What to do when a necessary surgery is denied?

Question

I have been ill for over 2 years with bladder related issues.Drs. found blood, bacteria and other abnormalities in my urine. The most difficult problem I face is constant pelvic pain, severity increasing as time goes by eliminating quality of life My PCP submitted a referral to a top notch dr at Stanford U. Palo Alto. This was approved by ins company. Pacific Care I had the consult and the Dr. found an abnormality that needs removing and biopsy, he wants to do a biopsy of my bladder, he also will look at my ureters for masses etc and finally do a bladder distention that would eliminate the severe pain I live with daily. NO other urologist in my area have even come close to suggesting these intervetions. It would require anethesia so the cost I found out is about $60,000 that I could not afffort on my own. I found out yesterday the group that reviews this denied the surgery. (Central Valley Med Group). I believe because this could be done here. I do not trust local Drs Any advise?

Answer 1

maybe they had some good reason or another to deny your surgery. maybe they felt it was too risky, or you could have been to young/old or didn't have a strong immune system or it could have been some other reason. maybe it was the cost, even.

however, if you are still ill, then you should definitely go to another hospital, and it's likely that they will disagree with the initial opinion and preform the surgery.