I am so confused. I went to see my Nutritionist she told me I have to do a 6 month weight management program. But she didn't tell me where. So her clinic offers a weight management program (that is the actual name of it and that is what she wrote on my list of things to do )so I thought that this program is what I was suppose to do but after talking with them I found it wasn't the 6 month diet program, this program was only 12 weeks long I knew that and thought I would have to do it 2 times. NOT.So I called my insurance company and they told me I had to do the 6 month diet with my PCP. I made the appointment and saw her today. She said she never heard of this and it wasn't equipped for this and it wasn't worth her time ( her real words too) I had this doctor for 14 years. So I came home and called my N.P. and now I'm waiting to hear from her about where I am suppose to do this at. I am sitting by the phone waiting now for 2 hrs. and I have somewhere I have to be. So I feel like what am I suppose to do now. Thanks for reading this I just had to rant about this it is so frustrating. I hope the rest of this process is easier than this. UGH
get the actual paperwork from your surgeon's office on what your PCP needs to document. My documents say physician or other health care professional. My surgeon said go to my PCP... so?? I have medicare too and my PCP/doctor must document my weight, current dietary regimen, and physical activity/exercise plan every month. In my case it's for 4 months because I have Noridian in California and I'm going for the sleeve. My medicare contractor doesn't require a diet for the gastric bypass. Every medicare area (contractor) has different guidelines. You may be able to look yours up online if you know who your contractor is. My surgeon's insurance person gave me a copy of the policy requirements (LCD - local coverage determination) to take to my PCP.
I did that even printed out the whole book with the billing codes and everything that needed to be done. It had web sites in it for questions. I hope the rest of the time I have to complete everything I need to do isn't going to be like this. I just started and have ran into some other problems also. I qualify for the surgery. In my opinion that should be enough other than maybe some test.
agreed. i had been in a food 12 step program for several years and ,y docs had my weight records...but OA did,t count. i get copies of my weight records from doctors weigh ins, print outs from m my gym, food RECIEPTS, and i did 6 months of online weigh****cher (as little as possible cause i was going to oa already, n 3 months face to face mostly to get the receipt that I was there, I tuned out a lot of it in real life....had flunked that sooooo many times....just needed the weigh ins for the insurance company. And my food logs that i had my primary add to the medical record. They had everthing thye needed and I didnt have to do much more than be a squealky wheel. Got them to take the food network off of the nutritiiost wiating room tv....nd got approvced
I don't understand why your PCP has a problem with this. All they have to do is document your weight, see how you are eating and exercising and discuss any changes you need to make. It's not a big deal and only has to be done once a month, not a big issue, thousands of docs do it all the time.
Not worth her time? You pay her for her time. Did you explain to her what she would be required to do? Basically chart your weight, talk with you briefly about diet and exercise, and document that in your chart. How easy is that? How can she not be equipped for it?
Well, you can change PCP's if you need to.
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
I had issues from my PCP as well. He is very old school and didn't understand why I was choosing this route. I have seen this doctor since I was 13 years old. Like it was really a surprise to him that I struggled with weight all of my life??? Anyway, My surgeon's office took me in for the supervised diet visits and such and my insurance was approving of it. My only requirement was to go to the surgeons office once monthly to be weighed in and visit with the nutritionist, and keep a diet journal. Would this be an option for you?
I am sure one way or another you will get it ironed out! Best of luck!
I am guessing that is what is going to have to happen for me too. I am seeing the nutritionist Tuesday and I am going to call the N.P. back tomorrow and keep calling until I get an answer. Every time I call the WLC I get a different answer if I don't get an answer by Tuesday then I will give someone else my business there are plenty of clinic/hospitals that want the money. I don't know why they make it so difficult some times.
WOW, not worth her time?, your pcp sounds like a jerk. I did the diet management program with the surgeon and the nutritionist, maybe your insurance will accept that as well, especially if you tell them what your pcp said to you, otherwise you might need to find a new pcp. Good luck!
No one surgery is better than the other, what works for one may not work for another. T-Rebel