Yikes, she was denied!

My friend and I are both seeing the same doctor. We saw her on the same date and both requested referral for WLS. She found out last night that her request was denied, for multiple reasons per HAP(no 12 month supervised diet, no psych eval, etc). I checked the status of my referral and they don't even show one pending. WTF? Now Im concerned. I guess I should call and see if my request has been submitted, but Im too chicken. I don't want to jinx myself by calling. Especially since the letter(s) were sent earlier this week and they denied her 2 days after receiving it. Im hoping mine is still in review and that is why nothing is showing up online for mine yet (you can check the status online at HAP.org). Should I sit tight for a few more days and see what comes up? I know you can appeal and appeal, but damn I was hoping neither of us would have to do that.

Hi Colleen, You and I are in EXACTLY the same boat. I don't see mine online yet either and I know for a fact they receieved my paperwork on Tuesday. I want to call too...sorta..and then I tell my self to just "let go and let God"... Do you know if your friend sent in a detailed diet history? I was just wondering what supporting documents she had with her referral. I was also under the impression that they would approve "pending psyche eval"... Hmmm.. I just wish I knew for sure. I just wonder why ours are not online.... I'm hoping like you that it's in review still...

I do know at present, unless her sleep study shows otherwise, that she does not have any comorbids...where as I do. She also did not have her records from her former PCP transfered...I did, in fact I even had my pregnancy records from 2002 and 2003 also included so that they could see that I was on an 1800 cal ADA diet from July 2002 through December 2003. I also provided my PCP with a detailed list of all my dieting attempts since 1983. However, my PCP was still worried that they would claim the "12 months supervised diet" issue to deny me. If they do, I will appeal based on my dietary restrictions in 2002 and 2003, plus my former PCP gave me a 1500 cal ADA diet when I saw her post pregnancy. So technically, I have been supervised since 2002. As for letting it go, I feel the same way. I keep telling myself God wants me to be happy, he wants me to be healthy, and he will provide the way, which Im hoping is WLS.

I would call. When I was in the process I called my Ins everyday to find out the status. then you never know they may ask you for more info while on phone to speed up the process. Best wishes to you hun!

Well, I called HAP and spoke to a representative. She said that she cannot see anything for me submitted yet. When I told her that I sent the referral letter from my PCP in with my supporting documentation fed ex and that they received it on Tuesday, she mentioned that this was not the standard protocol for submitting a referral. (Did I NOT say that I thought it was strange that I sent in the referral??????? SHEESH!!!) I asked if I should contact my PCP back and she told me to hold on..she would check with the referral dept. and get back to me within the hour to let me know if I have to call my PCP and have her re-submitt the referral. Needless to say, it doesn't make one feel to positive about the pending outcome when you are not following "the rules"....I'll see what happens when she calls back. Colleen.. I would call... I mean truly, if you are going to be denied a phone call to HAP is not going to be the determining factor..and you may find out something that you can take care of before you wait 2 weeks and then find out!

Hmm, ok, I'll bite the bullet and call. I so hope its not bad news when I call. Oh, supposedly my g/f's request was recieved on Jan 17 and she was denied on Jan 19. Damn, how could they possibly move that fast???? Unreal.

I think I will wait until Monday. Im off on Monday and that will be two weeks since my appointment with the PCP. If I call today and get bad news, Im gonna have a hard time finishing my shift and Im on until 9 tonight.

I hadn't thought of that, Laurie...good point.

Call them Colleen it's only 3:25. You still have time~no sense worring about it for the entire weekend. God bless you, Annette

Well, this is what I found out. I did not receive a call back from HAP..so I bugged them again and reached another representative who seemed like she wanted to help (we'll see). She said that my PCP needed to send my referral by fax or IRS (Internet Refferal System). She said if the office did not know how to do this to contact them and they would help. In the meantime she said she would track down my paperwork I sent in with the original referral because it is in limbo somewhere there. I gave her the Fed Ex tracking number which she said they use to find it and that she will call me on Monday. Now, I called my PCP's office and they were a little confused. At first they gave me to a message service that said "Please excpect 12 - 14 days for referrals, leave your name, and who you want to be referred to, and we will let you know. No need to call us back". Well, I was not comfortable with that so I called back and spoke to a real person. She was still confused as to what HAP was asking them to do and said that faxing the referral and using the IRS are two seperate things.. I told her they would help if she called them and she said she would ask another person there that is more knowlegable and that she will get to it on Monday. Looks like I'll be making more phone calls on Monday... (and the fun begins!)