Question:
Has anyone had problems with his or her doctor not wanting to approve the surgery?
My doctor didn't know anything about the surgery until my insurance company asked for some information. He is totally against the surgery. In fact, he suggested other options, but I told him this is what I want. I hope my insurance company doesn't turn me down because he doesn't approve of it. Does anyone out there have SuperMed (Medical Mutual of Ohio)? If so, what was your experience with them? — Theresa W. (posted on June 6, 1999)
June 5, 1999
Have your doctor go to this site: http:surgilite.hypermart.net
he can find out all he would want to know about bariatric surgery. Dr. Dapo
Popoola has doen over 6000 of these surgeries with a 0 mortality rate and
that in itself is quite impressive.
Rich
— Richard T.
June 6, 1999
Call the bariatric surgeon you would like to use (call all in your area to
see who you want to use). Then explain to them your problem with your
attending. They may have an attending physician they deal with that is on
your plan. Change to that attending. It will probably be better for you in
the long run, to have a doctor who is genuinely interested in your health.
— Deborah L.
June 6, 1999
I haven't personally had this issue, however, if I did, and I had a doctor
who KNEW I have gone thru hell with attempts at losing the weight in
"traditional methods" I would fire him/her. If you're on a PPO
or HMO that requires your family doctor approval or
recommendation/referral, if it were me, I would be consulting with other
doctors on my plan who support your efforts and will provide you with the
recommendation you need. Yes, a Health Insurance plan who requires your
doctor's approval or referral can and will deny coverage if your doctor
says it's unnecessary. There are a lot of good doctors out there that still
think that if we cannot push ourselves away from the table we have some
kind of character defect. They need to be enlightened that obesity is a
disease, just like alcoholism and drug addiction. Good Luck & Best
Wishes!
— Sherrie G.
June 6, 1999
Yes, I have the same problem. In fact, that's the reason my approval took
so long, and what the final decision is now hinging on. My Dr was to have
written a letter outlining the physical and emotional issues I had been
experiencing back in August, but never did. Now I have to go back in, with
even more troubles, and force her to write one. Good luck to you.
— Molly S.
June 6, 1999
The nurse practioner that I was seeing prior to surgery was
totally against the surgery and told me I would have diahhrea
for the rest of my life. Luckily my insurance does not
require a referral so I went directly to a surgeon after having
made the decision to have this done. The insurance company
should have certain guidelines regarding your weight, bmi,
co-morbiidities that they will base their decision on. As
long as the doctor provides them with that information you
should be okay.
— dboat
June 6, 1999
I would try a different doctor, one that would approve of the surgery!
Robin
— Robin C.
June 6, 1999
I had the same problem. My doctor was totally against it (as was the rest
of the world!). My secondary insurance is a PPO and doesn't require a PCP
so I got to go directly to the surgeon. I'm lucky.
Regards,
Diane - Empire BCBS - New York
Lap RNY 4-9-99 Dr. Champion - Atlanta
Beginning weight - 310 BMI 55.0
Pre-op weight - 5' 4" -263 BMI 46.7
8 Weeks Post-op 231 BMI 41.0
25% of Excess Weight Lost
O :)
— Diane N.
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