Dr frustration

Cwood
on 2/26/17 1:43 pm

I live in Ontario Canada.

So the surgery is covered under our health car plan.

But we need a Dr's referred and need to meet the Bariactric Network requirement.  Which they post on there website.

With my height weight and BMI the website says I qualify with 1 medical condition.

So now...I don't know what to do. And if I can get switched to thw surgical program

CC C.
on 2/26/17 10:38 am

I wouldn't be frustrated with the doctor. This sounds like you not meeting the insurance requirement. Call them as ask what your requirements are.

Cwood
on 2/26/17 10:45 am

Sorry...I'm confused. What insurance requirements. 

I thought we just had to meet the Bariactric Network requirement 

CC C.
on 2/26/17 10:48 am

Ah, Bariatric Network sounds like Canada? I was assuming you were in the US. Sorry, I'm not familiar with how WLS coverage works in other countries.

Pond Jumper
on 2/26/17 1:13 pm - Calgary, Canada
VSG on 07/10/17

If we are talking about Canada then similar applies. Over 35bmi with two weight related issues or over 40 with none. At least that's what it is in Alberta, other provinces might be slightly different.

I would still ask for the referral, the program will make the decision and not you PCP. 

Referral to CABSC: Aug 2016 (weight 267.4lbs) Orientation (Online): Sept 2016 Intake Assessment: Oct 2016 Nutritionist: Nov 2016 Psych: Dec 2016 Nutritionist: Jan 2017 Surgery Info Class: Feb 2017 Nurse Practitioner: Feb 2017 Meet the Surgeon: Mar 2017 (weight 225lbs) Surgery Prep Class: April 2017 Nurse Practitioner Check in: May 2017 (weight 221lbs) Endoscope: May17th 2017 Surgery: July 10th 2017

Pre-op: 52lbs; Post-op: M1: 14lbs, M2: 10lbs, M3: 5lbs, M4: 6lbs, M5: 2lbs (stall), M6: 4lbs, M7: 5lbs, M8:6lbs, M9:5lbs, M10:4lbs, M11:4lbs

Cwood
on 2/26/17 1:46 pm

I live in Ontario Canada. So it is not an is rance company the government pays for the surgery if you meet the requirements. 

According to the Bariactric Network website. ...who is responsible for doing both the medical and surgical program.

With my weight height and BMI plus 1 medical condition I do qualify

White Dove
on 2/26/17 2:01 pm - Warren, OH

I have seen people from Canada post that they just walked into a clinic and got a referral.

Real life begins where your comfort zone ends

Cwood
on 2/26/17 2:15 pm

The Bariactric Network  is where everyone in Canada  needs to get the referral  to. On there website it says only a dr can refer tou.

I know I have the option of derostering from my own dr finding a new dr and having my records transferred. But that could take up to 6 months.

I was just wondering if there was another way

Travelher
on 2/26/17 6:14 pm
Revision on 10/04/16

Have you thought about trying a "walkin" clinic?  You might be able to get a referral.  My doctor didn't even ask about the requirements..she just offered to refer.  I opted to self pay and had my surgery in Montreal so I didn't have to wait.

Band-RNY revision age 50 5'4" HW 260 SW: 244 (bf healthy range 23-35%) bf 23.7% (at 137lbs) cw range 135-138.lbl with butt lift and mastoplexy March 23, 2018...2.5lbs removed.

Pre-op-16lbs (size 18/20...244) M1-16lbs (size 18...228) M2-15.6lbs (size 16/18...212.4) M3-10lbs (size 16..202.4) M4-11.4lbs (size 14...191) M5-10.8lbs (size 12...180.2) M6-8.4 (size 8/10...171.8) M7-6.4 (size 8...165.4 lbs) M8-11.6 (size 6...153.8) M9-5.6 (size 4/6...148.2) M10-5.8 (size 4....142.4) M11-4 (size 2/4...138.4) Surgiversary -1 (size 2/4...137.4) M13-2.6 (size 2/4...134.8) M14 (size 2/4...134.8) M15 (size 2...135) M16 (size 2...131.4) M17 (size 2...135) M18 (size 2...135) M19 (size 2...138) M20 (size 2...135) M21 (size 2...138)

T Hagalicious Rebel
Brown

on 2/26/17 2:32 pm - Brooklyn
VSG on 04/25/14

You might try cross posting on the Ontario forum. They might be more familiar with the health ins hoops to jump thru than those of us in the US.

Did you call the Dr as to why you don't qualify for the surgical? If the website says 1 thing & she says another, someone from the ins must be telling her something. You should call & find out what it is rather than depending on the website.

No one surgery is better than the other, what works for one may not work for another. T-Rebel

https://fivedaymeattest.com/

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