I have the Doctor from HELL...........I have completed all the prerequisites for appoval and the surgeon is ready to submit for approval and my PCP is standing in the way. She was with me all rhrough the process but when it came time for her to do her part ( writing the recommendation ) she refuses....saying that she does not have the time to do that, and further that my insurance co Horizon BCBSNJ doesn't pay her to do these kind of things....I even offered to pay her myself and still she refused. She faxed copies of the patient chart records tto the surgeons' office and said that he (the surgeon) should be able to get whatever he needed fron that....I have called the Ins co. myself to try and see if we can get around this MONSTER..and was told to have the surgeon get in touch with the Utilitization Dept...My question is ...have anyone here have this kind of issue and if so how did you manage it....

BTW....obviously I will change my PCP..but she has been my PCP for eight years and I don't want to change midstream....but as soon as this is approved!!!!!!!!!!!!!!!!!!!!!!

Wow that is unbelievable. Yeah okay you are a doctor......get over yourself! I am glad you have decided to get a new PCP. I love mine. I can not imagine having to go to a doctor with that kind of attitude. You are just trying to improve your life and health. Ugh. You have my total sympathy!! Has she seemed so bitchy for lack of a better word previously? My PCP actually wins awards locally for his bedside manner. He is also voted as one of the top docs by other doctors which is amazing because he is about 35 and a D.O.! I am glad you have decided to drop this doc who doesn't have time for you and your needs.

{(hugs)}

She sounds so mean! I would try your OB/GYN. Mine said if I had any problems with my PCP he would do whatever I needed. Good luck!

The PCP doesn't have to write it. Someone in her office can do it and she signs it.

Did your surgeon give you a "format letter" that you can give to her to just copy the format and insert your name and your medical conditions?

I worked in a PCP office ( 8 years) and all the Dr would say is "I need a letter for blank and here's what she has" and we took it from there.

Here's my suggestion: I would write a small note to the Dr. reminding her that you have been a patient in her office for over eight years and appreciate the good care she's given you and this letter is part of the "care" you need, yoou know blah, blah. And then fax it to the office.

Dr.s write letters for patients that can't do jury duty,for patients that have to bring something on a plane, like diabetic meds etc. They do this stuff all the time. Yeah, it's a pain and yeah they don't get paid to do it, but it's just part of the job.

then I would follow up the letter you faxed, with a phone call to the office 2 days later and speak with the staff and explain and then ask when your letter might be ready. And get the name of the person you talked to on the phone.

Second suggestion, have someone at the surgeon's call your PCP and have them ask the DR. for the letter.

I have the Doctor from HELL...........I have completed all the prerequisites for appoval and the surgeon is ready to submit for approval and my PCP is standing in the way. She was with me all rhrough the process but when it came time for her to do her part ( writing the recommendation ) she refuses....saying that she does not have the time to do that, and further that my insurance co Horizon BCBSNJ doesn't pay her to do these kind of things....I even offered to pay her myself and still she refused. She faxed copies of the patient chart records tto the surgeons' office and said that he (the surgeon) should be able to get whatever he needed fron that....I have called the Ins co. myself to try and see if we can get around this MONSTER..and was told to have the surgeon get in touch with the Utilitization Dept...My question is ...have anyone here have this kind of issue and if so how did you manage it....

BTW....obviously I will change my PCP..but she has been my PCP for eight years and I don't want to change midstream....but as soon as this is approved!!!!!!!!!!!!!!!!!!!!!!

Shorty, Had the same thing happen. My dr. copied a few things in my file (had only been seeing him for a yr b/4 starting this process). Anyway, the surgeon's office got to pages of copy from my file and that's it. It had one weight documented, a physical, a mammo and that's about it. After calling him the second time to request a letter, he sent copies of pages for the prior five years from my file that I had with my previous dr.

Luckily, my ins. company said that they did not need a letter from him and went with other documentation I was able to have our hospital and clinic send in. Hopefully, when it comes time for insurance approval, I won't run into problems. Good Luck:smile2:

My doctor's office had the nurse fax my letter to my surgeon. This doctor sucks! I agree with Caramia, have your OB/GYN do it for you.

Good luck.

my surgeons office dealt with all the insurance stuff. i just brought the info from my doctor to the surgeon, and they took care of it. no problem with insurance.

My PCP was far from happy about me doing this surgery and the fact that she had to get records together made her really not like it. I did have a form letter I gave her... but I know for a fact the office staff took care of it, I know it takes a lot of their time to do it. I did have to listen to my PCP going on and on about how she doesn't have the time, but I've been with her for 22 years!! She owed me to do it! The office staff was wonderful, they put it together and are cheering me on!!!!

I have the Doctor from HELL...........I have completed all the prerequisites for appoval and the surgeon is ready to submit for approval and my PCP is standing in the way. She was with me all rhrough the process but when it came time for her to do her part ( writing the recommendation ) she refuses....saying that she does not have the time to do that, and further that my insurance co Horizon BCBSNJ doesn't pay her to do these kind of things....I even offered to pay her myself and still she refused. She faxed copies of the patient chart records tto the surgeons' office and said that he (the surgeon) should be able to get whatever he needed fron that....I have called the Ins co. myself to try and see if we can get around this MONSTER..and was told to have the surgeon get in touch with the Utilitization Dept...My question is ...have anyone here have this kind of issue and if so how did you manage it....

BTW....obviously I will change my PCP..but she has been my PCP for eight years and I don't want to change midstream....but as soon as this is approved!!!!!!!!!!!!!!!!!!!!!!

Can you schedule an appointment with her to "discuss the procedure" but really use the time for the letter to be written/signed etc, that way you are right there in her office, face to face and she's getting paid? Then change PCP's right away...what a CAD!

wow that sucks!!! I was really lucky my surgeon's office took care of everything. I know my PCP was involved but I don't know in what capacity. They have one person who all they do is handle the insurance companies. I always thought that it was standard practice but being on here I have learned that it's not. Goodluck and I Hope you find a better PCP.

Im so very sorry you are giing through this but I tell you I know a God that will open doors for you that no man can shut, and that is Jehovah Jarah our provider Jesus went through everything for us even to die on the cross for us so come on lets build up some faith that monster is not a monster shes what you would call a stumbleing block that you can walk over by faith. God is on your side so be not dismayed the Lord God is most certainly with you.

From a careing lapband friend

Mrs. Peace

Wow, Shorty, what a PITA your doctor is being! I wouldn't wait or ask, I would just write the letter myself and present it to the office staff to have it signed. I'm sure your surgeon's office can give you the text, which you can tweak to be specific to you. Don't sit around and wait, but don't be rude either. Just do it!

I have the Doctor from HELL...........I have completed all the prerequisites for appoval and the surgeon is ready to submit for approval and my PCP is standing in the way. She was with me all rhrough the process but when it came time for her to do her part ( writing the recommendation ) she refuses....saying that she does not have the time to do that, and further that my insurance co Horizon BCBSNJ doesn't pay her to do these kind of things....I even offered to pay her myself and still she refused. She faxed copies of the patient chart records tto the surgeons' office and said that he (the surgeon) should be able to get whatever he needed fron that....I have called the Ins co. myself to try and see if we can get around this MONSTER..and was told to have the surgeon get in touch with the Utilitization Dept...My question is ...have anyone here have this kind of issue and if so how did you manage it....

BTW....obviously I will change my PCP..but she has been my PCP for eight years and I don't want to change midstream....but as soon as this is approved!!!!!!!!!!!!!!!!!!!!!!

You know what... you are her employer at this present moment... and if you have an HMO she is required to write a letter for you. She can have an assistant of hers to write it if she dosen't know how... That's what the real problem is. What a jerk. I would call her and make her staff aware that I would report her to the american medical association, but that prob. wouldn't do any good because she it's really not like she prescribed u the wrong medication or anything.... What a jerk

:blushing::mad2:

Edited April 23, 200818 yr by mstrina27

Oh my gosh...what a pile of poo. I would be on the phone everrrrrrry day calling to get that letter. Eventually, it will be easier to write the letter than to have you calling.

The other thing you might do is write the letter yourself....and just ask her to sign it.

But, seriously, change PCPs. I've been with my current doc for more than 7 years. She has been amazing. Watching my weight go down....then up....then down. Nothing but supportive and when I asked her for the letter, she was happy to do it. A week later, I called the surgeon's office to see if they'd gotten it and they said, "We have it right here and it's even done in a nice font."

I'm outraged by your experience. Just...shocked.

Best of luck to you.

Well I've dsecided that I'm going to write the letter myself...and present it to her for signing....

Anyone have sample " medically necessay" letters that I can copy/download....

SHORTY

I typed out my letter and took it to my Dr, had her copy it on their letterhead and sign it. I scheduled an appt specifically for that.. figured since I paid the copay.. she was getting paid to do it. That's what worked for me.. Good Luck.

DATE

To whom it may concern;

I am writing this letter on behalf of my patient XXXXXX DOB XX/XX/XXXX. XXXXXXXX is XXXX tall and weighs XXXXlbs. and a BMI of XX.X with a diagnosis of morbid obesity (278.01). XXXXX has been excessively overweight for most of her adolescent and all of her adult life and having attempted and been unsuccessful at many different methods of weight loss, would certainly benefit from some sort of bariatric surgery.

In addition to morbid obesity, XXXXX also suffers from the following co-morbid conditions, sleep Apnea (780.57), GERD (530.81), Shortness of breath (786.05), Stress Incontinence (625.6), Back Pain (724.2), Knee Pain (716.98), and has a positive family history of obesity, hypertension, diabetes and hypercholesterolemia. (These are just a few that may qualify you)

XXXXX has tried many method of weight loss including a physician administered diet and diet pills with an approximate weight loss of XXlbs only having to gain the weight back plus more. (Weight Watchers, Jenny Craig etc..)

XXXX is limited due to her co morbidities in the ability to exercise however she is currently a member of XXX fitness club with a weight loss of 0lbs.

I feel that XXXXX would benefit greatly from the Lap Band Procedure (43770) as a tool to help lose the excess weight and lessen the co-morbidities and regain a more healthful life.

Sincerely,

Edited April 25, 200818 yr by Maya314
:D