Well I must have rattled some cages
Mar 06, 2019
I spoke to the patient support people at the clinic last night
I spoke to the surgeons office
I spoke to the insurance company
And this morning, just moments after my last post, I got a small miracle. The doctor has suddenly decided that surgery is medically necessary.... I am on my way again!
After a significant amount of nudging
Mar 06, 2019
My doctor agreed again to submit the paperwork but was very clear that he would not say it was medically necessary. Medical necessity is the very first hurdle with my insurance. I contacted the surgeon's office for help and while they cannot see me until stages 1 and 2 are complete, they were helpful in that they suggested I contact my Insurance and ask for a case manager to help me navigate the process.
I cannot go back to this doctor. I am so angry and while our relationship was not great before it is now broken. Do I have to be on death's doorstep to make surgery medically necessary? It sure as hell isnt cosmetic!
So now I need to find another primary care physician. I am not sure how to move forward. How do I make sure that I find a doctor who feels that surgical weight loss is an option?
Jan 22, 2019
Got a message from my PCP yesterday. He has agreed to submit the necessary paperwork to the insurance to get me started. From what I understand once that is approved I have to lose 5% and maintain that for 6 months... Not really sure on that, hopeful that I will get some sort of packet in the mail. Also have to see the therapist but I am not worried about that. I got my head straight in OA a few years back - just need to get some help fixing the physical issues that have followed. 5% does not seem like such a much... only 18 pounds... but what about fluctuations? Do you worry about water etc and popping up and down a bit?