Can someone help with Healthnet guidelines?
I called the management group who decides if iam approved for my surgery and was told there is a new medical director who will reviews all the requests for surgery and he is going to be going through every file to make sure they are medically neccesary. I was told by my surgeons office staff that health net sent them NEW guidelines and one of them is for a medically documented supervisored diet for 12 months !!! Which i don't have. I am told I meet all the requirements before this came to light. I am totally devestated and abosoutley sick to my stomach. What iam going to do ??? Right now as it stands noboby knows anything. This new medical director is going to weed out this type of surgery in order to save this hospital or medical groups ( in their eyes Money) on unneccesary surgeries. In that case why even bother approving me to see the surgeron in the first place??? I just hate it when people say oh just think positive about it. Yeah right !!! I have had health net for 16 years and they have recieved from me over 100,000 dollars from my monthly premiums. Boy o boy, they really got me going !!! Anyone out there dealt with health net hmo in california???? Sure could use everybodys input and adviced. Thanks to all who answer me.
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