Getting the run around from PCP/ advice please...
Hello Everyone,
Just needed some advice. I am getting the run around from my old PCP in regards to my weight history from 2007. My Ob-Gyn has provided me with weight history for 2008. I am only required to have 2 years 07/08 of weight history per BCBS.
While my PCP is willing to give it to me, they are playing games with me. I had an appt with my PCP in early July and she told me that she supports WLS and let her know what I needed. So late July I called and let them know what I needed and they said that they would get it over to my surgeon. Well August came and I called back and they said I needed a release form(had already signed one), So we went back and forth and finally I got someone else in the office who knew of the situation and she said that she would get it taken care of. Needless to say that it didnt happen. I didnt know that the bariatric center didnt have the information until Monday... So I called back to the office of my PCP and they said that they will get it taken care of again.... The nurse called me back that same day and said that she was about to fax it over to the bariatric center. Well they still didnt receive it as of today, so i called back today and they said that confirmation of the fax was on record. So i asked if they could fax it to me, lo and behold I get the mean nurse telling me i need a release form(already did that).. And why would the other nurse fax it if there was no release on file.... Fishy I say... Anyways, I am desperate for this info so, I ask if they could send me the release form via email, fax, mail or however.... Nope they are unwilling to do that and I have moved away from the city where the office is....
With all that being said, my question.....
In 2007 I had an Ob-Gyn when I lived in Atlanta. I called them up today and they said I can write up a release of info request and fax it over to them and so I did.... In January 07 I am sure that my BMI wasnt 40. It was maybe 37-38 or so. If this document is submited to insurance will it hurt me if my BMI is not 40? Right now the only Co-morbidity I have is Hypertension and possibly sleep apnea(will know for sure after Sunday night).
or should I continue to fight with my old PCP to try to get a documentation of my BMI definitely being 40+?
Sorry for the long message
Thanks in advance for any responses
Just needed some advice. I am getting the run around from my old PCP in regards to my weight history from 2007. My Ob-Gyn has provided me with weight history for 2008. I am only required to have 2 years 07/08 of weight history per BCBS.
While my PCP is willing to give it to me, they are playing games with me. I had an appt with my PCP in early July and she told me that she supports WLS and let her know what I needed. So late July I called and let them know what I needed and they said that they would get it over to my surgeon. Well August came and I called back and they said I needed a release form(had already signed one), So we went back and forth and finally I got someone else in the office who knew of the situation and she said that she would get it taken care of. Needless to say that it didnt happen. I didnt know that the bariatric center didnt have the information until Monday... So I called back to the office of my PCP and they said that they will get it taken care of again.... The nurse called me back that same day and said that she was about to fax it over to the bariatric center. Well they still didnt receive it as of today, so i called back today and they said that confirmation of the fax was on record. So i asked if they could fax it to me, lo and behold I get the mean nurse telling me i need a release form(already did that).. And why would the other nurse fax it if there was no release on file.... Fishy I say... Anyways, I am desperate for this info so, I ask if they could send me the release form via email, fax, mail or however.... Nope they are unwilling to do that and I have moved away from the city where the office is....
With all that being said, my question.....
In 2007 I had an Ob-Gyn when I lived in Atlanta. I called them up today and they said I can write up a release of info request and fax it over to them and so I did.... In January 07 I am sure that my BMI wasnt 40. It was maybe 37-38 or so. If this document is submited to insurance will it hurt me if my BMI is not 40? Right now the only Co-morbidity I have is Hypertension and possibly sleep apnea(will know for sure after Sunday night).
or should I continue to fight with my old PCP to try to get a documentation of my BMI definitely being 40+?
Sorry for the long message
Thanks in advance for any responses
I think the answer is both. Get the info from your PCP however you can even if you have to drive to their office and get it in a sealed envelope and hand deliver it to the Bariatric clinic. But it would be a good measure to get the earlier one because it shows the weight gain trend if nothing else.
Ann and the 'Bean'
Blogs mysecondhalfoflife.blogspot.com/ and amanicinsomniacsreadinglist.blogspot.com/
High/Surg/current/goal - 320/253/150/healthy - I am 5' 3" tall - Size 8 now! Past surgeon's goal now!
Blogs mysecondhalfoflife.blogspot.com/ and amanicinsomniacsreadinglist.blogspot.com/
High/Surg/current/goal - 320/253/150/healthy - I am 5' 3" tall - Size 8 now! Past surgeon's goal now!
Because you have at least one co morbidity, you should be fine with a BMI of 35 or more. You don't have to have a BMI over 40 if you have at least one co morbidity. The insurance requires a BMI over 40 if you don't have any co morbidities, so from that perspective you should be fine.
I agree with Ann. I would go get the information from Dr's office if they won't fax it to you.
Good luck!
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
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