Should I see my PCP first or wait?

pengworm
on 7/9/03 6:30 am
I've been reading all the stuff about getting insurance to cover surgery. Now if I do get my insurance coverage it probably won't start for about 2 weeks, I think. But I'm wondering, would it be stupid to go see my PCP now before my insurance starts? I'm just so afraid then they would say it was a pre-existing condition or something. But I also want to have as much done as I can when I go for my first consult with the surgeon. Also I'm not sure how the PCP feels about surgery. I guess the person I had been seeing most of the time was just a nurse practitioner. She's the one that was all against the surgery. I'm just so not wanting to even have to deal with the PCP. They just always seem to give you the same old crap about diet and exercise and blah blah. And of course they always are rude about it and it just sucks even having to think about it. Although I really don't remember how the actual Doctor felt about my whole weight issue. I do know that a couple of years ago she wouldn't give me diet pills, so I'm assuming she wouldn't be to keen on the surgery either. So I guess what I'm hoping is that I could just go straigt through the surgeon(Dr. Sundberg). Wouldn't he probably be able to tell me what I need to do as far as insurance and paperwork and stuff? By the way on Wellmark's website it says they do cover the procedure...it says Prior Approval Recommended-Yes. But they do the cover the surgery and I would think with my BMI being 50 that I shouldn't have much of a problem. Am I being naive(sp?) here? Whadya think?
Tina B.
on 7/9/03 6:59 am - Ia
Hi Jamie, I wanted to have all my ducks in a row so to speak also before I went to the surgeon but he had soooo many things he wanted done it was unbelieveable. Clearance from heart DR., from psych evaluation, to every doctor i have been to in the last 10 yrs. plus a sleep study and ekg, eeg, massive amount of blood work, oh my god, it's unreal SO if you know your surgeon will want a bunch of other tests done, well you just might be wasting your time doing it ahead of time, I would think your BMI alone will be ok for you to have this surgery. My PCP was great at first, this whole thing was her idea to begin with but soon as the surgeon called her, she is now really draging her feet on it, she hates to be the person who has to go to fight for me, I have no idea, she wants someone else to do it, I told her just yesterday bull**** she started this thing and she needs to help me get it done, don't know if she will or not but she also knows I won't quit ragging on her either. I think you will be okay but just call the surgeons office and ask them what they recommend you can do to get this thing rolling. Good luck to you, it will all work out for you, keep the faith.
princessbella
on 7/9/03 8:14 am - West Des Moines, IA
Jami - My surgeon is Dr.Myrie and I have Empire BCBS, my insurance nor the surgeon required a referral from a Primary Care Physician, so you might want to check with that branch of BCBS to see if you even need to have your Primaries referral, it may just be unnessacary. As far as other doctor appointments I had to have my blood drawn and a psych eval, that was it. So it just depends on your insurance and what your medical conditions are. Oh yeah, I also was seeing a nurse practitioner when I started trying to lose weight two years ago, she was also very much against the surgery, wouldnt put me on diet pills but did send me to the dietician and then finally told me after about three months that I was just meant to be big and that there was probably no way I was going to lose weight, that I should just learn to deal with it. It'll work out! ~Kelly
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