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Rabu, 09 Januari 2008

[surfacehippy] Re: Attention California Hippies with blue shield

Thanks for the information. The jury is out on minimal invasive
being good or bad at this moment. There are no long term studies
pointing either way with HSR or THR. I just want my fees reimbursed
if possible.

Congrats on your appeal. I had to appeal BSCA decision not to
preapprove benefits last Jan 07. Luckily, it didn't go as far as
the Ca dept of Managed care because I would have lost for sure
because my company is self insured and BSCA only administers the
benefits(CA has no jurisdiction for self insureds).

Dr. Gross performed my HSR and my experiences mirrored yours. My
surgical wound was completely healed when I took the bandages off in
ten days, and I have not needed any pain medication post op. The
nurses gave me tylenol during my two and a half day hospital stay
and I have not taken any since. My hip is pain free.

--- In surfacehippy@yahoogroups.com, "rodwindle" <rodwindle@...>
wrote:
>
> No, Dr. De Smet wants to see what he is doing and get the
prosthesis located properly.
> I'm firmly in his camp: make the incision as big as you want,
just get the metal aligned
> perfectly. You don't want to have to do it again.
> I have a nice 8 inch incision from my surgery three weeks ago. I
would caution against the
> (logical) conclusion that smaller incision equals faster and
easier recovery. I have had no
> need for post-op medication and my incision was completely closed
after nine days. I am
> feeling amazingly normal (WAY better than before surgery). I
believe the skill of the
> surgeon is of critical importance, no matter how large the
incision is. Dr. De Smet thinks
> that the 'minimally invasive' approach is no good for resurfacing
and will lead to trouble.
> He was not at all happy with some of the techniques he saw at the
1'st 'annual' resurfacing
> conference back in November.
> If you're interested in BSCA appeals, go to this website:
http://www.dmhc.ca.gov/dmhc_consumer/pc/pc_imrdec.asp
> to see how cases have been decided.
> --rod
> LBHR De Smet 12/18/07
>
> --- In surfacehippy@yahoogroups.com, "ps2_sfca" <ps2_sfca@> wrote:
> >
> > Does Dr. DeSmet use the minimally invasive surgerical
procedure? If
> > so, did BSCA cover it? I looking for any info on minimally
invasive
> > for BSCA appeal purposes.
> >
> > --- In surfacehippy@yahoogroups.com, "rodwindle" <rodwindle@>
wrote:
> > >
> > > Thanks for the accolades, Alan. However, I don't think I'm
the
> > first...
> > > I know that Kani Rowland got reimbursed by Blue Shield Alaska
last
> > year for his
> > > bilateral surgery with Koen. In any event, I will do all that
I can
> > to help others succeed with
> > > their insurance companies. BTW, I've enjoyed your posts since
I
> > first started lurking on the
> > > site a few years ago.....
> > >
> >
>

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