plastics approval procedure question...
I would assume once your name is in the OHIP system for applying, it's there. You might find another doc better at filling out paperwork or such, to get you approved, but I think they might look at the first rejection letter.
Bonnie
Bonnie
I can do hard things, life is teaching me that I can.
Lost 222lbs with rny, 20 lbs regain.
Plastics, July 2010 with Dr. Sauceda in Monterrey, Mexico
I have written my experiences here several times..had a consult in Scarborough in Sept 2011...didn;t hear back until February 2012, was DENIED..based on my pannus was considered borderline.
My plastic surgeon was thorough and sent pictures (you sure can't modest for that)...and she told me based on her experience doing this surgery my pannus overhang fit the necessary guidelines laid out by OHIP.
At this point in time.
I have since decided to appeal....IN PERSON..which will mean I have to travel to Toronto (most likely) to be heard by a panel of 3 individuals, (1) from the Health Services Appeal and Review Board, (1) OHIP's representative and a court reporter.
I have sent in my appeal paperwork and will now have to wait and see when my Appeal date will be and what documentation OHIP will be providing.
Members of the Public are entitled to attend, but I can request a private hearding due to the explicit information discussed.
There are SPECIFIC guidelines in the Health and Safety Act...Appendix D (16), that outlines the criteria necessary for OHIP to grant coverage of a pannilectomy. Review it.
The Health Services Appeal and review Board works on behalf of the appelant in teh way that "The Board can change OHIP's decision if it is satisfied that OHIP made a mistake in interpreting the Health Insurance Act in your case."
All I can say.....is just because your pannus is incovenient or appears large...if it doesn't fit the criteria laid out...and you do NOT have substantial documentation regarding infections/rashes etc...it may be an uphill battle.
I am sure once you have seen a plastic surgeon and if you are denied, your informaiton is kept on file and easily accessible via your Health Card #. If you simply plastic surgeon hop...I doubt there will be any change with OHIP...UNLESS....you have specific documented changes (by a physician).
you are your own advocate.
My plastic surgeon was thorough and sent pictures (you sure can't modest for that)...and she told me based on her experience doing this surgery my pannus overhang fit the necessary guidelines laid out by OHIP.
At this point in time.
I have since decided to appeal....IN PERSON..which will mean I have to travel to Toronto (most likely) to be heard by a panel of 3 individuals, (1) from the Health Services Appeal and Review Board, (1) OHIP's representative and a court reporter.
I have sent in my appeal paperwork and will now have to wait and see when my Appeal date will be and what documentation OHIP will be providing.
Members of the Public are entitled to attend, but I can request a private hearding due to the explicit information discussed.
There are SPECIFIC guidelines in the Health and Safety Act...Appendix D (16), that outlines the criteria necessary for OHIP to grant coverage of a pannilectomy. Review it.
The Health Services Appeal and review Board works on behalf of the appelant in teh way that "The Board can change OHIP's decision if it is satisfied that OHIP made a mistake in interpreting the Health Insurance Act in your case."
All I can say.....is just because your pannus is incovenient or appears large...if it doesn't fit the criteria laid out...and you do NOT have substantial documentation regarding infections/rashes etc...it may be an uphill battle.
I am sure once you have seen a plastic surgeon and if you are denied, your informaiton is kept on file and easily accessible via your Health Card #. If you simply plastic surgeon hop...I doubt there will be any change with OHIP...UNLESS....you have specific documented changes (by a physician).
you are your own advocate.
prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss.
life is AMAZING when you continue on the right path~!. Use your surgeons gift to the fullest~!
Mary
surgery done in Duluth, MN
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