I accessed my super and APRA require a letter from a GP that has treated you. APRA now needs the letter to be stated the same as the sample letter in the forms. The dr can add other issues but it needs to read life threatening and also not covered by the medicare system

I had to have my GP redo mine twice because it did not have the correct wording


Jane

so if my letter from my new gp (as i have moved) doesnt cut it with apra, she wrote life threating blah blah blah...

Can i just get one from my old dr, or does it have to be the referring gp??

Yeah for all of us!

See you next week sleeve buddies! lol

Cinni

That's great news, Lynette - woo hoo!
Chris

WHOOO HOOOOO. YIPPEE, we can all get done together. Saw Dr P yesterday for 2nd appointment, all the paperwork done now. See you next week.

Way to go Cinni...

Cinni - YAYAYAY!!!

congrats cinni :)

applesauce

Great News all round I say Cinni ...... see you next week

Oh, that'd be great, wouldn't it, Shanna? To be all together and get it done. Not to worry - you'll have all your 'puter buds when you get home.
Chris

Oh Cinni- I am so excited- the early September Sleeve Sextet is set! Now we can do it (almost) together. Wish we were all in one big recovery room in the hospital together comparing scars. Your being approved has been the best part of my very, very long day.

That's fantastic, Cinni - great news. I'm very happy for you.
Chris

I decided to ring Apra and I am Approved!!!!!!!!!!!! Yippeeeee!!!!!!!!!! I will be poorer but thinner.

Cinni

Yay Cinni

Your fellow September sleever awaits your final OK with excitment.

I rang them again today and they said they would know Friday.

Great News eh!! Well looks like some of us are gonna be around the water cooler .....
So Cinni - get your fund act into gear girl!

See you late next week sometime ladies!

You next Cinni.

Way to go Lynette I bet that is a huge relief.

Whohay!!! Well done and Congrats!!
Its all full steam ahead for you now newlife!!
Hugs,
Hayley

That's great Lynette - it's such a relief, isn't it? Now you can relax and start to enjoy the rest of the journey.
Chris

YIPPEEEEEEE!!!!!! I got the official letter from my super fund to say all OK, money on the way.

PHEW

Simple it definitely states one from your specialist (surgeon)
and one from your GP.

Do you have a date yet? I am just doing this in a hurry if I had more time I would just go to a Dr until I found one willing to write it.

Have you got the Apra application? If I had my time over with the first Dr I would have asked him if he thought morbid obesity was a life threatening condition? I would have taken a pre-written letter that meets the criteria and showed him what you want him to write. There is a guide in the apra application.

If he/she is unwilling to say that then they can also say you are in chronic pain or chronic mental pain and the op is necesary to alleviate this.

Good luck

I am about to ring Apra and found out if they got my two letters, not sure if they will be able to tell me if I am approved yet though but I hope so. I think I need to start paying the bills.

Cinni

Oh where oh where did our smiley's go -oh where oh where did they go????

hmmmn Miss Hayley- have you been off looking at your butterflys farting instead of finding our smileys???????????

We need to get them ready for when all the September sleevers have their approvals- or at least the first half of the group.

Dear Simple- The rule of thumb around here which is certainly nowhere near you is

BMI of 40 plus
or
BMI of 35 plus with comorbid conditions

Of course- private pay is different but a lot of surgeons won't operate even on private pay if the starting weight is not high enough- too afraid of malpractice suits I expect.

Hey, Simple
APRA says that you need to have a letter from your GP and a letter from your specialist, so I guess it depends on who the assessor is.
Chris

Hi guys,

Been reading this and begining to dread asking my gp for a letter that meets apra's requirements.

i have my pre-surgery appoints coming up with assessor. exercise and dietician. do you suppose the assessor would likely be willing to write a letter since they deal with this issue more frequently? saves me going to gp just to get a letter, and also from having to convince him what to write...

simple.

Sounds like a productive day today. Let us know how tomorrow goes.

The doctors surgery tried to fax the letter to Apra but it wouldn't go through. I couldn't stay any longer so the receptionist said she would keep trying. So i just hope it went through and I will ring Apra tomorrow to double check they got it.

Oh Cinni- Thank goodness - are they sending the letter out by fax or email? Fill us in on the details.

Well I got up early and drove all the way to Perth and when I got to the doctors surgery they said 'oh sorry the doctor isn't in today he has hurt his back, we tried to call you'

Ummm yeah using my old number. :[img]http://ww

Luckily they took pity on me after driving all that way and another doctor agreed to squeeze me in and write the letter.


Lets hope this time it is written correctly.

Cinni

Hey Cinni- We are thinking about you. That doctor better come through for you or he'll have the entire forum descending upon him.

Hi Cinni,

Hope that your appointment with your old GP went well today. Can’t believe that that you are having to go through all this stress. It’s stressful enough without that.

Looking forward to hearing the positive news when you get back from Perth.

Cheers
Emjay

Good for you Cinni- I have my fingers and my toes crossed for you- Well at least mentally crossed.

Well I am definitely going to my old doc as the one here is being ridiculous. He has a moral issue with saying I have chronic back pain even though last week he prescribed back pain meds. He has an issue saying I have a life threatening illness.

Umm well isn't that what obesity is or is it still just fatties too lazy to exercise! Grrr

I am pretty sure my old doc will help me.

The surgeons office was so helpful they even tried to ring my dr who still refuses to budge but asked if I could come in to see him for another appointment. Hello I don't have time to wait.

Ok vent over

Shit I am a grumpy old F*%$ since I started Opti!

Wrote two long replys this morning and must have mucked up both but the essence was to type up your template letter so that it has all of your pertinent information filled in so that all the secy. has to do is retype. The less someone else has to do the more likely they are to do it right.

Your September Sleeve Bud.

I rang my old doctor and he isn't in till monday so I made the appointment and will drive up to him. It is so worth it Chris. :)

I had a feeling it was wrong but the gp refused to change it.

Dr P has already changed it and sent it to apra so I am just waiting on the gp's letter.

Well I think that is enough stress for one day. :[img]http://sm

cinni

Oh, Cinni, what a pain in the butt!
Actually, my GP didn't write the right things either, even though I gave her the wording - also had a problem writing that obesity is a life threatening condition.
Eventually, though, she did what yours did, and fiddled it - though, because I have diabetes, she was able to write that that was a life threatening condition that would be relieved by the op.
Took me a few weeks to get it organised, but that was before I even sent it in - I just wouldn't send it until it was right, because I didn't want them to knock it back.
Even if you have to drive the 3 hours to your old doc, it would be worth it, wouldn't it? And maybe s/he would even do it if you just made a call and asked for it - and specify wording, too!
Best of luck
Chris

OMFG is right. I am surprised that Dr P's letter wasn't OK because they use a template, so all our letters would have been worded almost identical except for maybe our individual medical conditions. But, that said I am sure it will work out OK, try not to stress too much. Bloody red tape. :http://smileys

OMFG Apra rang me and they can't pay out because the wording of the doctors AND the surgeons letters does not meet the criteria.

I have called the surgeon who are faxing it through to apra fixed up but do you think i can get hold of the doctor?!!! GRRR Even if I do he may not change the wording he wouldn't write a life threatening condition but wrote will lead to a life threatening condition. I asked him to change it and he refused. I also said he could say that I suffer from chronic pain which is true but as he doesn't know me well (new doctor I have just moved) je hasn't treated my back pain so he didn't write that either and said his letter would be fine as it was similar to the surgeons. Now it looks like I may have to drive all the way to Perth (3 hours away) to see my old doctor who knows about my chronic pain and medical history!



I am not out of the game yet though as Apra did say if we get it worded right we should get it.

Shanna is that you asnew1

Nice to meet you!

Cinni

Off to work now girls- or as we say here in the US- Off to make the donuts ....

but great work Lynette. You are next up Cinni- go get those guys to cough it up- we need your approval.

Cheeky Cinni. Much as people knock the public service, we do actually work pretty hard and without us where would you all be.

except when I'm on this forum, naughty, naughty.

Good news, just spoke with my super fund and it would seem they are processing my claim as we speak. PHEW.

You next Cinni and Asnewme (US insurance)

What was that Lynette? Without you oot there'd be no tax? lol

No I agree we all have to get approved. So we can go through this together. :)

I don't care if I don't get the money before the op but I just need the approval.

Couldn't agree with you more asnewme1. I actually work in the public sector and even I, as a bureaucrat, hate bureaucracy (still without us there would be no tax $ going to areas of need). Hopefully we will all get our $ before surgery. I certainly don't want to unnecessarily delay things and as you said, it would be nice to tick that box as done.

Lordy, Lordy- APRA, Oxford,

Bureaucracy- no matter where you go, there is bureaucracy. I have been assured by my physician's insurance specialist that my approval will come through in the next 3 days, and I know I am being a baby but I am starting to get really nervous about everything right now- and I wish I could just cross this item of insurance approval off my list.

Listen- we have to get approved Cinni, Lynette- we are sleeve week buddies

I guess I should be grateful that I am running my biggest construction project right now and it is at the most critical point between now and the end of August. At least it keeps me from spending more that 3 hours a day on this forum. Otherwise I might take over Chrisbychic's position as top poster!!!!

Just as well you rang a second time Cinni. I got a bloke when I called, so it wouldn't surprise me if he gave me the wrong info anyway. Hopefully you will get word soon. We will all cross our fingers and raise our eyebrows together.

Lynette I got my hubby to call yesterday and he got a guy who told him we don't have a shit show of hearing anything before the 9th of Sept. Hubby tried to explain our situation and he said the only way they will escalarate our paperwork is if the super fund can guarantee and provide proof that they will have the money out to us before the 4th of Sept.

Hubby then rang his super and they said it will take 3 weeks! Eeek No money until at least the 19th by the time the paperwork is all processed from Apra and that they can not do anything about it. :http://smileys

So we had to decide whether or not to do the op anyway and put it on the CC or Mortgage and have faith that it will be approved. :[img]http://sm

Well I dodged a bullet hopefully because I decided to ring up and try again. I talked to a lovely lady who said it wasn't a problem and she would escalate our claim and to ring up and find out if I am approved in a few days! Double PHEW!

Just shows you it depends who you get sometimes. I think the guy was just being a prick, needless to say if i ring back and he answers I think I will just hang up till I get the sweet lady again lol.

Cinni

Some relief by the end of today. GESB are already on to it and have requested some additional paperwork ie certified ID and bank details etc and the assessor indicated that she would put it through asap given the urgency etc and it will just need her supervisors sign off. So should have the $ before surgery fingers crossed.

PHEW!!!!! :

Cinni, it may be an idea to give APRA a call and stress the urgency etc ie with your surgery date so imminent and maybe they can hurry it up a bit. It would seem that they are running behind at the moment and it may take in excess of three weeks otherwise.

Thanks to all for your words of encouragement.

Newlife: Bummer about APRA and the lost time Lynette but did your fund give you any indication on how long it would take to clear? I think that Dr P is fairly flexible especially if you can keep him in the loop if things get a bit tight for you. So I wouldnt panic just yet matey

Oh, Lynette, what a pain in the backside. If only we'd known!
Good luck getting it sorted quickly - let us know how you go, okay?
Chris

Lynette shite!!!!! Praying it all goes through for you! Bloody hell. They should have someone opening the letters to check for things like that initially. ggrrrr.

OMG I only just sent mine in. Ekkk Have to pay soon don't we?

Cinni