Re: clarrification please

[Guest guest]

Please e-mail me his answers. Those were good questions. Thanks,

Kaufmann

[Guest guest]

Hi. I will try my best to help with your questions. The very first

step is to fill out the patient information form on www.clos.net.

After you do that, Dr. R's office will send you a letter that you

will need to send to your insurance company(better yet, have your PCP

fax it so that it will look like a referral from them). It is great

that you have your PCP behind you. You can get him or her to write a

letter to the insurance company explaining the weight related health

problems that he has been treating you for and give your weights for

the last two to five years(Some insurance companies need two and some

need five). If you have been obese for five years, then have your

doctor give documentation to your insurance company stating those

weights. You can schedule your clinic appointment with Dr. R yourself

by calling his office(number is on his website). If you live out of

State, you can schedule the clinic the day before your surgery so

that you don't have to make two trips. Dr. R will speak with you

after clinic and that is the only " appoinment " you will have with him

before surgery. When you call, you can ask for who schedules

the clinic appointments. You can go ahead and send in your

information to the insurance company as soon as you get it. Some

insurance companies require that you see Dr. R before approval, but

if you go ahead and send the info in, you won't have as long a wait

and can always send proof of your visit if they ask for it later.

I have several co-morbids, but only sent in my sleep apenea results

with my packet because none of the other stuff was going to affect my

surgery. I think that he only needs things that could cause you

problems with the surgery. Maybe someone else can comment on that.

You should be able to get your PCP to write up something to the

effect that you have been weighed on a monthly basis because you have

been dieting and needed medical monitering. That should satisfy the

insurance requirement of a medically supervised diet as long as you

send a list of the types of diets that you have tried in the past and

the results of each diet. I did not have to pay the fee, but I

remember reading that Dr. R wrote that he will consider " working

something out " depending on a person's financial situation. You might

want to ask Barb or email him regarding that. I had surgery one and a

half months ago, and was able to get surgery one week after mailing

my packet. It took him about three days to approve my packet and I

had insurance approval. If I can help you at all, please email. I

only have a computer in the evenings right now, but I will get back

with you. Good luck with everything.

Stormy in Alabama

> I have read the steps to getting the MGB..now the questions..

> 1.) My PCP is all for me having the surgery. In fact, he brought

> the information about Dr R and the surgery when I went for my last

> month's check-up. So, does the PCP contact Dr R for an

appointment

> to clinic or do I contact him? I have sent request for clinic

visit

> form. Now what?

> 2.) Does the PCP contact the insurance company now or does Dr R

> after my visit with him at the clinic? Or, am I to contact them

and

> when?

> 3.) For patient records, How far back does he want my records?

The

> last five years, what?

> 4.) My weight loss attempts have not been physician monitored any

> more than my monthly visits for med check. Will that be enough?

> 5.) Why the change wanting the $$$ for the clinic visit and

surgery

> despite insurance? I have been told we will be reinbursed, but the

> amount is still $$$. The extra $$$ is hard to come by with a son

> getting ready to enter college. I will sell my handmade dining

room

> furniture before backing out of this. Interesting, huh? Selling

> something to eat off of so I can live longer.

> 6.) After Dr R approves me, how long will it be before I can have

> the surgery? I have to let work know so I can make plans.

> I realize this is long and I apologize. I just want to make sure I

> am on the right track as I want to sure to be approved by Dr R for

> surgery.