Dont know what to do

Hi Im so confused and really dont know what I should do. Ive been denied by HAP. Had a sleep study done and was waiting on the results to see if I have apnea. Was going to have my PCP turn in another req along with my appeal letter to HAP. Went to a seminar at another hospital and was told that because I was already denied, Ive more or less put myself in a position where Im going to have to abied by HAP's rules and follow a medically supervised diet for a year or call an obesity attorney. The attorney wants to much money for sending a letter....... Should I follow through with my pcp and sending in my appeal. Should I change pcp's and start over, this time having my doctor chart that Im seeing him for weight loss. I do not know what to do.........I do know that I do not want to diet for another year..I just cant do this....please...any suggestions would be appreciated..... Thanks Sandy

FIGHT EM TO THE END!!!! No insurance wants to pay, start you appeals process NOW! It will take a little time, but in the end it's all worth it. Do you have apnea? Make sure to put all your co-mobidities in your appeal including the apnea if you have it. In the mean time, watch what you're eating, and get walking. This will happen. Hugs Linda

Hi Linda So stick with my pcp and send in the appeal ....what happens if Im denied again?

yep, stick with your pcp now and have him or her help with your appeal. I'm not sure how many appeals hap allows you, but when you've exhausted all of them you can take it to the state level. Hap is very hard, but in the end you will win. Don't give up, it's what they want. Good luck Linda

Sandy, I don't know anyone personal that has HAP that hasn't had to fight for there surgery. So don't give up.!!! Fight the good fight. Good luck and God Bless.---Toni

I will follow through with my pcp then. I need to make an appointment to talk to the sleep clinic about my results and if they tell me I definately have apnea....that might help me a bit. Cross your fingers......you have all been so supportative.....thank you...smile Sandy

Hi Sandy, Please don't quit. Hap gives everyone a hard time. They don't want to pay for this. I would just keep going from where you are. Make sure you go to your p.c.p. often for supervised weight loss, make sure it is put in your medical chart. Keep appealing, if you have to appeal to the state level then do it. You are fighting for your life~hap is trying to save money. Don't let them do this to you. You can win this~but only if you don't give up!!! God bless you, Annette

Hi Sandy I know first hand what you are going through right now. I dont have HAP but I do have BCN and I am going through the same thing you are at this moment. My last PCP did not document enough so I started seeing a new PCP and a dietician for the last year. Im going to keep fighting and I want you to do the same. My prayers are with you good luck Dayja

Ive decided Im going to stay with my pcp. I called her office today and asked if they would give me a referral for a psyhc eval....Im waiting to hear back from them. After getting the results for that and my sleep study results should be there by now....I will make an appointment to talk to my pcp and see what she is saying in my referrals....then have her send another req and my appeal to HAP. I wont give up. I feel this is the only thing that is going to help me get rid of this weight once and for all....... Thank you all so much for your help and prayers........ Hugs Sandy

Sandy: Have you tried pouring your heart out in a letter of your own...??? When I sent in all my information, My PCP was supportive...But I also pettioned the insurance company myself.. I wrote a 7 page letter explaining everything from how long I have been over weight, what diets I have tried, listed co-morbid conditions, Regulation Guidelines from the NIH, Red Cross and so on.... Pour your heart out Girl,,,FIGHT THIS FIGHT...I was told my by case nurse that the medical director cried his eyes out when he read my letter and saw me on a personal level, not just another number... When I got the approval, I sent the health plan a beautiful arrangement of flowers with a thank you card.. Let them know you are human and not just a number to them...believe me I know how hard this is for you right now....dont cry....they are trying to intimadating you...This is your life...take charge of it..... Good luck and if you need to talk email me and we can chat any time....I am 10 months post op and started the process of my panniculectomy...believe me I did the same thing as I did before....Wrote my letter re introducing myself and thanking them for the surgery they did approve and so on... Trust me..they will appreciate hearing your side of the story,,,, Good luck' Rae Ann 315/165/ soon to be 130