Hi im new to the group ???

[DianaCox]

It may well be that you have no choice - but until you FIGHT for the right to go out of state to a more qualified surgeon, you have not done your due diligence. And you must learn to fight for your rights if you are going to be a good candidate for the DS.

 

[Tawanna Atkinson]

It may well be that you have no choice - but until you FIGHT for the right to go out of state to a more qualified surgeon, you have not done your due diligence. And you must learn to fight for your rights if you are going to be a good candidate for the DS.

 

[Tawanna Atkinson]

It may well be that you have no choice - but until you FIGHT for the right to go out of state to a more qualified surgeon, you have not done your due diligence. And you must learn to fight for your rights if you are going to be a good candidate for the DS.

The problem is, is that im not sure where to start! I have called my insurance company several times to talk with someone concern bariatric department/surgery, but I was told there is no such department. I was informed to have my pcp submit the medical necessary form for approval.

 

[Tawanna Atkinson]

My process was to find the surgeon I wanted, meet with him, confirmed he did the true DS , then he did the paperwork for my insurance to approve my surgery, not my PCP.

I don't know others did it, nor do I know anything about your insurance; that was just my experience
With Staywell Medicaid of Fl. my pcp has to provide a letter to them in order for them to approve it along with the other finding a the entire procedure.

 

[southernlady]

Like 4k, I did get a letter from my PCP but it was to the bariatric surgeon. My surgeon did everything else.

 

[Whit]

Welcome to the group. I too traveled for surgery. My process was the exact same as 4Kids. Research, interview surgeons (3), then the Dr.'s office took it from there.
I had RNY and revised to DS. It truly is the best option available.

 

[Munchkin]

And BTW, my H and sister had theirs in Spain. It's not always easy but it's worth it.

 

[Tawanna Atkinson]

I found a surgeon that accepts my insurance but have found out Dr. Hoddinott is a no go!

And BTW, my H and sister had theirs in Spain. It's not always easy but it's worth it.

 

[Tawanna Atkinson]

I totally agree, but when I can the different surgeons I get turned around as soon as I say florida medicaid!

 

[DianaCox]

You need to talk to MediCaid and get a waiver to go out of state. Tell them there are only two surgeons in FL who even claim to do the DS; Hoddinott has a very troubling record with medical outcomes with even less severely morbidly obese patients to the extent that he was forced to stop offering it for several years, and Jawad is relatively inexperienced with the DS at all - you are a very difficult case and you need a FAR more experienced and qualified surgeon for this difficult surgery, and most of all, you do NOT want to have it in two parts, with two anesthesias, two hospitalizations, two months-long recoveries, as well as losing the benefit of the synergistic interaction of the two parts when they are done simultaneously, which will prevent you from losing as much weight as possible, and thus will likely prevent you from getting to a BMI below 40.

 

[Spiky Bugger]

Tawanna,

There is no SANE reason that any of us should have to become something we are not just to get a surgery that will save our lives. But that is the state of affairs in this country right now.

[Political comment: over the years, I have seen many, many people go through hell trying to get the care they need and I wonder if those people have bothered to vote in local elections. Some of us live in states where VOTERS have caused there to be state insurance offices who will help them...and others, who "don't get involved" in politics, live in states which have rules set up only to benefit the insurance companies. We need to remember how voting in a local election can truly impact our health.]

So, your choices are not great right now: you can have the wrong procedure, given your current BMI; you can hope to get the right procedure but settle for either an inexperienced surgeon or one with a lousy track record; OR, you can learn all about advocating for yourself.

That last choice holds the most promise...but it will take a lot of work, a willingness to try even though it will take more time and you will need to develop a thick skin dealing with all the underpaid CSR peopke who have no idea what the topic is or what the rules are.

Anyway, if you decide to become your own advocate, your very best bet is to start a conversation with Diana Cox and Larra. Together, these two HIGHLY educated women have helped many people win this important battle. This is NOT what they do for a living...but they easily could.

Good luck.

ETA--PS...you also need to learn to say, "Thanks, but I don't understand. Can you guide me through this a little more?" Because...when you are as smart as Diana and Larra, it's hard to remember that not everyone "gets it" as fast as you do and not everyone feels comfortable debating people in power.

 

[Tawanna Atkinson]

Tawanna,

There is no SANE reason that any of us should have to become something we are not just to get a surgery that will save our lives. But that is the state of affairs in this country right now.

[Political comment: over the years, I have seen many, many people go through hell trying to get the care they need and I wonder if those people have bothered to vote in local elections. Some of us live in states where VOTERS have caused there to be state insurance offices who will help them...and others, who "don't get involved" in politics, live in states which have rules set up only to benefit the insurance companies. We need to remember how voting in a local election can truly impact our health.]

So, your choices are not great right now: you can have the wrong procedure, given your current BMI; you can hope to get the right procedure but settle for either an inexperienced surgeon or one with a lousy track record; OR, you can learn all about advocating for yourself.

That last choice holds the most promise...but it will take a lot of work, a willingness to try even though it will take more time and you will need to develop a thick skin dealing with all the underpaid CSR peopke who have no idea what the topic is or what the rules are.

Anyway, if you decide to become your own advocate, your very best bet is to start a conversation with Diana Cox and Larra. Together, these two HIGHLY educated women have helped many people win this important battle. This is NOT what they do for a living...but they easily could.

Good luck.

ETA--PS...you also need to learn to say, "Thanks, but I don't understand. Can you guide me through this a little more?" Because...when you are as smart as Diana and Larra, it's hard to remember that not everyone "gets it" as fast as you do and not everyone feels comfortable debating people in power.

 

[Elizabeth N.]

Tawanna, are you on a computer or a phone?

 

[Tawanna Atkinson]

Thanks to everyone who are providing me with information. I'm having a slight problem being able to manuver this system setup. I received a message through my communication box and I tried responding back but couldn't. I want to reach out to Diana and Larra but it hard too, seeing is that I'm using a cell phone to make post and such but have not figured out how to reply.

 

[Tawanna Atkinson]

Tawanna, are you on a computer or a phone?

I'm on a phone and having a hard time keeping up