Looking for Primary Care that is advocate of Gastric Bypass - Page 2 - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

katlover66 · 12-31-2004, 04:56 PM

You are right he is very caring. You also know how professional he is. Can you imagine him absolutely floored. I couldn't either until I floored him. He was like a little boy who just saw his first shiney bike WoW!! every other word.

Deana · 05-09-2005, 08:22 PM

Hello to everyone that responded to my request and thank you. I did find a physician--actually a physician's assistant and I have to say, I've had the BEST experience with medical care that I have ever had in my life at North County Internist. Truly. They made me feel so comfortable that I was able to tell her everything that was going on and I have never been treated with such kindness and caring, it made me cry. She was very reassuring.

I have been referred to Dr. Callery's office, I got the call from my doctor's office today

. I didn't expect to walk in off the street and immed. get referred, which I didn't and that's okay, because my health is the #1 goal. That being said, I have to admit, when they called me today.......it was like this huge weight had been lifted off of my shoulders and the RELIEF that comes from knowing that someone actually listened and that I am going to be able to live again is sooo great. I can't wait until I can sleep without the c-pap or until I have a great nights sleep....you know the one where you wake up in the morning and just give that great big stretch from head to toe and then you jump out of bed ready to face the day and your life??? I can't wait.

I know this is just the first step and that there are many more but still, pretty exciting. All in all, a very good day.

Thank you for taking the time to point me in the right direction.

Deana

eyesthatkissu · 05-10-2005, 08:32 AM

Hey girls....

We need to be careful of mentioning the names of our PCP on the public board. My doctor, which I was refered to by this board, has made it very clear that the insurance companies are keeping an eye out for things like this. She even said they "red flag" certain names of PCP's who refer for the surgery on a regular basis. Maybe it's an exageration, but I just think we should say the actual names in a private message, just in case! I know we'd all hate to have our cases scrutinized just because of the PCP we use. We have enough troubles! Just my two cents! Love ya bunches!

JohnsWife4Life · 05-10-2005, 09:14 AM

They can red flag all day long, bottom line, if ya fit the criteria you belong. If PCP is abusing this privilidge then they need to look at them. I have heard this before. I think it is a bunch of bs. The requirements are BMI 35 with co morbidities. If you fit that, and your doctor sees you are in need of the surgery, he shouldn't and won't be penalized for that. If you are looking for a doctor that might get a skim off the top if they refer to certain surgeons office, then I see the point. I want a pcp that can withstand all the scrutiny. That is what this surgery is for, to save our lives. My PCP can be scrutinized all day, they won't find any. So if I were you I wouldn't want to employ any doctor that was afraid of scrutiny.

eyesthatkissu · 05-10-2005, 09:18 AM

I don't think she's afraid of scrutiny persay, but two of the patients she had and referred, who met all of the criteria were denied, and required to be put on a 6 month medically approved diet. That's within a few months of recieving surgery, and again, they met all the rquirements. I know one of the girls personally, and she is devestated. I'm just of the belief, I will do whatever it takes to make sure my case goes smoothly and without something being thrown at me in the last minute.

JohnsWife4Life · 05-10-2005, 10:10 AM

Many people are denied, they need to appeal. Believe it or not, a 6 month documented diet is prerequisite for many insurance companies. What would someone say if you were recommending a cardiologist too much?

msterry · 05-10-2005, 01:06 PM

Deana,

When I finally got my nerve up to have surgery I got on the phone and called Dr. Callery's office and asked what medical groups refer to their office. A couple of my friends had surgery with Dr. Callery so I knew that he and his office is very well respected. They told me that Sharp Inland Medical Group (which is different from Sharp Rees Steely or Sharp Healthcare) did refererrals to their office. To make a long story short I immediately called my insurance (Blue Shield of Cal, Access plus and picked a physician in their group. From the time I was able to get my first appointment (Feb 10) until the date of my surgery(May 6) went very quickly. The medical group approved everything very quickly and they are just on the other side of Dr. Callery's office. I was able to get my gall bladder scan within a week, I had my mammogram the same day of my first visit. etc. It was serendipity. For me they are very close as I live in Carmel Mountain but I'm sure there are many more out there.

Terry

Shows how out of it I've been you've already got a doctor, Good luck and my BMI was 52

bridgetgirl · 05-10-2005, 01:43 PM

Hey Traci, scrunitization is a bad thing. Robins point is right on. There are some PCP's name that when you google it this site used to pop up. Some PCP's ae very, very supportive of WLS and will do whatever they can and even fib a little to get their patients approved. Just because they are all too familiar with the insurance carrier politics regarding WLS. Im sure you can relate...... so I spoke with Dr Callery about this problem if naming supportive PCP's by name on the board and he agreed also that is nto a great idea to name Dr's by name.

The thing is, if a PCP is too supportive their recommendations by start becoming denied because that individual may be judged that they are too quick to refer to WLS without trying more diets. I know, I know diet schmiet, but thats the way the HMO ball bounces!

So FYI if anyone posts that they are looking for a PCP, send that individual a private message with your suggestion and recommendations. Thats how we have been doing it lately. Actaully, I dont think anyone has popped up here in a long time asking for a referral.

eyesthatkissu · 05-10-2005, 05:55 PM

Also as much as we'd like to think WLS is a normal referral and a wonderful idea. Many insurance companies just don't want to pay for it, they will look for any reason to deny this 20-30 thousand dollar surgery. Just be careful!! I just want everyone to have the best possible outcome!!

lealphachienne · 05-10-2005, 10:56 PM

Uh, my insurance was billed for $54 K!