PCP is such an a** any one with OXFORD LIBERTY

Oxford Liberty Patients please help me.. this is what happened....I went to my PCP today to get the letter I needed for my insurance company. I had to switch doctors because my current insurance was not accepted by my previous doctor who I have been with for 5 years. My PCP tells me that most insurance companies require a 6 month supervised diet. but when i called my ins. co Oxford Liberty they said no. She also wanted a list and the years I was on diets.. how can i remember the years.. I have been heavy since 7th grade.. what else am I to do...the thing is she told me i have no co-morbiditities... So no I have to go back, pay another 15$ co-pay to have a physical. What does she want me to do lay down and kiss her butt.. so anyway, what co-morbitity does she want me to have.. I have swollen ankles, hypo glycemia, can't walk a great distance w/out stopping have a BMI of 59, knees are always hurting, can't sleep only because i wake up and use the bathroom about 4 times durning the night due to all the water I drink. legs are swollen, i push a finger and a hole appears........ what else am I suppose to tell her... any suggestions.. Sorry for the rant.. had to do it.. getting really peeved.. Charlene

just tell her all of that my pcp made me come in for a physical also, but then she did write me a nice letter. she also asked for a weight history, just do the best you can, nobody can remember all that stuff i was heavy since childhood and became obese in my early twenties and yada yada and thats what i told her. good luck, dont let the red tape get you down hugzzzzzzzzzz, jacki

Hi Jacki: I gave her my wieght history and all the diets I have been on...I refuse to let the red tape get me down, she was just like, "we write these letters all the time".. so why is she giving me a hard time..

Charlene, Just talk their language...... your swollen holey legs are Bilateral Lower Extremity's have 3 plus pitting edema Your waking up frequently to the bathroom Extreme Polyuria that causes sleep disturbances or Nocturia hypo glycemia can be Pre-Diabetes or Metabolic Syndrome If your PCP is willing to spend 5 minutes, they could help you put your symptoms into medical terminology. As for the list, do your best.... even if your memory isn't perfect, how can they check? Good luck Mary!

Mary: Guess I am going to have to talk her language...its just frustrating.. Charlene

Ugh Charlene, that is awful! Doesn't your doc submit the letter to insurance?? I only needed a letter from my PCP saying that I was healthy enough to have surgery...it wasn't up to her to determine whether she thought i had co-morbidities or not! I go to Dr. Mastro at Family Medicine on Mathistown Rd....she is all about the WLS...she interned in Women's and Children's medicine. Dr. Mastro is all about being healthy and if we need the surgery to do it, she says it far outweighs the bad of the surgery! Also, do you have to see a pulmonary doc??? if you have sleep apnea its a co-morbidity...that is all i have! blood pressure is normal. no knee damage. I didn't even have to talk to my insurance at all...doc's office did everything. Good Luck!!!

hi charlene is the PCP just ignorant about WLS and the paperwork you need beforehand?? she said that most insurance will require a 6 month diet -- does she know or is she guessing?? go online and look up oxford insurance and READ your policy -- see exactly what is says under Weight Loss Treatments or Surgery -- and like Mary said -- have them put all your complaints into medical terms -- my PCP told me what i had wrong with me haha ask your surgeons office what letters and clearances you need for surgery -- we found out from our surgeon the day of the initial consult that i would need a 6 month diet and ross would need a 3 month diet with PCP -- when you call the insurance company -- write down names and times and what they said -- ask them if you 'can have that in writing please' everything will work out in the end roberta

Charlene - don't let it get you down -- first of all, whether you have co-morbidities or not, your BMI is way above the minimum of 35 required for WLS. Yes, many insurance companies require a 6-month supervisied diet, but if yours doesn't, you're ahead of the game. Many docters just throw obstacles in your path to see if you are determined, and that is a reflection of how serious you are and will take this life altering step in your future. Be your own advocate - that is your strength. Good luck. Hope to see you at the next Toms River meeting. Hugs, Nannette

Hi Nannette: Mine doesnt' and my surgeons office would know since they deal with insurance companies all the time. The thing with my PCP also is that while she is telling me i have no co-morb. she is on the heavy side as well... go figure....but i am determined to do this... TR here i come..thank you Charlene