Health Partners Denial

This probably isn't the greatest way to introduce myself  --- so please excuse the intrusion.  I tend to stick to the the DS board but someone suggested I post this here since there may be more people it pertains to in Minnesota.

I was denied by HP and was wondering if anyone else has gone through an appeal with them.  Any help or insight would be greatly appreciated!

Thanks and I hope everyone is having a wonderful day!

What was the reason they denied you?

The denial letter wasn't very informational regarding why I was denied, but I called HP yesterday and found out it was because the pulmonologist said my sleep apnea is under control with conventional medical treatment.

I think it's a misunderstanding in that the pulmonary specialist meant it was under control enough to undergo surgery (which apparently is also what HP thinks but the report he sent them was just too ambiguous on that point for them to make a determination). 

HP has actually been very helpful.  They told me what I need to do in order to get approved for the surgery.  I guess I wasn't expecting that from them.  Anyway, I need to get a better report from the pulmonary specialist I saw or see a different one to get a specific opinion on how the sleep apnea is affecting my daily life.  Once I get that, I can resubmit and they'll reconsider.  Since the HP people said that was the only reason it was denied, if I get a report like that, it will be approved. 

HP doesn't seem to be too bad of an insurance company (I think).

it does help to know why they denied you.  Alot of insurance companies do deny on the first submission for DS hoping you won't fight it .....

I was denied by UHC first round - but I appealed and did a peer-to-peer review and was approved....

hope we are able to help you out here!

 

You guys are all a great big help!!  Thanks!

Don't give up == appeal.  Another contact, besides Peaches, is Diamondgirl (she has a few posts on this page) and she might be able to help you too.  She's in her appeal process now.

I have to admit, I was ready to give up! Well, I was ready to wait until I had two years' worth of documentation of a BMI over 40 (that would only have been about six more months).  But I really don't want to wait that long.  Still, it might take that long to get them what they need for me to get approval, anyway!

So many hurdles!