New and Worried

[mommyoftwogirls 75]

Hi everyone I had my first appointment with the surgeons office August 5,2014.He wanted to know why I did not come in sooner.He said I was a poster child.I am 214,bmI 38 with sleep apnea,high blood pressure,asthma,and newly discovered diabetes type 2.I have my psych eval Sept.10th.I already had my 1st nutrition appointment on the 5th at the surgeons office.My insurance wants 3 months with the nutritionist.They also want,psych,endocronologist,sleep study which I already have done because I have a cpap I've had sleep apnea for a while,and blood work needs to be done.I also need my medical recorde to show that I am not newly fat.The medical necessity letter from my primary might be hard.The reason because I changed primaries from the one I have been going to for a long time because of an issue that happened,The new one I have now I have been only going for a little while.I know I can get my medical records from my old doctor to show that I have been obese with co-morbidities for a long time.But I am worried about the letter.The Doctors office that I use to go to said that my old primary would not sign anything unless he sees me.That means I would have to switch back.Don't know what to do.I don't think my new primary would do a letter because I have not been going to him for long.He does not know my history.My surgeon is in my network.I have aarp medicare united healthcare.I am so worried that I am not going to be approved.

Edited August 8, 2014 by mommyoftwogirls

[Bufflehead 6,358]

Make sure your current doc has your complete file from your previous doc, and make an appointment to see your current doc to discuss everything and see where he stands. I think as long as he has your complete file and talks to you about it, the chances are good he will sign a letter for you.

If he won't, talk to your surgeon's office and see if they can recommend a new primary doc that they work with and who they think should be more realistic and flexible in terms of signing off on surgery. Chances are your surgeon works with lots of local primary care physicians on a regular basis and will be able to refer you to someone who will help your health care instead of hinder it. Good luck!

[Jersrose43 837]

You can also get this letter from an on gyn, you asthma doc - pulmonologist, your endocrinologist etc. I wouldn't let this letter stop you. Good luck!

[HalloweenBaby24 447]

I had the same issues and worries..

I had a new primary that I'd seen a handful of times over the past 2 years and my old primary who saw me all my life up until 16 when I moved so I had not seen her in 7-8 years. I went into the new primary who I really like she's super chill and easy to talk to so I explained the situation (she has none of my past records) and she wrote me a letter no problem. I also got a letter from my OB because most of my issues with weight have been related to infertility..

Had everything sent in early last month and was approved, Surgery September 8th.

[TEXASLADY52 264]

I went to a doctor for over 10 years. He told me on several occasions that he would never agree for me to have WLS. I changed doctors and the first thing my new doctor asked me if I had ever thought about WLS surgery? I ordered my records from the other doctor (my insurance required five years). They sent me the records on a disk. Before I went to see the WLS surgeon I had complete records on what my insurance (BCBS) required in hand. The insurance clerk was so surprise....said she had never had a patient bring everything in with them. After I had all of my test ran...they submitted my claim on a Friday and the insurance approved it on Tuesday....never dreamed they would approve so fast.

[VSGAnn2014 12,992]

I hope one thing that happens with every WLS patient is that they grant themselves more power in the doctor-patient relationships they have going forward.

Two of my relatives are high-end healthcare insurance brokers to companies. Over the last few years, they have taught me well that, regarding my healthcare, I am THE CUSTOMER. And that the doctors, the hospitals, and other healthcare workers who minister to me are my SERVICE PROVIDERS.

That has changed my whole perspective. That's not to say I try to diagnose or treat myself. But I really understand that I have the right to shop around, to question, to doubt, to debate (respectfully), and to make the final decision regarding my own care and where and from whom I receive it and ... big deal, here ... how much I will pay for it.

Consequently, I have learned to haggle with healthcare providers. I have learned a lot about how much they all get paid and what determines their prices and when I'm getting a great deal and when I'm getting played like a carny mark.

I am always polite. I see my best healthcare providers as wonderful assets and as my full partners with me to manage my healthcare. I appreciate that they, too, get to decide with whom they will work.

And that's as it should be.

[mommyoftwogirls 75]

Thank you all so much.