Insurance issues

[Dinneal]

Hi
I had RNY in 2010 at 297lbs and gained all my weight back CW 330LBS. I got pregnant at 13 months out. I tried a few years ago contacting my insurance “BCBS NY” (its through Medicaid) about Having Dr. Keshishian do my revision because there is no doctors in NEW YORK that do Traditional DS as Dr. Mitchell Roslin is no longer doing the Traditional DS. I was told to contact Diane Cox about doing an appeal. Please Help

 

[southernlady]

Hi
I had RNY in 2010 at 297lbs and gained all my weight back CW 330LBS. I got pregnant at 13 months out. I tried a few years ago contacting my insurance “BCBS NY” (its through Medicaid) about Having Dr. Keshishian do my revision because there is no doctors in NEW YORK that do Traditional DS as Dr. Mitchell Roslin is no longer doing the Traditional DS. I was told to contact Diane Cox about doing an appeal. Please Help

I’ll tag her but you will not likely be able to travel out of NY. Medicaid is state dependent and unless you are traveling and it’s emergency, it almost never allows you to get care out of state.

Contact Dr. Dakin at NYPresbyterian/Weill Cornell. He was partnered with Dr. Pomp (a known DS surgeon) and has done the DS as well. The problem is the revision list is so tiny. Have you contacted Dr. K about his accepting NY based Medicaid?

Roslin will give someone a DS if they are insistent but you’re right, he prefers to do the SADI-S (although he still calls it the SIPS (it’s what HE named it).

 

[southernlady]

And welcome Dinneal

 

[DianaCox]

What Liz said. You will need to find out what your options are under your Medicaid program if nobody in-state will do a traditional DS revision.

One possibility is to get a consult with Dr. Keshishian and get a letter of medical necessity from him to present to NYS Medicaid that the DS revision is the appropriate procedure for you. You will still need to provide some evidence that you can’t find a surgeon in NYS who accepts Medicare, who can or is willing to do the traditional DS.

 

[southernlady]

I did go to Dr. Dakin’s info: https://weillcornell.org/gfdakin He accepts both Medicare/Medicaid. However, the problem is we don’t know if he does the RNY to DS revision.

 

[DianaCox]

You need to get the information from the horse’s mouth, backed up on writing.

 

[hilary1617]

Hi and welcome Dinneal !