Recent Posts
RNY on 03/26/12
Topic: RE: Need Help
From what I understand an exclusion is an exclusion and will not be covered because it is benefit that your employer has not paid for. Maybe research the internet because unfortunately it doesnt seem like anybody who knows for sure is going to respond.
RNY on 03/26/12
Topic: RE: California Blue Shield HMO
Call the insurance and see if you can speak with the pre-cert dept. If they wont ask you then ask the customer service rep. Once my insurance turned in my paperwork I was approved the same day even though they could have taken up to three days to approve. I did not have to do a 6 month diet or anything. My records just had to show that sometime over the last twelve months that I met with my PCP about diet and exercise three times.
Topic: Need info on financing WLS in Mexico!!
I am just starting out on my WLS journey. I have just about narrowed my surgeon choices down to either Dr Ungson or Dr Aceves. Now I need all the info I can get on companies that finance WLS in Mexico. I am new to OH forums and need all the help and information I can get!! Thanks !!
Topic: Have an appeal meeting with IHC. Any advice?
I have an appeal next Thrusday.. I can meet in person or over the phone.
Any sugguestions?
I have never done this before.
I will be meeting w/ the board committee.. and I guess this process has never been done before, its brand new coverage.
Any advice??
RNY on 06/26/12
Topic: California Blue Shield HMO
Hello Everyone,
I was wondering if there is anyone out there that has Blue Shield of CA, and how long did it take for them to approve your surgery? Please advise? I just switched to thise insurance and am wondering how long it takes to get approved.
Thank you all in adance!
I was wondering if there is anyone out there that has Blue Shield of CA, and how long did it take for them to approve your surgery? Please advise? I just switched to thise insurance and am wondering how long it takes to get approved.
Thank you all in adance!
Topic: Need Help
I have heard, (and read on OH) that some people have over come exclusion clauses in their insurance by stressing the co-morbidities that are suppose to be covered. If anyone would share what those letters contained and how to write them so that the insurance company will take those into consideration I'd be greatful. Last time I talked to the office manager at my surgeon's office she didn't sound hopeful. She said she would discuss it with the doctor, but I "don't need to call them, we'll call you." since that was middle of November and I haven't heard from them, I guess they just wrote me off. So sad.
Topic: RE: Anyone ever gain weight to get covered by insurance for VSG?
It's 50 with or without co-morbidities?
Topic: Has anyone written their own letter?
I made an appointment to see my PCP today. I am going to talk about my blood pressure (that has been high for months and not treated. So I want to get it confirmed before I go to my surgeon consultation!) , and, to get a letter of medical necessity and other paperwork I'll need.
I'm writing my own letter from a bunch of samples I found, and, I'm going to see if they can put in on their stationary.
Is that nuts? Has anyone else done this?
I'm writing my own letter from a bunch of samples I found, and, I'm going to see if they can put in on their stationary.
Is that nuts? Has anyone else done this?
RNY on 06/26/12
Topic: Totally off topic...State Disability
Hello All
I have a question for everyone....when/if you received state disability when you went off for your surgery from work did they pay you clase to what you were making at work? I am just curious to see if it will be close tot he same so that I can plan ahead...thank you all in advance :)
I have a question for everyone....when/if you received state disability when you went off for your surgery from work did they pay you clase to what you were making at work? I am just curious to see if it will be close tot he same so that I can plan ahead...thank you all in advance :)




