Anyone had to fight DSHS for approval here in Washington State?

Hello I am new to this site. I am wondering if it is hard to get approval, and if anyone knows which hospital an open dshs med coupon usues or are any OK?

Hi Paula, Well, I don't really know if its that simple. This is what I know of the process. DSHS= Medicaid. Medicaid will not approve WLS unless it is "medically necessary." "Medically Necessary" means you have to go thru the "exception to the rule" department. Basically this is a brief synopsis of what it mightl go like (it did for my friend) You will need your primary care physician who knows your history to write a letter to medicaid stating that it will benefit your co-morbidities therefore bettering your health if you had the WLS. Also make sure that you have documentation of your co-morbitities. They will kick it back and send your primary care physician a form asking tons of questions. A lot of the questions your primary care physician won't be able to answer because they are done by the surgeon. So the next task becomes find a surgeon that accepts Medicaid. Other then the massive amounts of paperwork and phone calls to reps that either don't know or don't care, this is the hardest part. Finding a Doctor to accept Medicaid for WLS. Or again, at least it was for my friend. She still has not had her surgery and has been going thru this for almost a year. If you need phone numbers etc, I can get you those from her. I'm sorry to sound so dismal, but their system is about saving them money, not saving a life. I will keep you in my prayers and if I can help at all, let me know. Love God, Kimanne

Some phone numbers would be great. Are there any lawyers that fight dshs medical medicaide?

Hey there Here is the direct number for the Exception to the Rule Department in Olympia. 360-725-1584 fax # 360-586-1471 The State Of Washington Medicaid # is: 800-444-4606 As far as legal help goes try this website: http://lib.law.washington.edu/ref/legalinfo.html Or perhaps you can do a google search or contact a local free legal help office. I don't know much about the legal aspect. If you can't find much of anything, let me know... I'll see what else I can dig up for ya! I'm prayin' for ya Kimanne

PS>>> I just called my friend, she hired a private attorney. I suppose if you are going to go with a private one, you can use an attorney referral service to start off with. Good Luck!

Thank You so much for all your help. Your friend, what kind of comordities does she have? It is really to bad that it is just not spelled out like if your bmi is-- you qualify. Please give your friend my email perhaps we can link together. I am going to try to get help with the welfare rights coalition. Called Friday so the soonest they can get back to me will be tommorow. I was diagnosed with pcos does this help approval? Still trying to fiqure out if this is caused, or can be aggravated by obesity. Hope to hear from you soon Thank You, Paula