Does anyone it's trying to get a approval with Neighborhood Health Plan?

anadefreitas
on 10/7/08 3:03 am - newton, MA
 Hi! Does anyone has Neighborhood as your health plan?
How Hard it's to get an approval? 
And also, has anyone seen Dr. Edward Mun at Falkner Hospital?
thebestoneyet74
on 10/7/08 10:10 am - stoneham, MA
I have tufts so can't help you with that.  However I had my surg at St Elizabeth's in brighton and just love my surg.  Dr. mun has great reputation .. I know a few that he did lap band on and they love him.

GOOD LUCK...
anadefreitas
on 10/7/08 1:35 pm - newton, MA
 Thank you!


 I just went to see my PCP today and she gave me Dr. Mun name.
 Now I have to go to an information section at the Falkner Hospital.
 But I don't know yet how that works and it's going to be with my insurance.
redheadcurlz
on 10/8/08 3:26 am - Weymouth, MA
I am seeing Dr. Mun at Faulkner Hospital.  I went to the inormation seminar back in August and got my first consult with hin on September 3rd.  At that time I had NHP and was told that as long as I had a BMI over 40 or 35 and over with two medical conditions (diabetes.. high blood pressure) that they would cover it.  NHP does require a six month medically supervised weight loss class and they have one their at Faulkner. I think they meet on the second Monday of every month at 10:30. There is information on their website.  I only went to one of the classes because my insurance got switched to Harvard/Pilgrim and they do not require the six month class. You are going to love Dr. Mun. I have spoken with a few people that have had surgery with him and they were more than pleased. I have heard that the nursing staff there is excellent.  Your recovery is on a floor with other patients that have had weight loss surgery as well. My surgery is not until January.  Good luck on your journey!      
  Red
 

mary B.
on 10/8/08 11:23 am - new bedford, MA
I have Neighborhood Health Plan and when I called them  they said they cover it but they do not approve until all the paperwork from the surgeons office is complete.
I saw my surgeon today  and they are sending my paperwork in this  week. The process happened a lot faster than I imagined. So as long as your surgeon gets all the paperwork together   and you have the requirements the bmi or other health issues then you should be ok.



anadefreitas
on 10/8/08 12:26 pm - newton, MA
 I'm a little afraid that they won't approve. My BMI it's 37.5. I've been trying to put in some weight but it's as hard as is to loose.  I am trying to get pregnant. Did 5 IVF's already and I have only one more chance through the insurance ( and I don't have money to pay out of pocket). My Dr. thinks that this surgery could be my last chance.

I am coming to the information session next wednesday and then I can make an appointment. I hope I'm able to gain some weight till then.


zary
on 10/20/08 3:16 am
i am currently in the procees with Neighborhood, you have 2 attend a preoprative weight loss group for six months. Dr. Mun is ok he is very brief the visit with him took 2 minutes, because he had to return to the OR.
anadefreitas
on 10/20/08 7:56 am - newton, MA
 Good to know that. I am going to see him in december but I am already going to the weight loss group in november. 

Di you had a 40 BMI?
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