Is anyone else having a crisis with Badgercare's new requirements?

I had started the bariatric program and although relatively new to it, found out that the requirements for surgery approval had changed. My hopes were riding on a sleep study test I recently had done. I slept very little during it due to the fact that the technicians would not give me a sleeping pill my doctor pre-authorized. In short, the doctor said that the results showed I didn't have sleep apnea. Yet he bases this on a test that 75% of my sleep was in stage 1. I only spent an hour in stage 2 and REM sleep. It was clearly not a normal sleep pattern and basically all my hopes are crushed because of this. I guess what I would like to know is if there is anything I can do anymore to try to get this surgery... is there anyone I can contact, anyone I can appeal to... any suggestions? Also, if anyone else is fighting this new policy change I'd like to hear about it.

I sent you any email! I'll help you the best that I can. My appeal for the same thing is on the 23rd of the month. Kimmie

Thank you so much. Good luck at your appeal, I'm anxious to hear how it goes! Melissa

Hi Melissa, I work with insurance pre auth and with the new requirements you need a "life-threatening" co-morb condition that does not respond to treatment. It can be high blood pressure or diabetes etc...just work with your primary MD or the Bariatric Surgeon's office at documenting that for you. Most of us have at least one of these conditions. Good Luck, Mary PS If you are under a managed health HMO you can appeal a denial to an ombudsman. Our patients have overturned several denials that way.