Referral issues

JessShearon
on 1/16/18 7:42 pm
RNY on 01/08/19

Hi everyone this is my second post. I was approved for a referral from my primary care physician yesterday. My BMI is 37 but I have hypertension that I've been medicated for, for 6 years. Before I left the drs office his assistant told me my BMI wasn't high enough so I wouldn't be approved. I informed her that if it's between 35 and 40 with a comorbidity, that it fits OHIP's guidelines. So she called me today and told me she submitted it but it was denied, because my BMI is too low. So I discussed with her the rules regarding what I read and she said she would resubmit but she didn't think it would be approved because she doesn't think my comorbidity is serious enough??? I'm under the impression she is misinformed but if she submits improperly again I don't know what to do. Any ideas?

thanks!

oneatatime
on 1/16/18 8:27 pm
RNY on 09/01/17

Hi Jess,

She's doing it wrong. Keep pushing. Meet with your doctor. Print out the guidelines and bring them in to him. Sit with him at the computer while he fills out the forms online (I did that with mine). This is your health and your right. My doc booked it as a counselling visit.

http://www.ontariobariatricnetwork.ca/our-programs/surgical- program#tabs-5

These are the guidelines and hypertension is clearly listed.

You got this! Keep self advocating. :)

Success is not the key to happiness. Happiness is the key to success. Choose happy.

Opti -10 / M1 -25.5 / M2 -10 / M3 -14.5 / M4 -13 / M5 -10 / M6 -5.5 / M7 -9.5 / M8 -13.5 / M9 -0.5 / M10 -2.5 / M11 -2.5 / M12 +2 / M13 -5.5

Century Club and Onederland in month 7!!

JessShearon
on 1/17/18 4:58 am
RNY on 01/08/19

Thanks so much! That's exactly what I am going to do. And thank you for the link!

RosieBelly
on 1/17/18 7:55 am

If your doctor is referring you I would get that referral and take it myself to your local program. You would, at a bare minimum, qualify for the medical weight loss program. Once you are in that program many people are transitioned to the surgical program.

referred Jan 2016 intake May 2016 left programme returned June 2017 final pre-sx class Oct 2017 surgeon appt Oct 2017

Opti Wt Nov 4/17 226 lbs BMI 45 Sx Wt 212 lbs RNY surgery Nov 23/17 M1 -18 M2-9 M3-10 M4-8 M5-6 M6-7 M7-6 M8-3 M9-1(so far) Down to within one pound of my goal and 99 lbs down from my highest weight. I was not a fast loser but who cares as long as you get there! I know the newbies check the trackers and the signatures so although I kind of lost track of how the rest of the weight came off, you should know that it was not fast and furious but it was slow and steady!

current BMI 24.7 that, my friends, is NORMAL!!! Strong is the new pretty!

JessShearon
on 1/17/18 8:29 am
RNY on 01/08/19

Thank you Rosie! I was accepted into the medical because my BMI but denied into surgery because she left out my comorbidity. If they can't figure it out, I will definitely go to medical to be referred to surgery. Thank you!

Liveyourlife
on 1/17/18 6:12 pm

You don't need to wait and start with the medical program. My BMI too is 37 with the same cormorbidity as you. Show them the OBN website and have them resubmit properly. It's a long process as it is so would hate to add on more time. Good luck!

Orientation July, Surgeon consult Sept, Internist Nov, RD/RSW/RN Dec.

RNY March 2, 2018 HRRH Pam (49 / 5'5 ½)

HW: 237, PreOpti: 226, Opti: -10, M1: -20, M2: -12, M3: -13, M4 -10, M5 -9, M6 -7, M7 -2, M8 -3, M9 -1 CW 138

JessShearon
on 1/17/18 8:07 pm
RNY on 01/08/19

I agree liveyourlife. The assistant called me today saying she was working on it and is in email correspondence with the network so I can only hope someone helps her. If not, I'll try again with my dr.

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