Qualchoice HMO

Hey all, I was just wondering if any of you have had the surgery through Qualchoice HMO. And if so how did everything go? (Did the surgeons office handle the paperwork? How long was the wait for approval? How long did it take to get a date?) Thanks! Faith

HEY FAITH, I TRIED TO REPLY TO YOU YESTERDAY,BUT AS SOON AS I GOT TO THE END OF MY REPLY, OUT OF NOWHERE MY COMPUTER SHUTDOWN,SO INSTEAD OF REBOOTING AND STARTING FROM SCRATCH I JUST WAITED UNTILL TODAY. I HAVE QUALCHOICE INS. AND MY DOCTER IS AT UNIVERSITY HOSPITAL,BUT YOU DO NOT HAVE TO GO TO UH TO HAVE YOUR SURGERY,ALOT OF OUTSIDE DOCTERS TAKE QUALCHOICE,BUT THE OFFICE HAD NO PROBLEM KEEPING UP WITH MY PAPERWORK,AND ONCE I GOT ALL THE INFO QC NEEDED I GOT MY APPROVAL IN AS LITTLE AS 2-3 DAYS,HOWEVER IT IS TAKING A WHILE FOR ME TO GET MY SURGERY DATE,I HAVE BEEN WAITING SENSE 6-11 FOR A DATE,BUT I KNOW IT'S COMING,I'M JUST GRATEFUL FOR THE APPROVAL EVERYTHING ELSE WILL FALL INTO PLACE. TAKE CARE AND GOD BLESS. EBONY

I have QualChoice as well. I got approved and I didn't even have a 5 year weight history. It was great! I went through University as well and they do take FOREVER to give you a date but when you finally get it everything moves so fast. I think i was approved in April got the date in May and now it's like 3 and a half weeks away!!!!

Hi Faith, I have QualChoice and I am having my surgery at University Hospital.I have friends that have the same insurance that went to St. Vincent's and there are some other network surgeons that do WLS in the NE Ohio area. You can check on the QualChoice website in the provider look-up section. UH handled my paperwork fine, I was approved in 3 days, but I brought with me to my first appointment a very complete package of info. I had had most of the testing completed and my documentation was all there. All they had to do was accept me as a patient and send the package to the insurance. The requirements of the surgery program at UH were more stringent than the insurance requirements were. If you can get your PCP to order you all the tests that QualChoice wants and the particular surgeon wants you to have, before your appointment with your surgeon, everything will move faster. You know you will need a psych eval, so call the number for the Behaivioral Department on the back of your QualChoice card and they will telll you who yopu can see and you can make the appointment. It takes awhile for the special psychologists who do the WLS evals to have an opening. I thought UH took a long time to give me a surgery date, but I let them know that I worked for a school system and I didn't want to miss too much of the start of school and they gave me the earliest possible date they could. My PCP is the School Board President, he and his staff were very prompt with any requests for letters, tests, referrals etc. so I could get back to work asap. I have my pre-op testing the 28th and my surgery is Aug 10. Good Luck, Alice