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Was it hard for you to get a referral?

For insurance to pay for my banding, I have to get a referral from a general doctor to do this. Did anyone else have to do this, and how hard was it? Most of my dieting has been on my own. My doctor did give me Phentermine for a couple of months a couple of times but it was awful. I was really hyper but I feel high all the time and it made me unstable emotionally. I've always been fine emotionally but it messed me up horribly while I was on it.

I'm a bit worried that my doctor may not referr me since my diet attempts have been on my own. I know a 'doctor assisted' diet won't any better. Any weight I lose will just come back. When I diet I usually lose about 10 or so pounds then gain it back over the next few months as I cant stay on a diet any longer as I seem to platue and I'm miserably hungry. I eat too much. I'm 23 and have tried losing weight so many times. I've tried Atkins for 6 months and lost 20 pounds but I couldn't stay on it and gained most of it back over the next few months. That was my most successful weight loss attempt. My highest adult weight was 300 and my lowest is 280 which I am now.

Any suggestions on things to say to the doctor to help him realize that this is for me? My doctor is associated with my insurance so I'm worried they may try to avoid surgery if they can since that will cost them more... I have high blood pressure, Multiple Sclerosis, and diabetes and heart problems run in my family. From my point of view it seems pretty obvious that this is something I need to get and will be in my best interest.

Thanks!

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I was prepared for my PCP to be negative about it, but when I brought up the idea of WLS (at the same appt where he broached the fact that it looks like I am now diabetic) he said "well, that is an option, but I would recommend banding for you..."

Well, now THAT was hard! He then gave me the name and number of the surgeon that I will probably use.

To bad the insurance isnt as easy!

Good luck!

I am working on getting approved. I am in the process of writting the letter for the PCP that will include all the weightloss things I have dones, All my weights/bp/BMI listed. Along with when I was told about the co-morbitity stuff. I will then take the letter in and have them put it on there letter head and send it to the lapband doctor. If you need some help e-mail me at vcw61@excite.com.

Chris

Pre-Band

St. Louis

I asked two different Dr's and they both wrote letters for me. Just ask. If your Dr. turns you down because of belonging to the insurance co. get a new Dr. Best of luck.

JP

  • Author

My doctor referred me! I'm so excited. He filled out a little form recommended bariatric surgery and specifically lapband saying I was not responding to other treatments.

I gave the form to the secretaries and they said they would get it in the system and call the Lapband place to tell them. Should I do anything else with the referral part like ask the doctor to write a letter to insurance since insurance wanted the referral in the first place? It's "in the system" now but I've heard others mention writing an actual letter. He took my spreadsheet I made of all my weight loss attempts and other various stuff.

So should I call my doctor and ask if he can write a referral letter to insurance, or should I wait until I get further along in all of this? I meet all requirements for this although I want to make sure my insurance stuff goes as smoothly as possible as I'm HOPING I can get this surgery before college starts back up. Or at least very early in the semester so as to not cause too many problems there...

  • 1 year later...

Ok so, i have investigated getting a lap band. i really think this has the potential to change my life. I am 20 yrs old, weigh 105kg and am 158cm in height. My BMI is a little over 40. I am really worried about asking my GP 4 a referral. I have not really spoken to my GP about losing weight b4, but have had my choloterol tested and it is to high. I have been on lite n easy a few times, seen a dietician and exercised. I am just wondering what extent do they ecpect you to have tried to lose weight. Do you think my GP will refer me. Thanks guys

I was worried about getting a referral also. I had to use a new PCM because my original doc was not in network with my secondary insurance (my primary doesn't cover the surgery). So I had to go to a physician that didn't know me. And, my BMI is borderline (about 36). But I have high blood pressure and sleep apnea.

I typed out my medications and medical history. I listed my family history. I also listed every diet I ever tried (I know I forgot a few). I cut and pasted what my insurance requirements were, and I also put in there the height and weight chart that they go by. This doctor thanked me, and then wrote the referral! He did the blood work and ekg in the office.

I have my appointment this week with the surgeon and hopefully my insurance will cover the procedure!

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