Losing my surgeon

sandracurtis
on 7/22/11 3:46 am - Ashby, MN
I just received a letter last week from my surgeons office informing me that he is moving out of the state and that I need to find a new surgeon....only problem with that is that I live 175 miles from the nearest surgeon that my insurance will cover.  I guess I am just venting a little.  We live in a small town in west central MN and I will have to travel the 175 to the twin cities to see a new surgeon because my regular doctor won't see me about anything regarding my RNY, she won't even do blood work for me.  It is really frustrating for me right now, partly because my husband hasn't worked in 4 years due to a work comp. injury so our income is limited and taking an entire day off work, spending all that money on gas and all the time and travel involved is just too much right now.....thanks for being here to vent to, I don't have anyone in my area that I know who has had RNY so it helps to have all of you here to be able to "talk" to and to see what everyone is saying, it is nice for me to have other people who experience the same things that I go through, it just makes you feel like you aren't alone. 
(deactivated member)
on 7/22/11 4:20 am
 Sounds like it's time for a new PCP, why would you travel that far for routine care. 
A new PCP closer by, one that is willing to do bloodwork etc. 
We DSers have to do it all the time.
Laura A.
on 7/22/11 4:28 am - Manteca, CA
Looks like you had surgery about 18 months ago....and I'm guessing have had no problems?  So what you're really needing is not necessarily a surgeon (because surgery is done with), just  a physician to monitor your labs?

If your own regular doctor refuses to do this for you....find a doctor closer to you that might be willing.  And if not do the 'monitoring' themself, then at least write the blood draw order so you (in a pinch) can come back here to OH and get advice.  Just thinking (less than 175 miles) outside the box.....

 Laura A.         5'3"  BW299/CW135


sandracurtis
on 7/22/11 4:38 am - Ashby, MN
You are right, I have not really had any issues, not mush dumping, I can eat just about anything and I feel great.  I did talk to my insurace about this but because I have to use one of their "centers of distinction" for my surgery post op visits they won't pay for any other PCP to see me about anything concerning my RNY....is that stupid or what?  They already don't cover the blood work which runs $595 when I have that done, now they won't cover a visit to my PCP and that runs at leat $500 compared to the $30 co pay I have if I see a WLS specialist they approve.  I didn't have this much trouble getting approved for the surgery.
Laura A.
on 7/22/11 4:49 am - Manteca, CA
So maybe you'll just have to play similar games that your insurance seems to be playing....

Don't say you're seeing the doctor pertaining to anything to do with WLS....just visit the doctor for your general health and "these are the things I need checked with some routine bloodwork".

The other thing is, the further out you get, you may only need your labs checked annualy.  Keep track of your mileage and other expenses for tax purposes and make the trip 175 miles away to see the WLS specialist since it's just once a year....

Hope you can find a solution....

 Laura A.         5'3"  BW299/CW135


sandracurtis
on 7/22/11 4:53 am - Ashby, MN
I am looking for a new doctor that will do that...my current PCP always wants to focus on that and thinks that she has to list that in my chart every time I go in and I have tried to make her understand that all I want is for her to make sure that I am getting all the vitamins and whatever and she just refuses...hoping I can find someone new.
vitalady
on 7/22/11 8:25 am - Puyallup, WA
RNY on 10/05/94
I have been using correct coding for years for labs and visits. They just don't point to my WLS. It won't cover anything whatsoever.

But most of the labs are justifiable with codes that point to perfectly valid factors. Mine run nearly $2000 for all 14 vials, to test everything. There are maybe 20 codes your PCP can use that are legal and morally fine.

BTW, when I was faced with an ins that did cover and needed a surgical repair, my ins had a 30 mile limit! So, as long as my local doc would accept payment "as if" in network, my ins would pay that higher rate. The next surgeon over was 60 mi. My doc agreed to act "as if" and actually got paid more than he would have with most local insurances! LOL For 3 yrs, we had fabulous ins but it was out of state with few network providers in state. Unfortunately, that insurance ended. Bummer.

So, we're back to our local ins for small companies that pays pretty well on everything except WLS (not one slim penny) and it's kinda chintzy on phys therapy.

Michelle
RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

codlover
on 7/22/11 9:18 am - Celina, OH
PCP charges $500.........now that is a rip !!!!!!!

My PCP charges $65.......move to Ohio !!!!  I do love MN, that is unreal !!!!!
Jim from Celina   328 Pounds...GONE !!!!!      
MsBatt
on 7/22/11 4:43 am
You don't NEED a surgeon---you NEED a good PCP. Fire the one you have now and get one that's better educated about bariatrics.
sandracurtis
on 7/22/11 4:45 am - Ashby, MN
If my insurance would pay for it I would sure do that
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