frustrated

[mjlange68 24]

I have gone through everything and they submitted it to insurance and then they came back and said that they want a letter from my primary doctor for medical clearance. I had an ekg in September and they said that was fine at first but now my primary says its too old. I was fine with everything everything and because my doctor wants more money I have to do it again. And on top of that I have to do more blood work. When I signed up for this process they told me I didn't need anything from my primary. No he holds my fate in his hands. Prior to me starting this process he would every address my weight concerns. So I took it in my own hands and its all falling apart. I have non refundable tickets to the Bahamas for labor day that my friend bought be back when they said my surgery would be in June now we are being delayed longer. My major concern is that I won't be able to be healed enough and I won't be able to go. Im so depressed and feel like this is never going to happen.

[ElleG 394]

I know how u feel. Get into the doc ASAP the EKG is quick and so r the labs. He can write the letter while u are there and attach the EKG. Labs should take less than a week. Don't give up its just a hurdle u have have to jump over, stay in this thing! Best Wishes!!

[MamboMan 6]

I find it strange you were told you didn't need anything from your primary physician as that is usually one of the most important factors. Depending on where you live, how close you are (proximity) to your surgeon, etc. they want your PCP to state they will take responsibility to treat you, obtain your labs, and continue with your care. If your EKG was in September, well, that is almost a year old. I don't know how old you are, your comorbidities, or health history, but it is not entirely unrealistic that things could have changed since your last EKG. I highly doubt your PCP is requesting you to do these things to get more money. They are the one whose name and license are on the line. Personally, I would rather have a doctor that is cautious and wants his/her patients to be safe instead of just signing off without sound medical results simply because their patients request clearance.

If your only concerned about whether you'll be able to take your trip, simply delay the surgery after your trip. That way you can go on your trip, have surgery later, and not risk running into complications such as strictures or dehydration either right before your trip or worse, during.

[mjlange68 24]

Thank you elleg

[mjlange68 24]

I find it strange you were told you didn't need anything from your primary physician as that is usually one of the most important factors. Depending on where you live' date=' how close you are (proximity) to your surgeon, etc. they want your PCP to state they will take responsibility to treat you, obtain your labs, and continue with your care. If your EKG was in September, well, that is almost a year old. I don't know how old you are, your comorbidities, or health history, but it is not entirely unrealistic that things could have changed since your last EKG. I highly doubt your PCP is requesting you to do these things to get more money. They are the one whose name and license are on the line. Personally, I would rather have a doctor that is cautious and wants his/her patients to be safe instead of just signing off without sound medical results simply because their patients request clearance.

If your only concerned about whether you'll be able to take your trip, simply delay the surgery after your trip. That way you can go on your trip, have surgery later, and not risk running into complications such as strictures or dehydration either right before your trip or worse, during.[/quote']

Ricky you are very right. I needed that. I got it all done yesterday and I will here back in a week again. Thank you for your post.

[MamboMan 6]

Ricky you are very right. I needed that. I got it all done yesterday and I will here back in a week again. Thank you for your post.

No problem. I'm glad you were able to get everything taken care of yesterday. Good luck and I hope you get your approval very soon.

[mjlange68 24]

No problem. I'm glad you were able to get everything taken care of yesterday. Good luck and I hope you get your approval very soon.

Thanks I hope so too. Im just nervous and excited. I started this process back in may last year so I'm just ready.

[terry1118 1,274]

I find it strange you were told you didn't need anything from your primary physician as that is usually one of the most important factors. Depending on where you live' date=' how close you are (proximity) to your surgeon, etc. they want your PCP to state they will take responsibility to treat you, obtain your labs, and continue with your care. If your EKG was in September, well, that is almost a year old. I don't know how old you are, your comorbidities, or health history, but it is not entirely unrealistic that things could have changed since your last EKG. I highly doubt your PCP is requesting you to do these things to get more money. They are the one whose name and license are on the line. Personally, I would rather have a doctor that is cautious and wants his/her patients to be safe instead of just signing off without sound medical results simply because their patients request clearance.

If your only concerned about whether you'll be able to take your trip, simply delay the surgery after your trip. That way you can go on your trip, have surgery later, and not risk running into complications such as strictures or dehydration either right before your trip or worse, during.[/quote']

My primary care doc was not involved in the rny approval process in any way. My surgical coordinator ordered all my tests and made all the appointments with the specialists that I needed. I would get a phone call telling me where and when to go, and a packet in the mail with written instructions. The only thing my primary care doc did was contact Wareham surgical to get me into a seminar.

Good advice though. CAN you schedule your surgery for after your trip? It will avoid a lot of stress and after your surgery you can concentrate on recovery and learning how to eat. A bonus - you'll be able to eat tasty foods on your vacation instead of Soup or mushy food. And you can have some fruity umbrella drinks!

[MamboMan 6]

My primary care doc was not involved in the rny approval process in any way. My surgical coordinator ordered all my tests and made all the appointments with the specialists that I needed. I would get a phone call telling me where and when to go' date=' and a packet in the mail with written instructions. The only thing my primary care doc did was contact Wareham surgical to get me into a seminar.

Good advice though. CAN you schedule your surgery for after your trip? It will avoid a lot of stress and after your surgery you can concentrate on recovery and learning how to eat. A bonus - you'll be able to eat tasty foods on your vacation instead of Soup or mushy food. And you can have some fruity umbrella drinks![/quote']

You didn't need a referral or letter of medical necessity from your PCP from your insurance company prior to approval of surgery? That's awesome! In the research I've performed via forums, research articles, talking with WLS patients, and the insurance coordinator at my surgeon's office, the majority have said you typically start with your PCP to get the ball rolling and the letter of medical necessity is very important. My surgeon also sets up the additional testing, like the EGD and any other specialists, so not sure why the OP's PCP is having her do additional testing. If they are having to write her a letter of medical necessity, they may want to make sure she is appropriate/healthy enough before they give that recommendation. It's hard to say since we don't know her health history, their relationship, and as we all know, every insurance company/surgeon/doctor has their own set of rules and doing things.

I agree with you, if there is anyway she can wait until after her trip for surgery, her trip would probably be more fun and relaxing. =)

[mjlange68 24]

You didn't need a referral or letter of medical necessity from your PCP from your insurance company prior to approval of surgery? That's awesome! In the research I've performed via forums' date=' research articles, talking with WLS patients, and the insurance coordinator at my surgeon's office, the majority have said you typically start with your PCP to get the ball rolling and the letter of medical necessity is very important. My surgeon also sets up the additional testing, like the EGD and any other specialists, so not sure why the OP's PCP is having her do additional testing. If they are having to write her a letter of medical necessity, they may want to make sure she is appropriate/healthy enough before they give that recommendation. It's hard to say since we don't know her health history, their relationship, and as we all know, every insurance company/surgeon/doctor has their own set of rules and doing things.

I agree with you, if there is anyway she can wait until after her trip for surgery, her trip would probably be more fun and relaxing. =)[/quote']

It was a trip we win no way to mive the trip but I might see about the surgery. The reason everything is in a delicate balance is because my surgeon is leaving who I started the process and going to a different provider. As far as my health I have no high blood pressure or heart problems no diabetes no sleep apnea. I'm perfectly heathly except for my weight. Which makes me tired and on and on. The reason I felt like this is because when I started this process this was the first question I asked do I need the blessing of my primary they told me know that they could do it all without him. I went to the seminar starting in May. They never called me until September so that's when I had my first appointment with the surgeon. Then I started my 3 month diet but missed the last month because I didn't have the rest of the money for the doctors diet. So in January I had to start all over again. They made me do three months of diet which ended in April. Then they said they were going to submit everything to the insurance in May. Then June they submit it all and say we need the letter from the doctor. Then he was out of town so I have to wait another two weeks for him to come back. Then he tells me that he needs the ekg that was done but its too old and they want a new one. I just feel like I've been doing this process for so long and I'm ready for it to actually get to the time where I can do my liquid diet. Because of my BMI I have to do a three week liquid diet. It'll all work out I'm just impatient.

[terry1118 1,274]

You didn't need a referral or letter of medical necessity from your PCP from your insurance company prior to approval of surgery? That's awesome! In the research I've performed via forums' date=' research articles, talking with WLS patients, and the insurance coordinator at my surgeon's office, the majority have said you typically start with your PCP to get the ball rolling and the letter of medical necessity is very important. My surgeon also sets up the additional testing, like the EGD and any other specialists, so not sure why the OP's PCP is having her do additional testing. If they are having to write her a letter of medical necessity, they may want to make sure she is appropriate/healthy enough before they give that recommendation. It's hard to say since we don't know her health history, their relationship, and as we all know, every insurance company/surgeon/doctor has their own set of rules and doing things.

I agree with you, if there is anyway she can wait until after her trip for surgery, her trip would probably be more fun and relaxing. =)[/quote']

My PCP wasn't involved at all, beyond making my appointment for the seminar. Maybe the process is different based on your health ins requirements? I had done Optifast a couple years ago (which insurance helped pay for) so I already had my documented weight loss and it's subsequent failure. I checked with my insurance for the criteria you need to get approved and I met all the requirements.

There may have been a time limit to the tests she already had done. Maybe that's why the repeat?

My surgeon's office had me sign an agreement that I will commit to all follow-ups and instructions. If I miss any than my PCP needs to be made aware and is notified.

[momma_doe 50]

My PCP was not required for anything either. I understand that's up to the insurance program. Surgeon didn't require it. If my surgical coordinator contacted my PCP, I haven't heard. But now that I need to go back to my PCP I feel kind of weird, like I've hidden something from him.

[mjlange68 24]

So I went to the doctor Friday to do my ekg again and more blood work. They are finally getting me in to do my pre opt diet and then my surgery will be on July 31st! I'm so excited and I'm sorry for pouting. Yay@--}----

[mjlange68 24]

So Thank you to everyone with your advice I canceled my trip and my surgery went well I'm down 9 lbs for my 1 week. Excited for the future. xoxo

HW 375<br />SW 337<br />CW 328<br />SURGERY DATE 7/31/13

[MamboMan 6]

So Thank you to everyone with your advice I canceled my trip and my surgery went well I'm down 9 lbs for my 1 week. Excited for the future. xoxo

HW 375<br />SW 337<br />CW 328<br />SURGERY DATE 7/31/13

Congratulations! Bummer about your trip, but there can always be more trips, but just one healthy you! Best wishes.