FRUSTRATED AND ANGRY IN MONROVIA
I HAVE BEEN GONG THROUGH A TERRIBLE TWO WEEKS. HEALTH NET HMO DENIED MY AUTHORIZATION TO SEE THE SURGEON. THE DENIEL REASON WAS AS FOLLOWS:
THE MEDICAL DOCUMENTATION RECEIVED DOES NOT SUPPORT THE NEED FOR THIS SERVICE BECAUSE ACCORDING TO HEALTH NET CRITERIA THE PATIENT MUST HAVE PARTICIPATED IN A PHYSICIAN-SUPERVISEDNUTRITION AND EXERCISE PROGRAM INCLUDING DIETICIAN CONSULTATION, LOW CALORIE DIET, INCREASED PHYSICAL ACTIVITY, AND BEHAVIORIAL MODIFICATION), DOCUMENTED IN THE MEDICAL RECORD FOR AT LEAST 6 MONTHS. NOW I AM A 53 YR. OLD 281 LB. WOMAN WHO HAS TRIED JUST ABOUT EVERY DIET THAT I COULD AFFORD TO BE ON. JOINED GYMS AND EXERCISE CLASSES, AND HAVE BEEN FIGHTING FAT SINCE I WAS BORN WEIGHING 10 LBS. RIGHT NOW I AM WAITING FOR AN ANSWER TO MY FIRST APPEAL.. IS THERE SOMETHING THAT I CAN DO TO HELP THESE PEOPLE TO MAKE THE RIGHT DECISION? PLEASSE GIVE ME ANY SUGGESTIONS YOU HAVE. I CAN USE THE ENCOURGEMENT......