I am steamed with Great West PPO...sort of? Anyone want to help...

I had finally started my process for gb. I called my insurance company and talked with a member specialist. Asked them the important questions like what is my first step. They said have a letter faxed to the insuranced company etc etc. Did that called back a few times and of course they did not recieve my fax. So as I am emailing back and forth, I scan the letter and attach it to one of my emails. Then they send me this email stating it takes 3-5 days blah blah blah. Today is the 5th day and just found out these "member services"  people don't know jack and I should have asked for the preapproval/preauthorization dept. Well duh!!!! So finally needless to say they have started my claim. I still have not recieved the information of everything that is required, but I have a case manager now and we are going to become best friends whether she likes it or not. I would like some more form letters, like initial information letter that the md can send with more detailed info and I got a diet letter because I had to go on a year diet in California through blue cross, then moved to california. What else? Anything anyone else might think is helpful. I am determined. Thanks for everyone's help. Denisha

Thanks that helps. I will just have to be a little more tolerant. It was just very frustrating being told different things in January and now its February and I am starting over again. I will just take a deep breath and remember that which does not kill me, only makes me stronger.

Hi, I have Great West PPO also.  I am undergoing my 6 mth diet plan with my PCP.  He seems to think I will have my six months finished my May. (fingers crossed)  I have not talked to Great West except in the beginning when I asked if I had coverage and what my deductible would be.  However my surgeons office mailed me a copy of the insurance papers stating that I needed 6 mths of diet/weigh in with PCP or Weigh****chers, etc.  Also if your BMI is over 40 you do not need to have any serious health issues.  If your BMI goes btwn 35-40 you will need proof of some other illness such as diabetes, sleep apnes, etc.  Also I have to have a psych. evaluation and an evaluation with a nutritionist.  I am contemplating whether or not I should be staying in contact with Great West or should I just sit and wait til my 6 mths is over.  I would love to keep in contact with you and help each other out in anyway.  Good luck to you :)

I have Great West too, so far they have been so great.  I was assigned a Case Manager right away and she's been very nice and helpful. From what I understand you need the following: 1.  Detailed letter of necessity from your doctor (I also had my doctor put in a little note about me being on a closely supervised diet) 2.  Evaluation from a Psychologist 3.  Nutritional Evaluation 4.  6 month diet history - with chart notes (I'm using LA Weight Loss paperwork - I"LL LET YOU KNOW HOW THAT GOES) I've already done everything except pick my surgeon.  I've met with 2 of them and I meet with the 3rd on Monday.  If I like him I'll start the process and have his office help me through it.. Wish me luck and I'll do the same.

Thanks for all your info. I finally had someone email me all the requirements which is not bad. My pcp is great, he is like I will sign anything. I just moved to washington from california, so 1/2 paperwork is in Ca half is here. Anyway, he is willing to sign off my 6 month diet. It was great b/c when they assigned me a case manager, she just happens to be on vacation for 2 wks. I was like c'mon, but the nurses are great, another nurse just emailed it to me. So now I am just trying to still get all my ducks in a row and then send my next round of paperwork to my case manager and hopefully get an approval. I picked a surgeon already and he is supposedly the best in Washington. I just need to get in to see him. So I wish you luck also.  P.S. I will add you as a friend and keep me updated. I regularly add things to my blog, so let me know. The other day I was crying b/c I was so frustrated, but it would be nice to have someone that understands. Thanks