whats my next step...do I need a Dr referal?

zimmersdreamer
on 1/11/10 4:54 am - indianapolis, IN
I found out that I am on Mdwise, we are getting our cards in the mail this week. What is my next step? Do I call and set up an appointment with the sergeon? Do I call my PCP and ask to get a referal? I have not discussed lap band with my PCP because, I dont go to the Dr that often and the reasons I do go I forget to ask him about WLS.
I really want to get this ball rolling but I am at a loss as to what I do next. (yeah Im one of those persons that needs a map and written directions and...)
SweetSherri
on 1/11/10 5:44 am - Indianapolis, IN
I would advise anyone to call their insurance carrier (Mdwise) and ask them what their process for approval is and what their requirements are. Some insurance companies require a pcp referral and other s don't. Some require a physician supervised diet, some a dietician supervised diet. So...your best course of action is to call Mdwise and ask.

 

  AT GOAL!!
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Never allow someone to be your Priority while allowing yourself to be their Option......
Whenever God Closes One Door He Always Opens Another, Even Though Sometimes It's Hell in the Hallway...
Jo N.
on 1/11/10 5:54 am, edited 1/11/10 5:55 am - Crawfordsville, IN

I went to my PCP (cuz Medicaid at that time required a referral) with the information to contact Medicaid and the information to contact the surgeon I wanted. My PCP's office did everything (as getting records ready) and sent one copy to Medicaid and one set to the surgeon. About a month after the surgeon received my packet they contacted me and I went to an all day info seminar w/a lot of other patients getting different types of wls & met my surgeon. Then I had to wait for the surgeon's office to resend the packet to medicaid (Medicaid said this verifies all the info twice).. then waited for the approval and surgery date. 

Have you called Medicaid yet? I always tell people to call them & I've heard that sometimes they are helpful and sometimes you get that one CS rep that's there for the paycheck and could give a crap about actually doing their job and helping out people that call. But call them before you head to the PCP... ask them what's the quickest route for you to take to get approved ASAP. Hopefully you'll get a decent person when you call. 

If you have any questions, plz feel free to email me.

 

Good Luck
Jodi

Five+ YEARS WITH THE LAP-BAND( 8/31/05)
Highest Weight: 317/Surgery Weight: 267/Lowest Weight: 148
Currently Filled 1.4cc in a 4 cc band APBand
Panniculectomy w/psudeo TT proformed by Dr Bergman 10/8/2009
Need Help With Success? Read a Geneen Roth Book. "When Food Is Love!"

 

zimmersdreamer
on 1/11/10 6:48 pm - indianapolis, IN
Than you both! I guess my fingers will be doing some walking today. I have a ton of calls to make anyway so I can always add one more. I will keep yall posted!

thanks again! and Jodi I may just have to do that (e-mail you! I have so many questions and so many more that I just dont know to ask yet.)
zimmersdreamer
on 1/14/10 2:12 am - indianapolis, IN
so I am not officially assigned to my Dr till fri the 15th . one more day... then I an call back to find out the process and get it started! I will post when I have a set knowledge of what needs to be done
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