Health Plus HMO Commercial Members

Steve D.
on 9/10/12 7:28 am - MI
RNY on 11/05/12
 Pineview, it sounds like you are having issues with your PCP's office, not Healthplus! Might be worth taking a walk into their office to ha**** out face to face. 

Jessmom, congrats and good luck on the surgery date, I hope everything is pain free and smooth sailing! Make sure to get advice on what to take into  hospital and have ready for when you get home OH is a great resource for all that info.
jessmom131
on 9/10/12 3:42 pm - MI
Pineview,

Although I agree with Steve it might be an issue at PCP's office but if they submitted it to Healthplus and they denied it then it would be an issue with Healthplus.  I only say this as I do work at a PCP's office and know that we ask for things and they sometimes do not do what we ask.  So I would ask PCP office how they submitted it and then contact insurance company.
pineview01
on 9/10/12 10:24 am, edited 9/10/12 10:26 am - Davison, MI
Nope!  It wasn't the PCP's office.  I would talk to Health Plus for my office/me.  They would tell me what to have her do and if she had a problem to call them.  She would and would be told everything was OK.  Than WHAM, not!

I finally got a call back today.  Yes, they remembered me and my medical issues.  They called me and the office back and said the problem is with the inbetween place the PPO or POP or whatever it is called.  These pople denied it BEFORE it was getting to HP.  But, they work for HP.  HP said they made new policy based on my case and that THESE people weren't aware of it yet.

Anyway, I am one step closer to being able to appeal.

But, enough of that stuff.

You guys are going thru it for a first surgry.  Good Luck with your surgery!
Steve did you get your referal?

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Steve D.
on 9/11/12 5:04 am - MI
RNY on 11/05/12
Don't you just love bureaucracy?

Yes I got my referal through pretty quickly and have my appointment set for tomorrow 9-12-2012 with Dr. Kia at McLaren Bariatric. I should be about 6 weeks out from surgery at that point.
pineview01
on 9/11/12 8:56 am - Davison, MI
Great! 
Good luck to the both of you with safe and healty
surgeries and weight loss!

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

jessmom131
on 9/30/12 3:56 am - MI
Well I had my surgery on 9-24-12 with Dr Kralovich and Dr Farhan.  Everything went well just some issue with pain medications has some reaction.  I learned a very important lesson do not over do it or you will be sending it back to kitchen lets just say. 

I hope everyone else is having good luck with there process on getting surgery.  I did have a few days where I thought to myself why did I do this again.  Then I look at the doll my friends gave me and it keeps me going.  I wanna not let them down nor do I want to let myself down anymore.

Thanks for all your well wishes and best of luck to all of you *****ad this.
jessmom131
on 9/10/12 3:53 pm - MI
Steve D

Thank you very much good luck to you as well.
pineview01
on 9/30/12 12:23 pm - Davison, MI
Glad to hear the surgery went well!

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Steve D.
on 10/1/12 12:03 pm - MI
RNY on 11/05/12
Jessmom, Great to hear everything went well and that you are home safe.
I have my date set for November 5th, and have my EGD this Friday, October 5th. Still have 2 more classes and pre-op testing to complete.....going to be a busy month!!
Congrats again on your seat on the loser's bench, I hear the seats are like Michigan Stadium seats....they keep getting smaller!!
Kalliope0705
on 5/21/14 12:23 am

I'm coming to this discussion a couple of years late, lol. I'm hoping that some of you are still here and listening. I just found out that I was approved for psych eval through mcLaren bariatric. I am also a healthplus HMO member and I'm nervous about my chances of having the surgery itself approved. About how long after the psych eval will I know if I'm approved? What steps follow the psych eval? Te way that healthplus has me going about this is so full of unknowns. I feel like I'm groping in the dark for a light switch here.

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