Group Health questions

Hi, I just got an approval from Group Health for the "initial consultation". Is there anyone out there who knows what that means? Does that mean I am approved for the surgery or are there other hoops I must navigate? I have my consultation next Tuesday on the phone but I'm so anxious I wanted answers before that. I just want an idea of what to expect. Thanks, Carol

I don't belong to Group Health, nor do I know what their requirements are. I would think that you would be given answers if you were to inquire. Are you assigned a Case Manager? However, since it is a managed care type of organization, I would presume that you have the OK to see/talk to a surgeon and it will be covered by the plan. I would expect that you'll then get to jump through the hoops as they come at you. I wish you luck. If there are any questions we (the wonderful members of OH) by all means ask them. Hugs, Beth

it means that the consultation is approved, your surgeon has to submit for approval if he believes you are a good candidate. but if you are approved for your consult, you are well on your way

Contact Harriet Stambaugh ([email protected]). She is the coordinator for the surgery clinic (Dr. Bock, Dr. Au). I had Dr. Au for a surgeon. Have you received your approval letter in the mail? Have you been seen by your PCP and been referred for surgery? If you have not done or received these, then no, you aren't approved yet. You will get a letter in the mail stating that GHC has approved you for gastric bypass surgery. Or you will get a denial, like I did the first time. Hope this helps! Lori

Hi Lori, Thanks for responding. I have a phone consult with Harriet at 8:30 in the morning. My letter says that I have been approved for 3 consultations with the bariactric team and surgery if deemed necessary. This is not the exact wording but close. I want them to say, just hurry on down here, honey and we'll get that done right away for you. I know that's not going to happen but I'm so anxious to get started. I have seen my PCP and gotten a referral from him. I guess I'll find out tomorrow. Say a prayer for me! Thanks again for responding. Carol

Sounds to me like an approval to me! I got a letter from the review board since mine was denied the first time. And then I got the same thing you did. I think you are in from what you have told me. I hope things went well with Harriet. Let me know! Good luck to ya! Lori

That's what I thought too but was afraid to get my hopes up. By the way, I looked at your profile. You look amazing! You should be so proud of yourself. The phone consult with Harriet was a no-go. She called in sick today and I had to reschedule. I understand people get sick but it sure is hard to not be disappointed. My new consult is scheduled for Thursday at 8:30 am. Keep your fingers crossed for me that this one pans out. Carol