JRo
Member
- Joined
- Aug 14, 2015
- Messages
- 10
Perfect, that's what I had thought. Thank you @DianaCox and @Larra!!
I attend the Jossart seminar this Saturday and my actual consultation with him is on Sept 11th so we will see what happens. Funny thing, my PCP with Sutter IPA authorized the out of network referral, and then initially BSC approved it because Rabkin is listed as Sutter doctor but for ONLY his liver transplants, so they initially screwed up and approved it at the Sutter location. I sent this all to Matt at Rabkins office and he said unfortunately because it says Rabkin/Sutter they cant take it as an approval. I contacted my PCP and they said we authorized it for out of network not Sutter, you need to harass BSC to correct it; to which I did. After a few hours of calls, they advised they had to decline it since it was Out of Network (its an auto decline) and I can file a BSC appeal. I did the BSC appeal and they declined it officially for Out of Network. Now my next step is to file a DMHC appeal. All this just for the consultation, heaven knows what the actual DS battle will be like! In the meantime during all this back and forth with BSC, Jossart appeared on the DS Facts website and my PCP advised that since he is a Sutter in network surgeon and lists the VSG to DS revision as something he does, I need to meet with him first. If he sways me from the DS, I guess I can then essentially take that as a refusal to perform the procedure I want and then there aren't any surgeons BUT Rabkin to perform it and my DMHC battle should be much smoother. Fingers crossed!!
Thanks again for your responses!! Patience is definitely a virtue, I've waited this long, so whats a few more weeks
I attend the Jossart seminar this Saturday and my actual consultation with him is on Sept 11th so we will see what happens. Funny thing, my PCP with Sutter IPA authorized the out of network referral, and then initially BSC approved it because Rabkin is listed as Sutter doctor but for ONLY his liver transplants, so they initially screwed up and approved it at the Sutter location. I sent this all to Matt at Rabkins office and he said unfortunately because it says Rabkin/Sutter they cant take it as an approval. I contacted my PCP and they said we authorized it for out of network not Sutter, you need to harass BSC to correct it; to which I did. After a few hours of calls, they advised they had to decline it since it was Out of Network (its an auto decline) and I can file a BSC appeal. I did the BSC appeal and they declined it officially for Out of Network. Now my next step is to file a DMHC appeal. All this just for the consultation, heaven knows what the actual DS battle will be like! In the meantime during all this back and forth with BSC, Jossart appeared on the DS Facts website and my PCP advised that since he is a Sutter in network surgeon and lists the VSG to DS revision as something he does, I need to meet with him first. If he sways me from the DS, I guess I can then essentially take that as a refusal to perform the procedure I want and then there aren't any surgeons BUT Rabkin to perform it and my DMHC battle should be much smoother. Fingers crossed!!
Thanks again for your responses!! Patience is definitely a virtue, I've waited this long, so whats a few more weeks
