Hi from Southern California

[hilary1617]

Hello and welcome @BigBedRock - you're in a great location for DS!

 

[Larra]

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]

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.