I am preparing for RNY but would prefer DS. Advice please?
I will have Anthem BCBS as of January 1, 2013 as my primary insurance and SC Medicaid as my secondary insurance, I have gone through the entire process for RNY, and the request for RNY has been submitted to the insurance companies for approval. I recently read info about the DS( which I had never heard about before) I really think that it is a better choice for me. There isn't anyone who does the surgery in SC and that is my first problem but I also don't know what to do since I am at the end of the process. What can I do to get insurance to approve DS instead of RNY and will I have to do the 6 months over again since my current surgeon does not do DS?
The closest 2 DS surgeons are Dr Smith near Atlanta, GA and Dr Sudan in Durham, NC. Their contact info is on www.dsfacts.com. That web site will give you a lot of info about the DS and there may be some insurance help there as well. Welcome!
I don't have the same insurance you do but I can tell you how it worked for me. I went through a program here in Maine thinking I was having a sleeve or RNY but half way through decided I also wanted the DS. I continued the 3 month program here in Maine but contacted a DS surgeon out of state. I finished up my 3 month program here in Maine contacted the program that I was going to have surgery out of state and to please send all my records to my new surgeon. I can't say they were happy about me pulling out right before surgery but all the paperwork was sent to my new surgeon and their office sent in for the approval for me and I was approved for the DS. I can also tell you that my insurance requirement of 3 months ended up being much longer wait for my surgery just because you are trying to jump through all the hoops and the amount of reports and paperwork that need to be shuffled here and there takes time.
Best of luck,
DS 12/06/12 Dr Kemmeter
Plastics with Dr. Sauceda 8/14/2014
Lbl, bl/ba, al, tl, fl
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The salient point is that it's your life and your decision. So what if you're almost approved for a RnY. So what if the insurance company gives you heck for switching. So what if you have to travel for the operation. You have to live your life not the RnY doctor, not the insurance company etc... Do what's best for you. If you decide it's the DS then make that decision and pull the trigger on making it happen. As I said I was approved for the RnY when I switched. I hadn't heard of DS until I was in a doctors office one day and saw a poster about it. I asked my RnY surgeon and he informed me he doesn't perform DS and in his opinion it wasn't needed for me. Knowing me though I decided the DS was for me. In 1 month I met with my DS surgeon and scheduled surgery. The month was only because it was over a holiday and that was the soonest I could get in to see him.
I switched from RNY to DS at the end of my 6 month.. new surgeon as well.. all b/c my former surgeons hospital was now out of network.. so i took all my paperwork.. made a consult with a new dr and it was submitted to the insurance and approved in less than a week. i think the "prep work" is consitant with all the surgeries for the most part... just make sure you get ALL you documents from your prior dr, and any other stuff you had completed as well and given to them. letter from PCP, weight history, physc eval, dietician, etc.. i had everything ready to go and as soon as the new dr saw me... told me about the DS i was convinced it was the way to go and they submitted everything the next day.