Question:
Was your paperwork submitted by pcp or surgeon??
I am somewhat confused, I spoke again to my insurance company today and they keep telling me that my paperwork must be submitted by my pcp. When I met with the surgeon, I was told that his office would send it in and that seems to be what I see in most of the profiles I have read. Is there anyone out there whose paperwork was submitted by their pcp and approved by insurance without any surgeon's paperwork attached??? — Martina B. (posted on April 21, 2006)
April 21, 2006
All I have ever heard was that it was submitted by the surgeon, Hae never
heard of the pcp doing it
— Debbie B.
April 21, 2006
No, your insurance company is very confused. Your PCP will submit your
medical history ie controled diet etc. Your surgeon will submit the
actually paperwork. I would call them up and talk to someone who has there
head put on straight. You can ask your PCP to send his paperwork to the
surgeon and then submit everything. if your PCP submits before your
surgeon, you could end up in the lost file somewhere. make sure your PCP
waits until the surgeon does his first.
Good Luck
Steve Cohen
OH Support Leader
— Steve Cohen
April 21, 2006
Hi Martina ... my surgeon sent everything in and filed the appeal when I
was first denied.
— Karyn B
April 21, 2006
Happy Friday!
My PCP started the ball rolling - arranged for psych eval, Nutritionist ( I
completed diet history for her) and I Went to the Seminar at the bariatric
surgeons. Once all my paperwork was complete (med history, nutritionist and
psych) the Bariatric surgeon sent it in to be approved...
Teri
— TeriC
April 21, 2006
THANK YOU, THANK YOU!! You are all such a wonderful help to me! I was
sure that the surgeon needed to do it, but the insurance woman was just so
emphatic. I have begun to think they don't know what they are talking
about at M-Plan.
— Martina B.
April 21, 2006
Your surgeon should be the one submitting the paperwork, you should however
have a letter from your PCP in support of the surgery and stating medical
necessity for the surgery.
— classite
April 22, 2006
I have a HMO and I had to have my paperwork submitted by my PCP to get the
referral to the surgeon...in order to get that referrral I had to be
reffered for nutrition classes first and when that was satisfied I got to
see my surgeon who then submitted paperwork for actual surgery....That may
be what you need to do first...all Insurance companies and Physicians
Groups have different requirements. I actually only ended up doing 2
nutrition classes and from seeing PCP and asking about refferal to surgeery
day was only 3 months for me...just do what they ask and it will go
fast...Good Luck and be patient. ~L
— Laura G.
April 23, 2006
Well here's to contradict everyone but not to say who is right or wrong. I
was told my surgeon's office wouls submit everything too. But as my PCP
said he'd have my clearence letter ready in a week. And I thought the final
referral to use my surgeon.
Well my PCP's staff submitted everything and overnight had the approval for
my Open RNY but at the hospitalthat my PCP has vistation rights not the
hospital I was expecting (which as a whole ward just for WLS). It's ok
thoough my surgeon does the procedures there too. So the next morning I
knew before the surgeon's office as my PCP office called me before the
surgeon's office but the next phone call I recevied was my date being set.
— Michael Eak
April 23, 2006
my pcp wrote the prescription of the gastric bypass surgery then the
surgeon staff had the pcp faxed all they had about me being obese and then
then surgeon staff took care off everything!
— mimibbb30
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