Priority Health approval

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Hi Nancy, I have Priority Health and just a little bit ahead of you in the process. So far I haven't had any problems with the evals except for the behavioral health visit. When I went in to meet with the Psychiatrist the secretary just happened to check what my co-pay would be and it turned out I had to get approval through the behavioral health dept at Priority Health. So I had to cancel my appointment, go home and call PH. I took about 15 min talking to a PH rep from the Beh Health dept and I was approved. Please call PH and double check that you are approved for the BH part. I thought I was approved already but luckily I found out I wasn't before I went through the appt. I have also done the surgeon visit, nutritionist, sleep study, chest xray, blood work. As soon as I finish my BH testing then my PCP has to submit the Bariatric Surgery Approval form. That is the form that I will be waiting on pins and needles about until I find out if I am approved. So far things have been very smoothly and the PH reps have all been very nice to work with. Hope this helped! Krysti

I truely wish you both the best of luck but here is what I know I was set up at the women expo, working for a Baratric center therefor I spoke to thousands of women with PH and they all told the same sad story. PH in the end does not approve. I wish I had somthing better to tell you, but after 5000.00 Est... women told me the same thing...I thought I would pass it along. Good Luck and I hope you prove this wrong !!!

Cynthia, Thanks for your feedback. You mentioned that you worked for Bariatric Center? When I was researching a surgeon/facility I found out that PH only approves people to go to Centers of Excellence. I was interested in Bariatric Center in Yps. or Hurley in Flint. But when I talked to PH they told me they don't approve anyone to go to these locations. When I asked what locations they said - MMPC or Surgical Associates in Traverse City. So I hope this is the reason those ladies you have spoken to weren't approved. PH does have strick guidelines and I meet those guidelines so I hope this will helped me be approved. I guess we will have to weight and see..... Krysti

I was at the Womens Expo in Grand Rapids, when I spoke to all these women.....(sorry) These were not my patients. People with PH insurance come to all the time and cash pay. Call me if i can help

Hi Cynthia, Since you were representing a Bariatric Center at the Expo - can I ask you where you work? Have you had the surgery? What insurance did you have? Any insurance you would recommend for the surgery? Thanks for your feedback. Krysti