rebelmom2
I am just starting the process for the WLS. My PCP is sending in to get referral from Ins. Co.
Feb. 19- Dr. sent in a request for a consultation with Henry Ford Bariatric, it was denied because he only sent in for a consultation but didn't send in any information other than that. Now we have to do this again...yippee!
March 1- Called insurance company and they said to have Dr. do it again. This time my PCP sent in a full letter explaining all my medical problems...high BP, high Cholesterol, Heart patient since 1992 when I had a heart attack at the young age of just 33, and sleep apnea. He said that he thought the surgery was a good idea for me due to the fact that if I didn't get the weight off it puts me at a greater risk for more heart problems or worse. Then they faxed it in. Wish me luck!
March 19- went online to Hap.org to check on my referral request and it said approved!!!! I was so happy. I then called Hap to see what my next step was and they told me that it was still in review. How could that be? I told the representative that I have all the numbers that say it is approved, so she went and checked and came back to say yes it does say that but that I was to disregard that entry ...they didn't know how that got online. Well you can bet your sweet ass that I printed all that info from online first. I was really upset after getting off the phone with them.
April 13 2006
I was denied again. This time they said I would have to go on another diet for a year first. The problem is, aal that my insurance co. will except is one through Henry Ford called a WOW program. I live near Flint, michigan and that would mean an hour drive weekly to get wieghed. Oh I would do it if it meant getting me closer to the surgery, but I would like it if they had somewhere closer to home or would accept another program that is local. Now I will start my grievance process...I will not give up!
June 2 2006
Well I wrote my grievance letter today....Pretty good if I say so myself..lol. I stated in there about the deal I went through with the online decision and sent them all the paperwork from that. I mentioned the fact about not having anything local that was available for weight loss program and then how pissed off I was about their decision. I sent in all the exact same papers that I had for my appeal, just that I had proof of the mistake that was made online with them approving and then resinding on the decision. Maybe that will help.
June 26 2006
Guess what? I received a letter in the mail from my insurance co that said after receiving my grievance letter and all the documentation I sent, my surgery is pending a Psychic Evaluation. How wonderful is that? Like I said, the fact that I had all the info printed off that showed they made a mistake online must have really helped . I don't care what it was but I am very happy. Sometimes it helps to be persistent. So, now I will make an appointment for the eval. and go from there.
August 2006
Sorry I haven't posted in a while. Not too much to report...I do have an appt. for my Psych. eval. on the 31st though. My surgery is pending the eval. If I pass that, I will finally be allowed to visit the surgeon and see what he says. Wish me luck! I can't believe all the stuff the ins. co. puts you through. The fact that everyone on here has been so helpful has really made a difference...it's what keeps me going...thanks everyone.I have a list of questions for the Dr. that I would like answered. My sister in law is going with me for the eval. She is such a sweetheart, the best person you could ever ask for. She stands beside me more than my own sister does.Well, will update after thursday, or as soon as I find out something
9-17-06
called HAP to find out about the eval. They have no idea where the Psych. sent the report. Oh, isn't that just peachy ! Now I have called my PCP, Dr. Genaw, HAP, and Genesys...no one has a clue. I can't believe this S--T ! Here we go again.
Oct 2006
called Pshch. Dept. to see what's up? They said that I didn't sign a medical release form so that they can send out the results to Hap. They sent me one, of course they can't fax it cuz they need the actual ink that I signed with on it...hell, I'll send them the damn pen if they get their stuff together. Anyway, I sent it out, and now they can't find that!!!!! As I said before...here we go again!
Feb. 19- Dr. sent in a request for a consultation with Henry Ford Bariatric, it was denied because he only sent in for a consultation but didn't send in any information other than that. Now we have to do this again...yippee!
March 1- Called insurance company and they said to have Dr. do it again. This time my PCP sent in a full letter explaining all my medical problems...high BP, high Cholesterol, Heart patient since 1992 when I had a heart attack at the young age of just 33, and sleep apnea. He said that he thought the surgery was a good idea for me due to the fact that if I didn't get the weight off it puts me at a greater risk for more heart problems or worse. Then they faxed it in. Wish me luck!
March 19- went online to Hap.org to check on my referral request and it said approved!!!! I was so happy. I then called Hap to see what my next step was and they told me that it was still in review. How could that be? I told the representative that I have all the numbers that say it is approved, so she went and checked and came back to say yes it does say that but that I was to disregard that entry ...they didn't know how that got online. Well you can bet your sweet ass that I printed all that info from online first. I was really upset after getting off the phone with them.
April 13 2006
I was denied again. This time they said I would have to go on another diet for a year first. The problem is, aal that my insurance co. will except is one through Henry Ford called a WOW program. I live near Flint, michigan and that would mean an hour drive weekly to get wieghed. Oh I would do it if it meant getting me closer to the surgery, but I would like it if they had somewhere closer to home or would accept another program that is local. Now I will start my grievance process...I will not give up!
June 2 2006
Well I wrote my grievance letter today....Pretty good if I say so myself..lol. I stated in there about the deal I went through with the online decision and sent them all the paperwork from that. I mentioned the fact about not having anything local that was available for weight loss program and then how pissed off I was about their decision. I sent in all the exact same papers that I had for my appeal, just that I had proof of the mistake that was made online with them approving and then resinding on the decision. Maybe that will help.
June 26 2006
Guess what? I received a letter in the mail from my insurance co that said after receiving my grievance letter and all the documentation I sent, my surgery is pending a Psychic Evaluation. How wonderful is that? Like I said, the fact that I had all the info printed off that showed they made a mistake online must have really helped . I don't care what it was but I am very happy. Sometimes it helps to be persistent. So, now I will make an appointment for the eval. and go from there.
August 2006
Sorry I haven't posted in a while. Not too much to report...I do have an appt. for my Psych. eval. on the 31st though. My surgery is pending the eval. If I pass that, I will finally be allowed to visit the surgeon and see what he says. Wish me luck! I can't believe all the stuff the ins. co. puts you through. The fact that everyone on here has been so helpful has really made a difference...it's what keeps me going...thanks everyone.I have a list of questions for the Dr. that I would like answered. My sister in law is going with me for the eval. She is such a sweetheart, the best person you could ever ask for. She stands beside me more than my own sister does.Well, will update after thursday, or as soon as I find out something
9-17-06
called HAP to find out about the eval. They have no idea where the Psych. sent the report. Oh, isn't that just peachy ! Now I have called my PCP, Dr. Genaw, HAP, and Genesys...no one has a clue. I can't believe this S--T ! Here we go again.
Oct 2006
called Pshch. Dept. to see what's up? They said that I didn't sign a medical release form so that they can send out the results to Hap. They sent me one, of course they can't fax it cuz they need the actual ink that I signed with on it...hell, I'll send them the damn pen if they get their stuff together. Anyway, I sent it out, and now they can't find that!!!!! As I said before...here we go again!
Surgeon Info:
Surgeon: Dr. Arthur Carlin
HAP
I am having a rough time getting a referral for my first consultation at Henry Ford in Detroit. Been denied after appeal from my PC. They tell me I must go on their recommended diet for one year first, which I don't have a problem with, but I live in Flint and the only diet program that is accepted by Hap is in Detroit. That would mean going and hour and a half one way weekly to get weighed. They need to have a place closer to home.
