Question:
Advice on how to present bariatric surgery to PCP

Hello everyone, My insurance requires a referral from my PCP in order to be seen by the surgeon. The only problem is I have never seen this Dr. before he was assigned to me and I am a little nervous about how to present this issue to him and get the referral! Any suggestions would be greatly appreciated thanks    — monny2400 (posted on September 11, 2006)

September 11, 2006
Hi Traci, I just wanted to give you some advice on this. Do you have any other doctors that you see that have suggested this to you as a Weight Loss Option? Or did you decide that you wanted to do this? If you had doctors suggest this to you, see if they can send letters of recoemmendation to your new PCP suggesting that the surgery would be the right thing for you to do. If you made the decision, just make sure that this is what you really want to do and TELL him that!! I was just recently in the same postiion(my insurance did not require me to establish a new PCP though) and had to establish a new PCP(because I was going to a pediatrician and should not have been) and had my dietician send her a letter telling all about me being with her and what "diets" and programs I have been on and that since they are not working, surgery would be my best option. I went in determined that GBS would be my best option and just told her that this is what I wanted and why I wanted it. Suggestion: RESEARCH WLS to the max before making your decision!! I haven't entered a program yet but am attending a informational seminar tonight to learn more about the surgery and what to expect before and after entering the program.
   — C. Reed

September 11, 2006
Hi Traci, I had been researching this procedure for two years. I didn't have a PCP because I didn't have any problems. When I finally decided to choose a PCP when I went for my first visit I just flat out asked him if he would give me a referral to a bariatric doctor for weight loss. He said sure and he did. He even asked if I had one in mind and I informed him that I would go to a referral that he knew personally. I am glad I went to his referral. The doctor that I am seeing is Dexter Turnquest. I drive way across town to see him. So my suggestion would be just to ask.
   — The One

September 11, 2006
Hi there! I was kind of in your boat. I had just moved into a new city - about 1 1/2 hours from where I was originally. My original doctor had moved her business elsewhere - so it was not in the cards for me to get a referral from her. So I saw a new PCP - I had only been seeing him for about 2 weeks when I brought it up. He noted that in his letter of medical necessity. If you have documentation of your co-morbidities and your weight loss attempts - it isn't going to matter - it's just a formality with insurance companies to get everything documented. Don't fret over it! Tonja
   — tonjasm

September 12, 2006
Trici, a veteran here. My PCP refused to even talk about any type of Bariactric Surgeries for weight loss. Thus I got on the OH board and research under Insurance and contacted everyone who used my Insurance, Humana Gold Plus/Medicare. And finally found one in my area of Tampa Bay who told me to see her PCP. And as of the first call to see if they were accepting new patients, I told them I was looking to recieve the WLS. And repeatedly everytime I talked with them too. I had been to several seminars already and had made my decision on using Dr.Rehnke already too. Which the PCP tried to get me to use someone else across the Bay but why when this surgeon was a couple of miles away. And I pushed and got my wish. Besides if I had problems (and I had a few) I wanted a surgeon close by not an hour or so away. Well It took 10 months because I had to complete a 6 month Doctor's Supervised and Documented Diet per Insurance Requirements, but I got my Open RNY and I'm four months Post-op and 140lbs. less than I was last Christmas 2005. I've got 70lbs. t go to reach 200lbs. You can do this just be Positively Determined. There will be set-backs too but you will succeed! Just grow some pateints too!!!
   — Michael Eak

September 12, 2006
Write down all your rasons for needing the surgery. A.lso, find out your insurance's clinical guidelines for bariatric surgery (either at their website or by phone. Print out a copy or have one sent to you. ee if yiu meet all their requirements for the surgery. Some insurtance companies require six months or so ofdoctor-documented weight-loss attempts, for example. Write down any comorbidities, such as diabetes, sleep apnea, high blood pressure, etc, that you have. The best thing is to be prepared to tell the doctor exactly why you want the surgery.
   — Novashannon

September 13, 2006
Thank you everyone from your comments I developed the courage to go to my new PCP and ask for exactly what I wanted, and I got the referral!
   — monny2400