Question:
BC/BS Health Options plan
don't know how to proceed since Health Options is a HMO and their are no surgeons doing that procedure in FL. How do I proceed with my PCP? Should I contact the insurance company first. My Pcp did agree to refer me to a surgeon out of county and would probably out-of-state. Any hints of what I should do? Thanks everyone. Debi — Debi V. (posted on November 13, 2000)
November 13, 2000
Debi, if you are serious about wanting the DS then you need to go to
duodenalswitch.com and study the list of the only doctors in the US (and a
couple in Canada and one in Spain) who offer the DS. These are your only
choices. So that is the place to start-see who is actually willing and able
to offer this type of surgery. Then, check out the doctors locations and
find the one who is the best match for you. That means a doctor who is
close to you in their actual practice, a doctor who is close to family or
friends, or someone who is easy to get to. Can you afford the airfare,
hotel, taxi, meals, phone charges, etc to do this at a distance or alone?
An aftercare program is nice but unnecessary-the biggest thing post op is
to get your blood work done-period-even if you never lay eyes again on the
doctor. You don't read much about people going back to Spain for checkups,
and the importance of this factor diminishes with the reality of post op
life, believe me. Then look into a lap approach or an open approach.All
lap surgeons can do this open but not all open surgeons are able to do this
lap. This is another factor to think about. Then when you have picked a
couple of choices then the next step is to call their office and see if
they accept your type of insurance-speak to the business office or finance
manager-these are the people in the know about this stuff. Then check with
the office nurse/surgery coordinator and find out when the next available
appointments are and how far ahead the doctor is scheduling surgery-if you
don't want to wait 3, 6, 9, or 12 months, keep searching. Go ahead and
make your appointment if it won't be for a while-at least you will be in
place-even if you have to tell the office that you will be self pay (this
is if they are unwilling to make an appointment for you without insurance
preauthorization-remember the scheduler does not know what you talked to
the finance people about!! If indeed you do have to cancel your appointment
for whatever reason, take heart, there are many, many people who want your
spot-the doctor will not suffer!!!! Now that you have some of the nuts and
bolts out of the way call your primary care doctor and tell him that you
have made an appointment to see Dr. So and So and would like a referral to
him. A lot of offices are very happy that a person has taken it upon
themselves to attend to details so they don't have to-some people take it
as an insult or an uppity pushy patient. So what, you will need to take
care of yourself in this whole journey-no one will care as much as you will
nor follow through like you will. Debi, there is no doctor who is perfect,
not a one who hasn't had a problem or complication and there are unhappy
patients out there. When we go to any type of check point I have found
mostly all positve things written, I think the negative opinions are not
posted because people are afraid of slander and libel and being accused of
lying about "the precious doctor" you will not find many
objective opinions publically but privately you might. There is only one
doctor and operation where there is a lot of warning and out and out
aversion. The DS surgeons are all highly regarded-it is nearly impossible
to find a DS patient who will talk poorly about their doctor or experience
even though there are some. So just listen to everyone and make up your own
mind. The DS is a great operation but after you have gone through all of
the actual manuvering and what not to have a DS it may not work out for
you-I mean that the travel, insurance, finances (don't want to mortgage
your home and life for ever nor be in debt so deep that you can't make it
financialy), availability of lap vs open may not be feasable. Take heart,
the RNY is also a great operation and people are doing fantstically well
with it, too. (So my advise for picking a RNY doctor is essentially the
same withthe additional suggestion that the doctor be a member of the ASBS)
Always keep in mind the final outcome is to lose weight and get healthy.
Sometimes we don't get out first choice or the second one either. Grieve
and move on. This is a long process for some and you must take the first
step. I do try to be a clam voice in the midst of the confusion about what
doctor. operation, etc to choose. You must separate the emotional issues
from the practical ones. I believe that is the bottom line when it comes to
choosing a doctor. While you are in this stage of the process you see that
it is a good thing to complile all of your medical records and
documentation, write out a diet history and generally educate yourself.
Remember you don't have to know it all at this get go, just keep moving
along!!!! If I can helpo more just e-mail me!!
— Fran B.
November 13, 2000
Hi Debi...There are some great resources out there for you... You can go to
<a
href="http://www.duodenalswitch.com/Surgeons/surgeons.html">DS
Surgeons</a> for an ever growing list of DS surgeons world wide. If
you haven't already, I would suggest you join the eGroups <a
href="http://www.egroups.com/group/duodenalswitch">DS mailing
list</a>. You can read & ask questions from hundreds of people
who have experienced this exact thing.. traveling to have your surgery of
choice. And lastly, you can look at <a
href="http://www.myWLS.com">http://www.myWLS.com</a> for
samples of Diet Histories, Family Histories, Letter to Insurance,
Frequently Asked Questions, more Resources, and all kinds of good stuff.
Traveling to get the surgery you want is very doable. I did it, as did
many, many others. If you have any other questions, please feel free to
eamil me! Take care for now....
— [Deactivated Member]
August 13, 2001
There are surgeons in Fl and are on Health Options. I am seeing Dr.Rout at
Shand's Hospital. Talk to PCP or insurance company.
— KARLA S.
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