PCP is sabotaging my insurance approval

[equal.opposite 4]

Every time my surgeons office requests information from my PCP, they don't get what they asked for, they get it all back blank, they send records that weren't requested. I finished all my pre-op testing and even all my 4 PCP appointments in December yet the surgeons office is still waiting for an 'official' height and weight! I've had three separate appointments JUST to be re-weighed and measured so the info is accurate and as up to date as possible. Insurance will only accept ht & wt from PCP. At all my 4 monthly appointments with my PCP she lectured me about how getting the sleeve will destroy my health forever and ruin my life, (not very productive appointments!).

Has anybody had to deal with their PCP's prejudice against getting sleeved?

ROAR.

[Vixynne 695]

Yikes! Maybe it's time to get a new PCP? I can understand her wanting to share her opinions about the surgery, but in the end, it's your body!

Even if choosing a new primary sets you back a little timewise (and I can't imagine it would, at least not by much, since you've already gotten everything done), it will be well worth it to be allowed to finally move forward!

Good luck--keep us posted.

[JoiaRox 430]

Time to find a new PCP? I'm not overly attached to mine, but, thankfully, she had nothing to do with my sleeve approval - heck, she doesn't even know I had one! Guess she'll find out eventually!

[ebonisekim 1,713]

Request it your self and tell em your picking it up it might cost you a small fee but you'll get it then give it to your surgeon office

[equal.opposite 4]

EXCELLENT IDEA! I will call tomorrow morning. Thanks.

[M2G 1,836]

Request it your self and tell em your picking it up it might cost you a small fee but you'll get it then give it to your surgeon office

Yes! I did this before starting with anything because I wanted ALL of my medical records just in case. I called my ins., saw my surgeon's NUT, went to my surgeon's seminar, AND saw my surgeon ALL before visiting my PCP (I had to wait 6 months anyway to be approved so I had time on my side) but when I did finally talk to my PCP, I was pleasantly surprised that he was supportive. I had previously asked about bypass and he had sort of steered me away from it (giving me thumbs up to try South Beach, and Meridia, and eventually a card for a place that sold medifast-like supplements) so I was thinking he might not be on board. When I did see him I had taken ALL of my medical records and made a chart of my weights over the last 10 years (he's been my dr. at least that long!) I wrote down every single diet I had ever tried (with lots being recommended by him) and the results of those diets, how much I lost, how much I regained and how much I spent. What I realized during the whole process is that he just didn't want to be the one to suggest surgery. Faced with the overwhelming report that diets had indeed NOT worked for me, he was 100% on board.

Good luck, time to take charge and get the paperwork you need and deserve to have!

[mark! 449]

You can always impolitely inform them that what they're doing is against the law, and you'll be contacting the medical commissioners office reference their inability to pull their heads out of their asses.

FWIW, I had all of my records mailed to me by numerous doctors, I didn't trust the nurses aids to be able to comprehend what I needed or what my surgeon needed, plus I don't like the "end of the day" attitude most doctors have, I wanted my stuff faxed over ASAP to not slow anything down.

Be steadfast with them, and stay on them about it. Regardless of their personal opinion, it's their job to send the records when properly requested, and it's against the law to not send them when requested properly. If they keep jacking around, I'd have a very stern talk with someone higher up there and lay things out plain and simple. Either they get their act together or the next person they'll be speaking to is a rep from the medical board (make sure to at least look up the name of a rep in your area for authenticity play).

[solymarmivida 14]

9 years ago when I approached my PCP about gastric bypass he talked me out of it - he told me so many negative things and said he just couldn't see me doing it since besides having a BMI of 38 at the time, I was otherwise healthy. I as well have been on the weight yo yo most of my life but I listened to him, joined WW and did lose 50 lbs - however here I am 9 years later and have put on all that lost weight and more, my BMI is at 40, I have hypertension, high cholesterol, borderline diabetes, joint pain and can't do so many things I want to do. It just frustrates me that PCP's don't really listen to or evaluate their patients properly. Now they just want to throw medications at me and say "you need to lose weight". I just feel like I lost 9 years of a good life I could have had. At any rate now I am taking control of my own life and I feel it is the best decision for ME that I am making.

[equal.opposite 4]

My PCP has never even heard of the sleeve, all her issues are with bypasses done 15 years ago. I have brought in my info from the surgeons office and she isn't interested in looking at it or contacting the surgeon. I went in and requested my records 3 weeks ago and haven't received anything. I'm going in next week and I will 'discuss' my issues with the doc - again. The surgeons office says my approval is on hold until they can get a height and weight from the PCP. It can only be from the PCP, insurance won't accept a height/weight from the surgeon. AUGH!

[Heartonsleeve 32]

I had similar issues with my PCP. I told her I wanted a referral to the surgeon and she told me I should just eat a lot of giant salads to lose weight, in addition to trying to scare me off with horror stories...wth? I called my insurer the same day and got a new PCP.

[auntmissa1 39]

I am so fortunate. My PCP specializes in weight management and was all for me getting sleeved. I did need to pick up records and fax then myself after multiple attempts by the office staff to get it right. A PCP that fits your needs can make a huge difference.

[carstanger 346]

Sorry you had those problems!! My PCP sent info out that day!!

[cindymg 629]

I think my PCP is more excited about my sleeve than I am. I think she felt like a failure that she couldn't keep my weight, diabetes and blood pressure under control. She never brought up the surgery herself, but when I heard about the sleeve and asked her, she referred me to a great surgeon who had helped other patients of hers. She even visited me in the hospital after the surgery (not billing for the visit)! It's great and a shame that all doctors can't be that supportive.

[kw2walker 211]

Every time my surgeons office requests information from my PCP' date=' they don't get what they asked for, they get it all back blank, they send records that weren't requested. I finished all my pre-op testing and even all my 4 PCP appointments in December yet the surgeons office is still waiting for an 'official' height and weight! I've had three separate appointments JUST to be re-weighed and measured so the info is accurate and as up to date as possible. Insurance will only accept ht & wt from PCP. At all my 4 monthly appointments with my PCP she lectured me about how getting the sleeve will destroy my health forever and ruin my life, (not very productive appointments!).

Has anybody had to deal with their PCP's prejudice against getting sleeved?

ROAR.[/quote']

Be frank with your PCP, tell them of your displeasure in how they are conducting themselves. If necessary you can report them. The PCPs opinions aren't laws they are options, and it sounds as if they are very bias. My doctor did not want me to have this surgery and when diet after diet failedI boldly asked, " how do you plan to help prevent me from dying from obesity?" They signed off on everything I needed and their attitude changed. When you take control and your doctor see it they should recognize it as you mean business.

If they don't, remember they report to someone above them and can be reported. A new doctor can be assigned.

[kw2walker 211]

Request it your self and tell em your picking it up it might cost you a small fee but you'll get it then give it to your surgeon office

That's a great way to get it done.