Question:
Has anyone w/GREAT WEST in TX. been Approved? Please reply!

Need help with an approval strategy/doctor here in TX. Live in the Houston area, but would take any info. related to Texas. Denied once, two yrs ago., but now I have a lot more medical records to support claim. Please help by providing any information!    — Lee Ann M. (posted on April 1, 1999)

April 2, 1999
if any of the complications of your obesity constitute a life threatening situation, and you can get yout physician to verify this it will be difficult for the insurance company to deny you benefits.
   — AL M.

April 15, 1999
I think the first place you need to check is your policy to see if there is any exclustions or not. Than, if you find that the procedure is covered, check with Dr. Beryl Harberg, 713/7955322. It is very important that the doctor that prepairs your request for submittal be very complete in its own right. Thus the Doctor should be very experience in dealing with patients and their insurance companies and know what to say to get that approval. Myself, my mother, and 2 acquaintances I have met all have used Dr. Harberg and have gotten approvals on the first try. My approval took 1 month and one day. I have cigna, my mom has united health care , and so does one of the other ladies and then i know of a lady with edna and they have all been granted approval in tx and used dr. harberg.
   — cindy N.

April 15, 1999
I recently got approval with Great West, live near Dallas, Dr. Hamm in Plano was my surgeon. I had surgery 3/29/99 and am doing great. It took 3 months and an appeal to get an approval. Also I'm an attorney who worked for a Life and Health Ins. Company for 5 years. I had to use some of my legal threats to get them to come around. It was obvious they don't like to approve this surgery. I will help you any way I can. One of their toughest obstacles is showing one year of documented previous weight loss attempts in the last 3-5 years. Good Luck!!!!
   — Jim T.

April 15, 1999
Received my approval this week. I am having my surgery with Dr. Srungaram in Houston. Darline, is a wiz with insurance approvals. If you have not chosen a surgeon, give Darline a call, (713) 88-2797. Best wishes, Ed. T.
   — [Anonymous]

October 18, 1999
I live in Dallas Tx. and was approved today.!
   — Mary C.

October 18, 1999
I also have Great West One Health Plan PPO. I have my book right here that says they exclude obesity treatment. DO NOT let this discourage you. I have seen people with great west approved left and right since I asked about this same question. I think one of the key factors you should focus on are your co-morbidities. Chances are they will not approve you just for weight loss however if you have a BMI above 40 and at least 1-2 life threatening co-morbidities then have your Surgeon write a letter emphasizing the co-morbidities and you should be ok. Email me and keep me posted as to your success. I am having to wait that damn 1 year pre exist. My email is [email protected] Char Gibson Tulsa,OK USA Age 28/5'7"/468/BMI 75.8
   — Char G.

October 19, 1999
Great West approved me with NO life threatening co-morbs. I was told that they Do cover wls, that most people are denied becuase they don't submitt all the paperwork. The insurance company lost my paperwork 4 times. I only made progress after i was assinged a pending case manager. THen i called her 3 to 4 a DAY! When i was approved she called me herself to let me know. Good Luck!
   — Mary C.

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