Question:
Has my approval been sabotaged?

Previously I reported that my PCP was not supportive of my desire to have bypass surgery. I wrote him a letter asking him for his support in writing a letter to the insurance company as well as a referral. Getting the referral was no problem. However the letter left much to be desired. I gave him current info (5'5"/239/special conditions). His letter to the insurance company stated that I was 5'7"/233/with no major problems. On the day that this letter went I, I met with another surgical staff who will be sending out their own request with the corrected information. What is the insurance company going to say when they receive these letters within days of each other? Help!!    — tigerpaws (posted on May 19, 2003)

May 19, 2003
First thing. FIRE YOUR PCP! Whether it was a paperwork mistake or not.. "mistakes" like that should be intolerable. Second. Find a WLS frieldly PCP and get him/her to send another letter ASAP. Good luck!
   — SJP

May 19, 2003
I would make your PCP fix his errors. The difference between 5'5 and 5'7 has nothing to do with his opinion of WLS, and neither does your correct weight and medical condition. Then get a new PCP.
   — Monica H.

May 20, 2003
I wouldn't worry about the PCP letter too much. The surgeon's letter will carry the most weight when it comes to being approved, not the PCP's. My PCP, who I think is a very good doctor, was not all that enthusiastic about me having WLS. (5'3", 236). I didn't need a letter of referral, but the surgeon did require a letter from him, and he did that. It was matter of fact and short. The surgeon sent his letter to the insurance company after my first consultation - that's what got the approval. I was the first patient my PCP had who had lap RNY. (Well, actually the second - another of his patients had it the day before I did with the same surgeon, I later found out.) His opinion has since changed drastically - he is now very much in favor of WLS. (The other person was diabetic and poorly controlled - now not on any insulin at all! His wife is a business acquintance I don't get to talk to very often, and she is the one who told me about her husband's surgery.) To be honest, many PCP's just don't know all that much about WLS, and stay on the conservative side. If you have a good relationship with your PCP, stay with him and maybe he will learn from you. (My doc had a lot of questions about diet and vitamins and so forth when I went to see him after surgery.)
   — koogy