doctor consult today

squisheez

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Joined
Aug 29, 2017
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11
I'm sitting in the Kaiser waiting room, waiting for my consult with the doctor. I'm so nervous. I have been waiting for 3 weeks, and I know it will be over quickly. I just want this so much, and I know I am gonna get denied. Wish me luck.
 
Dr told me there is no such thing as a revision. I asked if he put in my chart that I requested one, he said he did. What do I do from here? Do I request a formal denial from Kaiser?
 
slow down, help us help you. Where are you starting from and where do you want to go?
 
slow down, help us help you. Where are you starting from and where do you want to go?
I had RNY in 2010, lost about 60lbs, am currently 280, and since I found out about the possibility of a revision to ds I have been working towards it. DS was never mentioned as a possibility when I had RNY. I told the surgeon I wanted the most severe surgery, RNY was it at the time.
 
The DS was available in 2010. They lied to you. Post a copy of your EOC here. That's Evidence Of Coverage from your insurance company. Should be @100 pages or so.
 
The DS was available in 2010. They lied to you. Post a copy of your EOC here. That's Evidence Of Coverage from your insurance company. Should be @100 pages or so.
I sent it to Larra, and she thought it was strangely worded. It didn't explain if a revision was covered, nothing about a second wls.
 
It sounds like you were told it was impossible (which you know is not the case) instead of being given a denial. It was a clever way to avoid making a denial, which you could then appeal.
Since you have now had your consult with the bariatric surgeon, you could send him/her an email, very politely stating that you know that a revision of gastric bypass to the DS is possible, that it is done by Dr. Rabkin of Pacific Laparscopy in San Francisco, and requesting authorization for a revision to DS with him. Rest assured you will get a denial, but this puts everything in writing so you have something official in your medical record. You can then start internal appeals, which will eventually get you a final denial, and at that point you can go to external appeals.
 
What Larra said is just what you need to do. You need a denial of your request for a revision - or a denial of a consult with a DS surgeons, since they don't have anyone in-network who even knows it exists. (The doctor FLAT OUT LIED to you - think about that for a minute or two ...)
 

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