I just want to CRY !!!

Christa B.
on 2/8/08 10:24 am - OH
Help! I don't know what to do.. I seriously just want to cry!! I received a call today from Humana HMO who stated that I met every piece of criteria but they changed their bariatric policy starting 1/24 and now they require 6 mos consecutive documentation of physician guided weight loss program.  Previously it was just documentation that it was attempted in previous 12 months.  I emailed then 4 times in January asking them their policy.. FURTHERMORE.. I called and spoke to them on 1/24 and was specifically told the old policy and not the new.. I documented the date, name and conversation.. I was seen in Aug, Sept, Oct, Nov, Dec and Feb... Not every month did my doctor necessarily write all the information down.. But she states that even though I missed one month, if I could get the doctor to type something up stating what my VS were, behavior things I was using, what diet and exercise I was trying that she would consider approval.  UGH!  I just want to cry. If what is written doesn't suffice I need to start my  months OVER! HELP! PLEASE! Christa
Vicki Browning
on 2/9/08 12:08 pm - IN
Christa I would fight this fight this fight this.......  You have the person's name and date you spoke to them and they quoted you the benefits, not to mention I am sure your stuff probably was turned in for predeterminan before 1/24/08  I would most certainly appeal this decision about the 6 mos consecutive documentation. If you need any help appealing let me know  Vicki
butterflyness
on 2/20/08 7:27 am - KS
In my honest opinion and i'm really not trying to be rude.  If they wont budge, just do it.  6 months is nothing compared to people (like me) that can't have the surgery due to their employer having an exclusion against it.  I would gladly switch places with you in a heart beat, do the 6 months knowing you'll get a big reward in the end.  It's not a big deal knowing ur 6 months away and others can't even get there.  You've waited this long, what's another 6 months?  I say do it.  Trust me if i was told that i wouldnt be complaining. 
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