Firing my PMD

[Catalystmb 2]

I started this journey in December!

I had to do the 6 month supervised diet with my Dr.

She is totally against any form of WLS.

June was my "6th" visit. I gave her another copy of a mock letter the surgeons office needed.

"Can't do it today" she said.

OK, I go in for the JULY visit (7th) and she asks how I am coming along with the surgery process.

"WHAT??!!" "Doc, I can't even SUBMIT to insurance without your letter and progress notes!"

"Can't do it today but here...." She handed me a SCRIPT with the 6 weights on it and a ICD9 code for morbid obesity.

I told her that would not be enough for them.

She proceeded to tell me again that she is against the surgery but she'll send the letter and info when she can.

It's AUGUST. They have nothing.

I asked for my progress notes and told them that I would just go to another Doctor.

She hasn't transcribed her progress notes yet!!

She uses a "cheat" sheet/tick form for her progres notes and then ( I suppose) transcribes them-I think into an electronic record.

I am sooo freaking pissed off at her.

I, thankfully, work with my surgeon. She and her partner will put some fire under her butt if I do not get anywhere next week.

Anyone else have these kinds of trouble!?:thumbup::w00t::thumbup::cool2:

[Melody2006 1]

:thumbup: This is a HUGE waste of your time and money.

Time to call your insurance company and make sure it's a supervisor and or someone high up immediately and make sure to tell them this story and make them document it. They will fight to get payment back from her. They need to be aware how this Dr. is doing business. Bet that will end up being a Dr. your insurance will no longer cover for other members in the future. You can also call the state medical board and let them know she refuses to give you copys of your medical visits for months past. These are the people you need to hit in the pocket book hard to get their attention.

[momx5 0]

:thumbup:

:cool2: This is a HUGE waste of your time and money.

Time to call your insurance company and make sure it's a supervisor and or someone high up immediately and make sure to tell them this story and make them document it. They will fight to get payment back from her. They need to be aware how this Dr. is doing business. Bet that will end up being a Dr. your insurance will no longer cover for other members in the future. You can also call the state medical board and let them know she refuses to give you copys of your medical visits for months past. These are the people you need to hit in the pocket book hard to get their attention.

I agree, it sounds like she is milking you! I so sorry. I know you dont want to hear this but I really had no trouble. Considering the fact that my PMD was the one to recommend the surgery to me and was very helpful in doing whatever i needed to keep going. After reading some of these stories i see i have been very blessed with quick action all the way around. i was the one to postpone my surgery because of previously scheduled vacation.

I hope it all goes better for you. Hopefully the sugeons can put a fire under her and get her moving! Good luck!:thumbup:

[BeckyinTn 0]

Sorry about all that you are going through! I would call your PMD on Monday and tell them you are giving them till Wednesday to have your records copied and a letter written. Tell the PMD that you will file a complaint with the State Board of Med if you do not recieve resolution. Call your Ins co and advise them you may have to change PMD and see if there is anyway they can approve this if you change DR's since your PMD is not doing her job. I personally think she is trying to sabotage you by not writing the letter as requested. If she waits too long then she knows you will have to start the 6 months all over. You have to be agressive and remember that your PMD works for you. After all it is your INS that pays her bills and you pay your Ins premium.

Becky

[Catalystmb 2]

Thank you for such FAST replies.

I knew I could count on you guys.

In July when I first sat gapmouthed as the receptionist told me they werent transcribed yet I told her she had a week.

That got me nowhere.

It's my understanding from both my surgeon and insurance company that as long as I have a supervised diet history of 6 months along with any comorbs I can submit.

My comorbs are self evident and I DO have the progress notes and letters of evaluation and test results from my sub specialists.

I take those along with my PMD's pnotes (when I ever get them) I should be able to go to ANY new Dr and have them review the info and submit.

I told myself in Jan that if in the 6 months I lost 50 pounds I would not have the surgery.

I have lost 24 pounds and then regained about 7 so I have a net loss of 17 pounds. Hey it's a loss but for 6 months, not good enough.

SO FRUSTRATING!:thumbup:

[Telecia 1]

CHANGE DOCTORS!! i I Spent a year trying to convinve m y doc, (appointments every 3 months) And finally gave up on her (Other reasons though also) And found me a new doctor. MUCH happier with now.

But no closer to surgery unfortunatly. In the time it took to change over doctors through my insurance ( took a month to clear the changes) I had to go to the emergency room for chest pain. The new doc wont talk surgery till he has seen me for a while and got my blood sugars stablized. And because of the chest pain I had to start seeing a cardiologist.

Well on the 25th last month they put 1 stint into my heart and on the 5th they will be putting another one in. THEN comes another round of stress tests and such on my heart before my cardio will clear me for surgery. IF THERE ARE no more blockages.

So I'm not any closer but at least I have a doctor now that WANTS to see more healthy. And will consider surgery if thats really what I want and we can get some other things under control.

[DebNH 1]

Ugh, Mary I'm so sorry for all this run around your getting. What doctors don't understand is this is a HUGE setback in our journey to SAVE ourselves. Such a blow could make someone just give up. I'm glad your strong and carrying on. You go get 'em girl!!!

Deb

[Catalystmb 2]

I just wrote a long post.....and it went poof.

If this is repeated, sorry.

Long story short (and with a lot less excitement grr))

I am SUBMITTED!

After nine months into my SIX month supervised diet, my surgeons' office went to bat for me and I am finally submitted to insurance.

I have to do the Psych eval (and maybe vascular ans stress test) but it is finally moving along!!

Woohoo. Finally something to smile about!

[*slim* 2]

I just wrote a long post.....and it went poof.

If this is repeated, sorry.

Long story short (and with a lot less excitement grr))

I am SUBMITTED!

After nine months into my SIX month supervised diet, my surgeons' office went to bat for me and I am finally submitted to insurance.

I have to do the Psych eval (and maybe vascular ans stress test) but it is finally moving along!!

Woohoo. Finally something to smile about!

Yay for you!:embaressed_smile:

[Pradice73 0]

That is wonderful. I know how frustrating it is just to have to do all the 6 monthly visits let alone any more. My doctor had recommended this type of surgery as of the beginning of 2007 and I wanted to wait to try and loose it on my own AGAIN. Apparently that didnt work as I put on quite a bit of weight with my back problems and little activity.

Crossing fingers for quick response from ins

[angieb12c 0]

sorry you had to go through all of that, but keep tryin