Who is a good DSHS primary care doctor?

Hi. I'm friggen 500 pounds (I peaked at 555), and my old primary care physicians (even though they were in a clinics) had no idea how to deal with DSHS as far as obtaining approval for weight loss surgery. We even had a so-called "insurance specialist" tell me it wasn't possible, even though my social worker says it is, and others are saying they just don't know what they are doing or don't want to deal with the paperwork. So, after screwing around for over a year on my own and running into brick walls, I could really use some advice. I need a PCP in a Seattle-area DSHS-approved clinic that knows his stuff in regards to weight-loss surgery and especially in dealing with DSHS/coupons. Any recommendations would be swell. Also, any recommendations for sleep doctors (I need sleep apnea testing) or surgeons that will accept DSHS would be great as well. Thanks a ton.

I am not from your area so I cannot help you with a PCP but I do know a bit about dealing with the DSHS institution. It is very unlikely that you are going to find a PCP that is a wiz at dealing with DSHS. Honesty all providers that I have dealt with are pretty clueless when it comes to DSHS. It is best for you to know what to do then lead the providers down the right path because if you leave it up to them you may be waiting for years. Anyway, when you do find a PCP that you like call the number on the back of your medical coupon and request that they fax all the information regarding the procedure directly to your PCP. Then get a copy of that sheet from your PCP and make an appointment to discuss it with your PCP. You need to gather all your medical records for the past 5 years and give them to your PCP to submit with their letter of medical necessity. They submit the information just like a prior authorization, they do those all the time. You will be covered as a fee for service with your cnp medical coupon. Once you are approved you will move to stage 2 in which you will go on a six month diet with your PCP and a dietician, you will need a psych eval, a check up from an internist, surgeon, and a couple other appointments. If you do everything you are instructed to do just as you are instructed to do it your PCP or surgeon will submit the paper work for stage 3 the actual surgery. Also make sure if you are going to have surgery at U of W call and get on their waiting list ASAP. Go for it full speed ahead, don't get discouraged, just know that it is a process it does take time. With WA Medicaid you really have to make it happen. ~Holly

Hi Holly, I just had to thank you for going in detail about what to do. This will sure help me out as well as others out there. I have some questions I'd like to ask you. I am seeing a new doctor next week and had my records transferred from my old pcp. Does it have to be all your records from the past 5 years??? I don't have really 5 years of medical records. Is this okay??? I started going to the doctor on a regular basis since Oct. 2003. What kinds of records should be submitted with my pcp's letter of medically necessity??? Medicaid is so complicated. I just hope I will get this all right along with my new pcp getting the letter together enough with the information they are wanting. It is all just so stressful. Debbie

I agree that you should get in touch with the University of Washington Medical Center Bariatric Surgery Clinic. Check the great OH postings about the UofW doctors! here is their website: http://depts.washington.edu/surgery/patientcare/bariatric.html Clinic Phone: (206) 598-4477 Patient Care Coordinators: (206) 598-5879 They might even be able to advise you of a primary care doctor within their UofW system. I know they have a sleep disorder department too (try this number 206-731-3000). And they take DSHS Med Coupons! There is alot of appointments and a check off sheet you will have to complete as well as a possible waiting period. Glad you came to this site, as there are so many here to support you in your life decissions! Hugs, Aunt Pam

Hi Aunt Pam, I wanted to thank you also for posting this information on how to contact the UW. I have been wanting to look into the UW and didn't know who to contact or where to start. Are they the only surgions there that excepts medical coupons? I have recently been hearing some good things about the doctors there. I was going to go with the Surgical Specialists of Spokane but they are not currently excepting medicaid anymore. I am not aware of any other surgions that excepts medicaid. Debbie

I wish you all the luck. I just wanted to thank you for posting this message. What good replies too. I can relate to what you are saying. I have been trying to get somewhere for almost a year and a half now with my old pcp. In fact, she told me that I should pay for it myself because of DSHS's strick criteria! Yeah right! I am on SSI. And I know that I can't give up that quick. It seems that this is all new to most pcp's. I will be seeing a new pcp and hoping to get somewhere faster with her. All my best to you, Debbie