Question:
What is Primecare in S.California's criteria for approving WLS?

My request for surgery was denied. I had chosen Dr. LePort in Fountain Valley, CA. as my surgeon and his office was absolutely NO HELP during my appeal(which was also denied). I decided to check out Dr. Terry Sandefer in Corona, CA as he now does the LAP procedure. When I called his office, the lady I spoke with (Vicki) was soooo understanding. She listened to my story for a good 15 minutes and seemed to understand. She told me that Primecare Medical Group has referred a lot of patients to them. So my question is, is there anyone out there that has Primecare in Southern California and if so what is their criteria for WLS? I have my first appt. with Dr. Heather West in Redlands, CA on 3/14. Thanks for your help!    — Carole S. (posted on March 6, 2002)

March 6, 2002
I am nowhere near S. Cali, but I looked up the insurers section of this site, and found some people that could probably help you figure this out: <HR> primecare/healthnet (03/05/00) Open Other Weeks to approval : 58 Pre-Op BMI : Comorbidities : Policy : Must be medically necessary Comments : they wern't to bad but they just kept putting it off, i had to stay on top of them and keep calling and do all of the calling myself and not wait for the drs, or anyone else Source: [email protected] -------------------------------------------------------------------------------- Primecare/Healthnet Approved after first letter (02/23/01) Open RNY Weeks to approval : 30 Pre-Op BMI : Comorbidities : Policy : Don't know Comments : Hard but be ferm and hang in there. Source: [email protected]
   — sbinkerd1