Well, it has officially been 3 weeks since my initial consultation with Dr. Wongsa. I called the insurance company today to see if they had received the pre-determination letter yet.
THEY HAVE!!! 
The Representative said that she would put a “rush” on it. From what I understand, a nurse has to review the documents and determine that it is medically necessary. She said it looked from all of the documentation that it would not be a problem. She warned me that I will probably have to see a psychologist.
I know that seems to be a normal hoop to jump through… but I’m nervous anyway.
Anyway… she said that in about 2-3 days, the nurse would get with Dr. Wongsa’s office and let them know what the next step is for me.
I called Ruth at Dr. Wongsa’s office today to ask the status of the insurance… It has been one week since my appointment. She said Dr. Wongsa put the packet on her desk today for her to “send.”
I don’t know if she mails or faxes or what…
Well, I had my consultation with Dr. Wongsa on Tuesday in Houston. My DH went with me. I have to say that I was extremely pleased. His office was very small, but that didn’t really matter. He and his nurse, Ruth, were soooo nice.
He had people waiting, but still took an hour with my husband and I… explaining everything and making sure all of our questions were answered. I didn’t feel rushed at all. He didn’t pull a “Dr. Scumpia” on me. He said that my BMI alone qualified me even without any of my co-morbidities. The thing he said that really touched me was that this was not my fault. I really appreciated that. I really like Dr. Wongsa so far.
So, now, I just wait for my insurance approval.
Well…
I have set up my consultation appointment with Dr. Wongsa in Houston on Tuesday 2/27 at 2:15pm.
I’m very excited about getting the ball rolling. My husband will be going with me, so I’m excited about him learning all he can as well.
I had a very rough day yesterday and wasn’t sure what to do. Thanks to everyone who told me not to give up and to either demand a referral from my PCP or switch PCP’s… I did it!
I left a message with my primary care physician’s (Dr. Marietta’s) nurse and said “I want a referral to Dr. Vorivat Wongsa in Houston for the reason of MORBID OBESITY.” MUCH to my surprise, the nurse called me back and asked for Dr. Wongsa’s phone number and said “ok, it will take 4-5 days for the referral to go through. you can go ahead and make your appointment!”
OH MY GOSH!!! I was sooo expecting to have to fight that I was speechless when she called me! Wow. Now to call Dr. Wongsa and set up a consultation.
I’m so torn… I don’t know what to do… I feel so depressed…
I had my appt with Dr. Scumpia today. She won’t give me the referral. She says I’m only overweight and not morbidly obese. Excuse me, but since when was a BMI of 42 considered simply overweight? Can she please tell that to the insurance company so I can qualify for life insurance? I’m sorry I’m so upset. It’s just… why should I not qualify simply because I hide my weight well? She also says I’m still young… well, no duh… everyone I’ve talked to who has had the surgery has said that they wish they had done it 10 yrs ago!
To top it all off, I hit an all-time high for me of 251 lbs today. I’ve never weighed 250 before. And now she wants me to go on the liquid diet… I’m terrified of the liquid diet…
My mom and brother have each done the liquid diet twice… my mom is now back to her pre-liquid diet weight and my brother is 100 lbs heavier than when he started it.
I realize that in comparison to some, I am not as heavy. But I feel MISERABLE. Don’t they make a cut-off for a reason? 100 lbs overweight and BMI of 40+… do I not qualify?
Well, my referral to Dr. Scumpia (endocrinologist) went through. I called to make my appointment, and the first available is February 19th!!! uuuggghhh
Well, I’m trying to look at the bright side and realize that it gives me more time to “do my homework.” I want to take TONS of information with me. i.e., family medical history, my medical and diet history…
Well, I took the advice of Sandy & Terri on the CenTex support group list… and called Dr. Marietta’s office (he’s my PCP). I asked if he would please switch my referral from Dr. Moore to Dr. Scumpia. He said, “yes”! YAHOO!
So here’s my latest concern… I logged onto www.obesityhelp.com last night and was searching for bariatric surgeons and insurance information. I saw that other people have really had a hard time with the insurance company I have. Apparently, even though they cover the surgery, you have to give them a lot of proof that you’ve done everything you could… i.e., 2 years of dr. supervised diets. Well, my doctor always told me to eat right and exercise… he never prescribed diet pills or anything like that. Of course, I’ve done everything I could think of (Atkins, Weight Watchers, Cabbage diet, grapefruit diet, etc.) I’m scared!
Oh, I also found out that if/when I do get approved for the surgery, I’ll have to go to Houston (but not Dr. Ferrari, he’s not on my plan). The San Antonio doctors aren’t on my plan either.
I went to the CenTex group meeting on Sunday. I am 118 lbs overweight, BMI 41.25… and I’m looking to have RNY gastric bypass surgery.
My insurance does cover it, so I went to my primary care physician on Friday to beg for a referral. He did not know much about the procedure, and wanted to do some research and possibly refer me to an Endocrinologist. (first he said he wanted me to do the liquid diet, but after talking to him about it, he changed his mind)
He just called me back and said that he’s referring me to Dr. Moore at the old Austin Diagnostic Clinic (now North Austin Medical Center). So as soon as the referral gets approved, I’m gonna make an appointment. And you can bet that when I go this time, I’m going to take a huge packet of information with me.
