One Small Step Forward
I had my appointment with my PCP this morning. He gave me a referral to a bariatric surgeon with no fuss whatsoever, which did not surprise me, since he had encouraged me to consider WLS a year-and-a-half ago. What did surprise me was that he referred me to a local surgeon, Dr. Monte Schwartz, whom I did not think was one of PacifiCare's providers.
In my preliminary research, I had found positive information about Dr. Schwartz and read good reviews written by his patients, but he was not listed in my new 2007 PacifiCare FEHB provider directory. I was expecting to have to go to Dr. Hilario Juarez in Phoenix, almost two hours away, because he appeared to be the only bariatric surgeon listed in my directory. Dr. Juarez has a great deal of experience and mostly glowing online patient reviews, and a good friend had her very successful WLS with him, but I wasn't thrilled about the prospect of having to deal with the travel as an added issue with the WLS and being so far from my surgeon and his aftercare program post-op.
When I called to make my appointment with the bariatric surgeon, I explained that I had been referred by my PCP. The receptionist asked for my insurance info, and I explained that it was PacifiCare. When I mentioned that the PCP's referral letterhead said PacifiCare Secure Horizons, she stated that they couldn't accept me as a patient with that type of PacifiCare insurance, and that they might have to send me to Phoenix.
Fortunately, I took out and looked at my insurance card, which said PacifiCare Signature Value, and told the receptionist that my card didn't match the referral letterhead from my PCP. She said the card information was what was important and that my PacifiCare Signature Value plan was no problem, and then she scheduled me for an appointment in January with the surgeon's RN/Clinical Coordinator of Bariatric Services. Yeee haw!
I am hopeful that my insurance will indeed cover Dr. Schwartz. Although he has been practicing for less time and has not done as many surgeries as Dr. Juarez, he has excellent training and credentials and has done almost 500 RNY GBPs, plus many other abdominal surgeries as well. I would definitely prefer to have the surgery here in Tucson and be able to participate in the aftercare program.
I know that this is just one small step in my WLS process, but it is a step in the right direction and I am delighted!
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