hilary1617
First time at the rodeo.
- Joined
- Jan 6, 2014
- Messages
- 3,764
Hello and welcome @BigBedRock - you're in a great location for DS!
Hi from Southern California
- Thread starter BigBedRock
- Start date
Larra
Well-Known Member
- Joined
- Dec 31, 2013
- Messages
- 3,524
If your EOC says Ds is covered and you meet their criteria, the only remaining barrier is lack of a DS surgeon in-network. Your pcp seems to have been mistaken (I think, keeping in mind I haven't seen your EOC) which is not surprising given that he/she probably sees people with all sorts of different policies. Or maybe he/she just made a poor assumption, IDK. In any event, I think you can/should deal directly with the insurer and not through your pcp, with the point being that they don't have an in-network surgeon who does a covered surgery. They may still insist that you see the in-network surgeon, and we've seen the DMHC back insurers up on that (I don't understand why) and if so, get the in-network surgeon to document that he doesn't do the DS. Hopefully it will be downhill from there.
Whit
Well-Known Member
Dr. K was my revision surgeon. He and his office full of beauties worked very hard to give me my life back. Welcome to the group.
