Priority Partners????

Brandywyne
on 2/17/10 9:37 am - Abingdon, MD
Hello Ms Curious here asking more questions..has anyone out there with this insurance have any problems with approval and how long did it take? And did it have to be medically ness.. to get surgery? All replies are greatly appreciated.
Jilly Durbin
on 2/17/10 10:35 pm - Pasadena, MD
Hi there honey. A girl friend of mine from HS had the sleeve procedure done and she had Priority Partners here in Maryland. She had no issues. She did have to go through the 6 month diet plan prior to her surgery though. Im not sure about Lapband but I would assume they would cover that too. Do you have a case manager?
Shannon W.
on 2/18/10 12:28 am - Baltimore, MD
Hi,
I work here at Johns Hopkins Healthcare which is Priority Partners. I work with the girl who does the approvals for the surgery for PP members. I know it was like my insurance I have EHP which i needed a 6 month diet with my PCP or a dietian like Johns Hopkins Bayview has a program for it. You also need a eval with the nutritionist and a eval with a psychiatrist. The Nut & Psych have to be done with in 6 months of submitting the package for approval. The 6 mnth diet history is good for up to 2 yrs. You also need certain labs done that they send you on a check list. Once you submit everything completed it usually takes about a week or so to get an answer from the insurance here. Then after its approved it took a few weeks to get a call from the surgeons office offering me the date. Let me know if you have any questions. I would be glad to try and find out for you!
 


RNY 11/3/09.........Pre Surgery 320lbs......Day of surgery 313 lbs
Goal: 150 lbs

 
Beauty comes in all shapes & sizes!





            
Jennifergalvan
on 1/28/18 6:27 pm

Do you still work there. I have a few questions that maybe you can answer for me..

lesley Y.
on 2/18/10 6:02 am - Delmar, MD
i have pp and so far things have gone well, i should know my date in the next few days or next week just finished my last appt today.

highest:334
current:315
surgery:322
first weight since surgery: 314
  
 life inst about what you put into it its about what you learned from it. what have you learned from your life today?

 

My Macronutrient Breakdown

Daily Average for the Last 30 Days



Like this widget? Get your own at ObesityHelp.comhttp://www.obesityhelp.com/myoh/healthtracker/source,widget/">ObesityHelp.com>
        
HEATHER J.
on 2/18/10 9:28 am - Church Hill, MD
I had PP for my RNY surgery. Mine was deemed medically necessary by my PCP, I had to do the 6 month supervised diet, I also had about 9 years of documented weight loss attempts, and I had several doctors submit letters as well stating other illnesses that were weight related. There was several labs that had to be done and also a sleep study. But I think the labs vary doctor to doctor.
My paperwork was submitted in April, and it only took 4 business days to get my approval. Stay on top of it once its submitted, call & ask if they recieved everything and inquire where they are with your approval, Always document who you talk to...CYA!!!!!
If you have anymore questions, feel free to ask!


Starting weight 301 Current weight 127


No Matter How I May Change, I Will Still Be ME!!!!

Miyncham
on 6/22/18 11:37 pm

Hello Ms. Heather, how long did it take for you to get to 127? I'm currently 300 and I want to have the VSG done ASAP! :)

Brandywyne
on 2/19/10 3:50 am - Abingdon, MD
Thank you all for your response,you where all very helpful..And eased my mind..
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