Question:
Advice on how to present bariatric surgery to PCP
Hello everyone, My insurance requires a referral from my PCP in order to be seen by the surgeon. The only problem is I have never seen this Dr. before he was assigned to me and I am a little nervous about how to present this issue to him and get the referral! Any suggestions would be greatly appreciated thanks — monny2400 (posted on September 11, 2006)
September 11, 2006
Hi Traci,
I just wanted to give you some advice on this. Do you have any other
doctors that you see that have suggested this to you as a Weight Loss
Option? Or did you decide that you wanted to do this? If you had doctors
suggest this to you, see if they can send letters of recoemmendation to
your new PCP suggesting that the surgery would be the right thing for you
to do. If you made the decision, just make sure that this is what you
really want to do and TELL him that!! I was just recently in the same
postiion(my insurance did not require me to establish a new PCP though) and
had to establish a new PCP(because I was going to a pediatrician and should
not have been) and had my dietician send her a letter telling all about me
being with her and what "diets" and programs I have been on and
that since they are not working, surgery would be my best option. I went in
determined that GBS would be my best option and just told her that this is
what I wanted and why I wanted it. Suggestion: RESEARCH WLS to the max
before making your decision!! I haven't entered a program yet but am
attending a informational seminar tonight to learn more about the surgery
and what to expect before and after entering the program.
— C. Reed
September 11, 2006
Hi Traci, I had been researching this procedure for two years. I didn't
have a PCP because I didn't have any problems. When I finally decided to
choose a PCP when I went for my first visit I just flat out asked him if he
would give me a referral to a bariatric doctor for weight loss. He said
sure and he did. He even asked if I had one in mind and I informed him that
I would go to a referral that he knew personally. I am glad I went to his
referral. The doctor that I am seeing is Dexter Turnquest. I drive way
across town to see him. So my suggestion would be just to ask.
— The One
September 11, 2006
Hi there!
I was kind of in your boat. I had just moved into a new city - about 1 1/2
hours from where I was originally. My original doctor had moved her
business elsewhere - so it was not in the cards for me to get a referral
from her. So I saw a new PCP - I had only been seeing him for about 2
weeks when I brought it up. He noted that in his letter of medical
necessity. If you have documentation of your co-morbidities and your
weight loss attempts - it isn't going to matter - it's just a formality
with insurance companies to get everything documented. Don't fret over
it!
Tonja
— tonjasm
September 12, 2006
Trici, a veteran here. My PCP refused to even talk about any type of
Bariactric Surgeries for weight loss. Thus I got on the OH board and
research under Insurance and contacted everyone who used my Insurance,
Humana Gold Plus/Medicare. And finally found one in my area of Tampa Bay
who told me to see her PCP. And as of the first call to see if they were
accepting new patients, I told them I was looking to recieve the WLS. And
repeatedly everytime I talked with them too. I had been to several seminars
already and had made my decision on using Dr.Rehnke already too. Which the
PCP tried to get me to use someone else across the Bay but why when this
surgeon was a couple of miles away. And I pushed and got my wish. Besides
if I had problems (and I had a few) I wanted a surgeon close by not an hour
or so away. Well It took 10 months because I had to complete a 6 month
Doctor's Supervised and Documented Diet per Insurance Requirements, but I
got my Open RNY and I'm four months Post-op and 140lbs. less than I was
last Christmas 2005.
I've got 70lbs. t go to reach 200lbs. You can do this just be Positively
Determined. There will be set-backs too but you will succeed! Just grow
some pateints too!!!
— Michael Eak
September 12, 2006
Write down all your rasons for needing the surgery. A.lso, find out your
insurance's clinical guidelines for bariatric surgery (either at their
website or by phone. Print out a copy or have one sent to you. ee if yiu
meet all their requirements for the surgery. Some insurtance companies
require six months or so ofdoctor-documented weight-loss attempts, for
example. Write down any comorbidities, such as diabetes, sleep apnea, high
blood pressure, etc, that you have.
The best thing is to be prepared to tell the doctor exactly why you want
the surgery.
— Novashannon
September 13, 2006
Thank you everyone from your comments I developed the courage to go to my
new PCP and ask for exactly what I wanted, and I got the referral!
— monny2400
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