What made you pick RNY over DS?

Larra

Well-Known Member
If the surgeon and/or his staff give you a hard time or try to convince you RNY is "just as good" or some such rot, remember that the surgery date isn't carved in stone. You have the option of cancelling that date and going to Dr. Ayoola. All of your pre-op testing, psych eval, etc can be transferred to his office.

The only concern of anyone and everyone involved with your care should be what's best for you, the patient. Of course your surgeon should be paid for his time and skill, but other than co-pays that cost shouldn't fall on you, nor should you be threatened with a substantial non-refundable cost over what is a perfectly good insurance code. If your surgery is delayed a month or two because you decide to change doctors, it's not a big deal. You won't be the first or the last person to do this. Living with an inferior operation for the rest of your life is a very big deal.
 

Remingtonh

Well-Known Member
You guys are right, I was going along the path of "least-resistance" because I thought the RNY was "good-enough" and I just wanted to get the surgery done. I know myself and I would never be truly happy unless I got the better surgery - and no reason I shouldn't as my insurance covers it.
 

k9ophile

Well-Known Member
As Susan mentioned the drinking water restrictions with RNY; I don't live so regimented as to eat at the same time to quit eating 30 minutes before I eat. I could comply with abstaining after meals.
 

RainCity

Well-Known Member
The majority of gastric bypass patients only restrict water/beverage consumption to during and after meals, not 30 minutes before eating. That’s what I do and were the rules my surgeon and many others advise.
 

Larra

Well-Known Member
Different surgeons provide different advice. The gastric bypass program I was in before I realized there was a much better option advised no water for 20 minutes before meals, during meals, and 30 minutes after. I've seen posts from a lot of other gastric bypass patients who got similar advice. That's not to say that everyone follows that advice, but that's what was provided. Also, 3 meals/day, NO snacks ever, with each meal to consist only of lean protein and maybe veggies. For life.
 

Remingtonh

Well-Known Member
Weird. I called Dr. Ganta's office first thing this morning, asked if the paperwork was submitted to insurance (it hasn't), advised them I was *not* getting RNY and to put me down for DS. About 20 minutes later I get a call from another person advising me that DS isn't covered "by insurance." (sounded like this was a general statement).

I advised her that "very specifically" DS was covered by my insurance, and I had verified that with the bariatric resource services with United Healthcare. She said "Oh, OK" and said she updated my file.

We'll see...
 

DianaCox

Bad Cop
I dunno - all these shenanigans would have me running in the opposite direction. I hope you’re preparing a parallel track of getting Ayoola to accept you as a patient so that once you get approval for a DS with Ganta, you can just change it to Ayoola.
 

Larra

Well-Known Member
I can only imagine how many other people they are providing with incorrect information, most of whom trust their doctors and his employees and don't check their insurance for themselves. You know the score, others don't. It's very sad.
 

Remingtonh

Well-Known Member
I dunno - all these shenanigans would have me running in the opposite direction. I hope you’re preparing a parallel track of getting Ayoola to accept you as a patient so that once you get approval for a DS with Ganta, you can just change it to Ayoola.

I am trying to do that, Diana, and I wanted to call them before I left work but they opened at 9 am. At first opportunity I'm going to call them.... (update)... I've sent a couple of messages, through email and through their website last week, and have not received any response. Called this morning and no matter what options I press on their automated menu I go to voicemail. I'll keep trying though.
 

DianaCox

Bad Cop
That’s not a great system. Perhaps he’s in surgery or on vacation? When you do reach his office, mention that that was odd and perhaps they don’t know that their answering system is picking up during normal business hours, which should be of some concern to them. In a very helpful voice of course.

I hold people’s feet to the fire, even people I trust - if Ayoola’s staff is putting on a bad face for him, I would hope he would want to know.
 

Remingtonh

Well-Known Member
I received a call from someone at Dr. Ayoola's office and had a good conversation. There are some logistics issues with appointment scheduling, but they seemed open to potentially taking me on as a patient, and said they had no problems with DS insurance billing, and seemed flabbergasted that this is an issue with Dr. Ganta's office.
 

Remingtonh

Well-Known Member
Jeez. I got another call from Dr. Ayoola's office. The person I talked to talked to someone in their billing, and that person indicated that insurance company's won't pay for DS if the patient's BMI is under 50. I haven't heard this, and it's nowhere I can find in my policy. I just left a message with my insurance representative (BRS nurse) to confirm.

I asked if Dr. Ayoola simply doesn't do DS surgeries on patients with <50 BMI, then. They said they do, but it's usually revisions.
 
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Larra

Well-Known Member
Different policies have different criteria. All that matters is what's in YOUR policy, not someone else's. If you don't already have it, get a copy of your EOC (Evidence of Coverage) which is a lengthy document, NOT just a summary of benefits, that has all the specifics of what is and isn't covered. It will also have information on your appeals rights, which you may need to know. The bmi over 50 thing, if present, can often be appealed.
 
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