Paperwork Questions

[brew44 0]

Hi!

I have an appointment for my first consult next week and they have sent me the paperwork to fill out before hand. I am worried that if I write down or miss writing down something that I may not be approved. So I have some paperwork questions and would like to how you answered the question.

1. Who is your PCP and may we contact them? I have recently gotten my HMO and picked a PCP out of a hat. I have seen him once to establish care (last week) and that is it. What do I say?

Because of my insurance I don't need a referal from my PCP so I never brought the subject up of lapband or WLS.

2. Weight loss attempts: Year, how much lost, and how much gained. I started dieting in 1996. How do I answer because I have so many attempts I cannot remember all of them; plus weight lost and weight gained on the attempt. How many do I need to catalog to prove that I have tried multiple times and failed?

Thanks for any suggestions you can give me on these questions!

Misty :biggrin:

[btrieger 21]

You are consulting with the surgeon and he probably has office staff that file reports with insurance companies every day.

Either give his office a call for help with the questions or bring the forms with you incomplete and let his staff help you fill them out.

They will do what they can to assist you and if they don't; do you really want to be dealing with that surgeon?

[BetsyB 9]

It's really great that you want to be sure to fill these out correctly--but you can relax. The information is for the surgeon's office, and will not affect your approval.

Yes, put down the HMO PCP. Lots of us don't have close relationships with our PCPs--but it's just routine info they need. My surgeon never contacted my PCP; he doesn't even know, yet, that I was banded. (I did tell him I was waiting for approval the last time I saw him.)

If you're still a little uncomfortable, make a note on the form that yes--they can contact him, but you've not yet seen him due to a recent insurance change. If you want, you can add the name and number of the last PCP who "knew" you.

As for diet history, we're ALL in the same boat! They really just want to establish that you have a history of trying to lose the excess weight, and have not been able to do so. If you accidentally miss an attempt or two, it will be okay. You still will have established a years-long series of attempts.

When it comes to approval, it really comes down to this: if your BMI is high enough (or a bit lower, with comorbidities), a handful of specialists say you're safe for surgery, and your bariatric surgeon agrees you're a good candidate, you will be approved. Your insurance will deem it MEDICALLY NECESSARY---and you will have the surgery.

Good luck! The process seems endless, but before you know it, you will be banded

[brew44 0]

Thank you so much for replying! It makes me feel better knowing that the insurance isn't going to see my doctors' paperwork.

Misty