HAP inquiry

Anyone that has used HAP HMO. How did you first get connected with HAP? Did you email? Call? Write? Go thru PCP? I had sent a letter to Henry Ford, and Wanda said I needed to give my PCP some codes, but does he just put in a referral or does he have to contact HAP.....I am lost...and not sure anyone at his office knows what to do. I know it's going to take months to get approved with having to go to see a nutritionist, a psych evaluation and possibly having to follow a diet plan AGAIN!! None have ever worked. Thanks for listening...

Your PCP will need to write a referral for bariatric surgery, and needs to include the codes in regard to the surgery. The referral is sent to HAP. The referral needs to state the reasons for the referral. It may take awhile or it may be a breeze.

Hi Deborah, Read through my profile and you may find some help. I haven't updated it since my surgery...just haven't had time, but it gives everything up until I got my date. You can call HAP and ask them for the guidlines for WLS. they will send you all the information with the codes. I then sent my first request for approval. I was denied, but I was lucky as I had a member advocate contact me with the denial information and she walked me through the rest of the process. My only suggestion with HAP HMO is that you need to be prepared...do you research...document everything... send pictures.... let them see you are very prepared and knowlegable regarding all this. I did have to go to an in person appeal and then was approved and by that time I had a binder with pictures and tabs for each section they require to be fulfilled. Good luck! HAP is very difficult, but I believe all it did for me is make me more educated on the process. I feel they were fair with me even though it took me to the in person appeal to get my approval. Blessings, Kim

Hi Deborah, I had a very good experienca with HAP and was apporved right away. I went to my PCP (priamry dr) and talked to him about my options and what my intentions were fpr having the surgery. He then sent a referal for th eWLS surgery. I have been with HAP for about 15 years and I have been in the HENRY FORD SYTEM even longer so my entire medicla history was at there disposal and I am not sure if that is the reason why I was apporved so quickly or not. I will tell you that HAP is now requiring everyone to have 12 months of documented weight loss prior to surgery so if you go see your doctor start on that right away. Good LUck. Patty Alley

Thank you for your replies...this is so confusing...and I am not a patient one. This "documented" weight loss for 1 year, is it just seeing your PCP for 12 months and checking blood levels and your weight? Or does it have to be completely detailed? I did talk to HAP today...they are sending me the qualification and I faxed the surgical codes to my PCP so he can start the referral. I called St Joes as HAP told me they have a weight loss clinic/program. I am willing to do whatever I have to. It's gonna take some time I am sure. The doctor I used to go to back in late 90's is no longer in business, (tell ya something, why he was't able to diagnose me)... I am hanging in there....