Question:
I was wondering what the first step would be for WLS?

I have insurance now as of 4/1/00, I dont know if i am to see my pcp first and have him check my comorbidys (if i have any) then refer me to a bariatric surgeon, or do i just have him give me a referrel to a bariatric surgeon and the surgeon does the rest. Do i need to have established comorbitys before i can see a BS? any input would be a great deal of help in this process and steps i need to take. thank you all. Amy    — Amy B. (posted on April 3, 2000)

April 3, 2000
Hi Amy! Your first step really depends on the guidelines of your insurance company. What I did (and this made the whole process very easy) was I first picked the surgeon I wanted (that was the most important thing to me), then I asked that surgeon for the name of a WLS-friendly PCP in the same IPA/Medical Group, then I registered through my HMO with that PCP. I made an appointment to see the PCP as soon as I could, and got the "official" referral to the surgeon of my choice. It's called "going through the back door", and many health care industry professionals do it in order to see the specialist of their choice. Heck, it worked for me! Please feel free to write to me if you have any questions.
   — Kim H.

April 3, 2000
Amy... Kim is the insurance guru around these parts, so listen to her. Something I might add, however, is that you research all kinds of WLS. You can get a lot of good info here about the RNY. You can check out www.duodenalswitch.com as well. For the Bilio-Pantcreatic Diversion with Duodenal Switch (DS), we have patient stories, pics, published medical reports, etc. Hope you find what suits you the best!
   — Kris S.

April 3, 2000
I know it depends on your insurance co. But usually you see your pcp and get a referral to the bariatric surgeon. He will in most cases do the rest. He will find out what type of risks you have, by tests or other means. I know I went through, a psych eval, ultrasound for gall bladder, and a dietician. I know others go much more, like sleep disorder test, bone density test, any many others that I am not sure of. I know others on this site will help you with that. You will have blood tests. I know that not all pcps are favorable to the surgery. But be persistant if this will be the case for you. Go for it all and stick to your guns. I know I had to wait to get insurance before I could finally go for the surgery. I was so happy when I finally got insurance. My pcp did not want me to have the surgery but I persisted and got the surgeons name from her and used that to make my own referral. I wish you all the best of luck. My surgery was 2 1/2 years ago. Now my dr. think it was a great idea for me. Go for it all.
   — chris M.

April 3, 2000
I choose a surgeon from this site first, and contacted their office. The surgeon's office sent me a packet to fill out on my medical history and dieting history. I returned this and then called the surgeon's office to make an appointment. Once that done, I contacted my PCP and made an appointment with him. I had him refill some Rx's for me and told him I needed a referral to Dr._________ for an appointment I had with him on ______. My PCP had no experience with bariatric surgery, but I just told him what I wanted and he complied. He didn't need to write me a letter saying I needed the surgery, just give me a referral. The surgeon wrote the letter of recommendation himself. While I was there, I got copies of my medical records from my PCP to take with me to my surgeon's office. I had two other doctors- a neurologist and a cardiologist. I called one office and asked them to fax the surgeon my records and I picked up the records from the other and carried them also to my first appointment. The surgeon had all my medical records to review which made the whole process faster. Once I saw the surgeon, he sent a letter into my insurance company, and I eventually scheduled surgery. I went ahead with surgery before my insurance approval came in because I was going to have surgery regardless of what happened. Insurance ended up approving and have covered the surgery. Hope this helps. Good luck.
   — Shar /.

October 4, 2002
Hi Amy, I'm just starting also. When I became interested in WLS I first contacted my ins co by E-mail. To see if this op was covered by them.they got back with me by letter. because I couldn't explain myself pro like. lol I printed out info explaining what I was tring to get. she called me and told my step by step what I had to do. She even had called my primary doctor and asked for a surgen close to where I lived. After hanging up from her I called that doctor. made a appt. they told me to get my referral from my primary dr. which I did. and on Oct 16 bring med list, referral,ins cards. What's next I have no idea. GOOD LUCK
   — Naes Wls J.

October 4, 2002
Hi Amy...I'm just starting to get the ball rolling. My profile is very detailed so feel free to look at it. But basically here's the steps I took: 1. Do tons of research-read Carnie Wilson's book Gut Feelings. The Medical Guide to WLS is also a good one. I got them at Barnes and Noble. Also this site and others are great resources. 2.Find a hospital-I'm also from NH. Dartmouth is the only one in NH that does it. I found though that Dartmouth's a very very long process. You may have to wait over a year. I'm going to Beth Isreal-there's lots of hospitals in MA that you don't have to wait as long. Go to a seminar/support group...surgeons as well as post ops are usually there to discuss everything and answer questions. 3. I do medical billing so I know it depends on your insurance plan if you need a referal or not. I have BCBS HMO so I did. POS or PPO plans usually don't require one, but the surgeon usually needs to be in their network. Go in armed to your PCP appointment. I was very lucky my PCP was supportive(actually thrilled)but some aren't. I don't have any co-morbities but my BMI is sky high and I have a strong family history of fatal diseases some triggered by weight. 4.After your PCP sends a referral you usually have to fill out a questionaire to the hospital and then the surgeon's office will contact you and schedule appointments. I'm going for my first pre-op tests 12/2/02 and I'll probably have surgery 1-3 months after. Hope that helps you! Feel free to E-mail me-I also joined a local WLS support group that meets once a month. Most are post-ops but anyone can join. I can give you more details. Take care :)
   — mzcath

October 4, 2002
Hi Amy...I'm just starting to get the ball rolling. My profile is very detailed so feel free to look at it. But basically here's the steps I took: 1. Do tons of research-read Carnie Wilson's book Gut Feelings. The Medical Guide to WLS is also a good one. I got them at Barnes and Noble. Also this site and others are great resources. 2.Find a hospital-I'm also from NH. Dartmouth is the only one in NH that does it. I found though that Dartmouth's a very very long process. You may have to wait over a year. I'm going to Beth Isreal-there's lots of hospitals in MA that you don't have to wait as long. Go to a seminar/support group...surgeons as well as post ops are usually there to discuss everything and answer questions. 3. I do medical billing so I know it depends on your insurance plan if you need a referal or not. I have BCBS HMO so I did. POS or PPO plans usually don't require one, but the surgeon usually needs to be in their network. Go in armed to your PCP appointment. I was very lucky my PCP was supportive(actually thrilled)but some aren't. I don't have any co-morbities but my BMI is sky high and I have a strong family history of fatal diseases some triggered by weight. 4.After your PCP sends a referral you usually have to fill out a questionaire to the hospital and then the surgeon's office will contact you and schedule appointments. I'm going for my first pre-op tests 12/2/02 and I'll probably have surgery 1-3 months after. Hope that helps you! Feel free to E-mail me-I also joined a local WLS support group that meets once a month. Most are post-ops but anyone can join. I can give you more details. Take care :)
   — mzcath