write it as > >medically necessary. I need ideas and connections. I am scheduled > >December 8th. If I can't get it covered I will have to pay, (he > >said 11,000) I think that is wrong anyway. If my doctor won't do > >it under insurance, I need to find a doctor who will. Living on > >social security does not give me any money to run up medical bills. > >Thanks. Ruby > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2003 Report Share Posted November 21, 2003 Is this the same doctor who gave you a " too large " stoma to start with (or did it simply relax - that is a possibility)? I don't know who accepts insurance up there, but I wish you luck, Ruby! I know that if I were to have a revision, I'd use Dr. Oh in Washington state. Pam in Niceville ----- revision scheduled > I talked with my doctor who is very hesitant to do a revision, > thinks I should have sheer will to lose weight, though my stoma is > large. I am managing my blood sugar, and have my diet in control. > I have joint problems and trying to avoid surgery and also have > reflux which is burning, possibly the stomack. Dr. said my > insurance (Medicare and Oregon Federal Regency Blue Cross) will not > cover revision. I told him it was up to him to write it as > medically necessary. I need ideas and connections. I am scheduled > December 8th. If I can't get it covered I will have to pay, (he > said 11,000) I think that is wrong anyway. If my doctor won't do > it under insurance, I need to find a doctor who will. Living on > social security does not give me any money to run up medical bills. > Thanks. Ruby > > Homepage: http://groups.yahoo.com/group/Graduate-OSSG > > Unsubscribe: mailto:Graduate-OSSG-unsubscribe > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2003 Report Share Posted November 21, 2003 Ruby, Dr. Keshishian in California takes Medicare. He has successfully revised many RNY to DS. He charges $3000.00 in addition for everyone. Because you don't need pre-approval you could get in for surgery much faster. You need to go to OSSG_revision and DS_Revision lists to get more info. Why would you want to go to the same doctor who messed your surgery in the first place? Many of us have been in your shoes. Best wishes, M. Lap Proximal RNY, Feb 98 Revision Lap Medial RNY Oct. 03 revision scheduled > I talked with my doctor who is very hesitant to do a revision, thinks > I should have sheer will to lose weight, though my stoma is large. I > am managing my blood sugar, and have my diet in control. I have > joint problems and trying to avoid surgery and also have reflux which > is burning, possibly the stomack. Dr. said my insurance (Medicare > and Oregon Federal Regency Blue Cross) will not cover revision. I > told him it was up to him to write it as medically necessary. I need > ideas and connections. I am scheduled December 8th. If I can't get > it covered I will have to pay, (he said 11,000) I think that is > wrong anyway. If my doctor won't do it under insurance, I need to > find a doctor who will. Living on social security does not give me > any money to run up medical bills. Thanks. Ruby > > > > Homepage: http://groups.yahoo.com/group/Graduate-OSSG > > Unsubscribe: mailto:Graduate-OSSG-unsubscribe > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2003 Report Share Posted November 21, 2003 I went to see my surgeon today about getting a revision. He and his staff explained that Medicare is the easiest one to get covered under if you still meet the 100 lbs overweight and/or comorbidities. Lori Owen - Denton, Texas SRVG 7/16/01 Dr. Ritter/Dr. Bryce 479/356/hoping for close to 200 On Fri, 21 Nov 2003 06:56:02 -0000 " zozyfox " writes: > Dr. said my insurance (Medicare > and Oregon Federal Regency Blue Cross) will not cover revision. I Thanks. Ruby Quote Link to comment Share on other sites More sharing options...
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