cha in Ky

Gary I just found this part of the website, Do you know anything about cha of Ky They were paying for wls, I've been told by doctors, They told nurse we had coverage, 1-29-04 They paid for certain preop tests that had to be precert, Then laid down a new date of 2-15-04 to stop That they would no longer cover the surgery unless, you had met the NIH 100 over and bmi of 40?? AND this is added on criteria Diabetic uncontrolled for 12 months. So they have denied surgery payment for my son, and stayed with the denial after a teleconference, Say's that the Hayes Technology Assessment Report determined that the only life threatening complication of obesity that bariatric surgery has been shown to have positive long-term health outcomes is diabetes. What do you think? Thank you Trish my email button here does not work, if you would like to email me [email protected]

Dear Trish, I haven't visited this site in awhile, since CHA denied me the WLS. in December. I have CHA through ARH and they were paying for the surgery and then stopped. I work every day with 4 people that it payed for then they just stopped and said it had to be a life threatening condition, which 3 of the 4 didn't have any co-morbidities that they knew of. I appealed and was still denied and told it had to be life threatening, I was diagnoised with sleep apnea which can be life threatening but they don't think so. Also Now I have to pay all those bills where I had all the work ups and then couldn't have the surgery, that in itself is depressing. I hope you have better luck with CHA, I started looking into the surgery in August 2003, and the people I work with, 3 of the 4 had their surgery in March and April 2003. I thought I could have it and then got denied twice, I did the appeal, and they wrote that after the secound denial that it was the final one, so I gave up and I just saw your letter, if that is so the why did they deny me last year?? If you find out more please let me know. Thanks Linda