I just want to CRY !!!
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
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
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.