Does anyone have HIP that is doing all pre-op testing with no approval yet?

[♥Amy♥ 5]

I'm just curious. I have HIP Prime Network and I was told by my surgeon's office that HIP changed their surgery guidelines the beginning of this month to include a 6 month physician supervised diet. I've tried calling HIP to get it from the horse's mouth but no one will tell me anything. Why is that? Such a pain!! Anyway, I was hoping someone who also has HIP and is in the same leg of their journey as I am in would have had more luck with info on that than I did.

Do we def need a 6 month because the insurance co-ordinator didn't seem 100% sure. She said "You might have to do the 6 month diet."

I went through this once already with Aetna and was hoping I wouldn't have to again with HIP but I will if it's necessary. My friend's daughter has HIP and didn't need to do the 6 month but she was approved and done by the beginning of December.

I want this so bad and nothing is stopping me this time. I would just like to know what to expect from the insurance when the surgeon submits me for approval in February.

Edited January 21, 2010 by ♥Amy♥

[ChrissyKat29 0]

Hi Amy

I'm curious to know what happened with HIP. I have HIP as well and I am in the early early stages. I haven't attended the seminar yet at lenox hill (5/19) but I would like to know what I should be expecting. Thanks for sharing

[♥Amy♥ 5]

Hi Chrissy :crying:

Here's what happened with HIP.

Before this past January I had Aetna and I had originally planned on getting my surgey done by Dr. Holover and I went through most of the pre-op testing and the 6 month Physician supervised diet under my Aetna ins. I ended up not being happy with Dr. Holover's staff and their lack of help and I ran into an old friend and he had surgery with another surgeon who's office was basically a one stop shop for everything except for the cardiology part. I had to re-do all the testing, of course and I was told that since HIP changed their guidelines in January when I went for my consult with the new surgeon that I would most likely have to do a 6 month diet but that they wanted me to get all my work ups done in a month and a half and they would submit everything when I was done to see what would happen. My Primary doc also sent them all my 6 month diet stuff that I did for the other surgeon. I think most of it was like almost a year old but they said they would try sending it in anyway.

My surgeon's Medical Assistant called me on Monday March 1st and said she was submitting my paperwork to HIP first thing the next morning and that I should hear something within a week. She called me the next day to ask me if I wanted surgery on March 24th because I had been approved! I was shocked! But, I couldnt tell you if the info that was submitted by my PCP helped any or if someone was just feeling generous that day. Sorry for the long-winded post!

I hope this helped! Good luck!

[ChrissyKat29 0]

Thanks so so much for the info Amy! Congrats on your progress! Hopefully it was the info submitted by your PCP