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Taniesa

Taniesa

Member
Joined
Mar 31, 2015
Messages
16
Location
Tracy, CA
Hi everyone.

I am currently looking to have revision surgery from RNY. I ultimately would love to have RNY to DS but it looks nearly impossible unless of course I grow a money tree in my yard.

I have Blue Shield of CA and Dr K is not contracted with them and Dr. Rabkin is not contracted with any insurance companies. Out of pocket will start at 15k and we just don't have that kind of money.

My PCP referred me to Dr. Coates in Modesto however as of a phone call to his assistant today to schedule my appointment, she said he is more than likely not doing revision surgery (of any kind) anymore.

Does anyone know of anyone else in CA that does revisions?
 
Hi again, Taniesa! so glad you found your way here. I've already given you what I know to be the CA alternatives, but if someone else knows something that I don't know they can chime in.
If you can travel, you could try Dr. Simper in Utah. I can't think of anyone else closer to CA who does these revisions for the reasons I gave you on the other website. Many people do need to travel long distances for this type of revision, this is simply the reality of RNY to DS revision.
I understand completely about the money tree, esp with us having this drought. Any possibility of a loan from family or a bank? Otherwise, I don't have any great suggestions. Or, is it possible that when open enrollment rolls around again next year that you could switch to a different insurer that does contract with Dr. Keshishian?
 
Thanks Larra!

We are private pay insurance... most other companies premiums are way higher than Blue Shield so its unlikely we could switch but you never know. I will be checking into it around November for sure.

Traveling might be an option if its a doctor in network... Not sure if blue shield of CA would cover anything out of CA? Need to check into that.

I did hear back from Matt with Dr. Rabkin's office. He said to see if Blue Shield will make an exception beings there is no surgeons qualified or willing to do the RNY to DS surgery and that Dr. Rabkin is. It's a long shot but he said it has happened in the past.
 
Thank you <3 I have an appointment with my PCP tomorrow afternoon. I have been in tears all day from this frustration. Hopefully there will be some better news soon
 
I suspect that Diana can handle that question better than I can. But I do know that sometimes people whose policies cover the DS can successfully argue that since there is no in-network surgeon who does the DS they should get coverage for the out of network surgeon who does the procedure. So the first step is to know your policy not only on the DS but also on revision bariatric surgery. So you need to get your EOC (evidence of coverage) and read it for yourself. This is a long document, not a little summary phamplet. If you have coverage AND you qualify medically, you may have a shot at it.
Hopefully Diana will also chime in.
 
I am having them send me my EOC today. Thank you all for your help, means more to me than you know. I have been so lost and frustrated.
 
Welcome Taniesa! You could not possibly be in a better place to get help! These Ladies (and a guy or 2) are the best of the best and know EVERY angle!! They have helped SO many people for YEARS and years! So...you can stop all that crying now ;). EVERYTHING is possible with the right tools and I never let money...or the lack thereof, stop me at anything! You/we will find a way! My best wishes to you! Rob
 

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