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Neighborhood Health Plan MA (NHP)

braziliangirl

By braziliangirl, in Insurance & Financing

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\Mara/    11

\Mara/
Posted

Hey! Yeah' date=' so nice to find MA people here :)

I had BMC(commonwealth care) until last month, but my surgeon said that they require a 6months supervised diet, and i really didnt want that lol, they told me to get NHP as they have worked with them before - and no need for the diet.

I'm hoping this is true, as i wait for their response :)

Day one of preop diet today - GOD helps me![/quote']

Hi girl!

I had NHP a few years ago and I changed because many people told that BMC its more easy....now, I want the Lap Band and I was reading in the guidelines of each plan and I saw that NHP requieres 2 years of something that I can't remember now (sorry)...and I always have the impression that NHP is more strictly with approvals. ....maybe I'm WRONG!! Where you live? I would like to know abo ut your process. ..! Good luckkkkkk!!!!

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\Mara/    11

\Mara/
Posted

Hi girl!

I had NHP a few years ago and I changed because many people told that BMC its more easy....now' date=' I want the Lap Band and I was reading in the guidelines of each plan and I saw that NHP requieres 2 years of something that I can't remember now (sorry)...and I always have the impression that NHP is more strictly with approvals. ....maybe I'm WRONG!! Where you live? I would like to know abo ut your process. ..! Good luckkkkkk!!!![/quote']

Oh and I forgot that my BMI is almost 35, and I have Diabetes 2 and pre hypertension...

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braziliangirl    72

braziliangirl
Posted

Hi girl!

I had NHP a few years ago and I changed because many people told that BMC its more easy....now' date=' I want the Lap Band and I was reading in the guidelines of each plan and I saw that NHP requieres 2 years of something that I can't remember now (sorry)...and I always have the impression that NHP is more strictly with approvals. ....maybe I'm WRONG!! Where you live? I would like to know abo ut your process. ..! Good luckkkkkk!!!![/quote']

Idk, that's what my surgeon's office said, that bmc requires the diet, and NhP doesnt.

I live in Framingham.

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\Mara/    11

\Mara/
Posted

Idk' date=' that's what my surgeon's office said, that bmc requires the diet, and NhP doesnt.

I live in Framingham.

[/quote']

I'm in Springfield...do you know what other requirements have NHP?

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braziliangirl    72

braziliangirl
Posted

I'm in Springfield...do you know what other requirements have NHP?

Looks like they are almost the same, but NHP doest say anything about a previous attempts of medically supervised diet.. (Which bmc asks)

Nhp askd for all the failed attempts but doesnt say about medically.

Which any other attempts like weight watchers, etc would work. (Thats what the office said)..

Here is the link:

http://www.nhp.org/PDFs/Providers/Clinical_Criteria-Weight_Loss_Surgery.pdf

\Mara/ reacted to this

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braziliangirl    72

braziliangirl
Posted

I'm in Springfield...do you know what other requirements have NHP?

This is for BMC: http://www.bmchp.org/app_assets/bariatric-surgery-effective-march-1-2012_20111223t095539_en_web_73194e4417d9400dbfcbd0188df5b1ef.pdf (note that they do mention about previous 6months of supervised diet)

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\Mara/    11

\Mara/
Posted

Great! I feel that all will be ok for you!!! Good luck with your pre op diet! You go girl!

I will call to my surgeon office, maybe they can advise me about the insurance, or which is more easy to approval in my case, remember I'm a low bander 35BMI.

Thanks!!!

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braziliangirl    72

braziliangirl
Posted

Got approved today! Yay!!

I still cant believe, it was so quick!

The whole journey will happen in less then 2 months.. God is good lol

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Sassybee0317    0

Sassybee0317
Posted

Got approved today! Yay!!

I still cant believe' date=' it was so quick!

The whole journey will happen in less then 2 months.. God is good lol[/quote']

Yay! Congrats. I told you they are fast and it makes it feel so surreal. When is your surgery?

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braziliangirl    72

braziliangirl
Posted

Yay! Congrats. I told you they are fast and it makes it feel so surreal. When is your surgery?

In a week! March 21

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\Mara/    11

\Mara/
Posted

Got approved today! Yay!!

I still cant believe' date=' it was so quick!

The whole journey will happen in less then 2 months.. God is good lol[/quote']

OMG!! Im so happy for you!! So fast, how they do? What they ask or what papers you used???? Tell me !!!!! Im really happy for you....♡

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braziliangirl    72

braziliangirl
Posted

OMG!! Im so happy for you!! So fast' date=' how they do? What they ask or what papers you used???? Tell me !!!!! Im really happy for you....â¡[/quote']

I know, right?!

Well, they used a letter of my pcp saying how long i've been trying to loose weight, and that i was a perfect candidate.

And i dont know what the surgeon sent, as they deal with ever everything insurance wise. I havent done anything, just the nutritionist and psych evaluations. They did everything.

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\Mara/    11

\Mara/
Posted

I know' date=' right?!

Well, they used a letter of my pcp saying how long i've been trying to loose weight, and that i was a perfect candidate.

And i dont know what the surgeon sent, as they deal with ever everything insurance wise. I havent done anything, just the nutritionist and psych evaluations. They did everything.

[/quote']

Great! Im gonna check your surgeon office....I dont know if is far from here....congrats again! Let us know about your progress and diet!

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braziliangirl    72

braziliangirl
Posted

Great! Im gonna check your surgeon office....I dont know if is far from here....congrats again! Let us know about your progress and diet!

Yes, call them! They are great! Talk to Jayne when you call.

Here is the website: http://www.massweightloss.com/

Even if it is far for you, you can book the apt all in the same day, and you will need to come only 2 times, then for your pre-op apt. :) its worth! I live almost 1hr away too

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\Mara/    11

\Mara/
Posted

Yes' date=' call them! They are great! Talk to Jayne when you call.

Here is the website: http://www.massweightloss.com/

Even if it is far for you, you can book the apt all in the same day, and you will need to come only 2 times, then for your pre-op apt. :) its worth! I live almost 1hr away too

[/quote']

Thanks, I checked the website and I will call tomorrow. I live 1:30 away..but I dont care is like u said I can book all the apt in the same day.....In your experience, I have to attend the seminar? Its very hars for me at 7pm, and what do you think about my bmi...is 35 with diabetes 2 and prehypertension.... I really need a good surgeon office with experienced people to fight with insurance approval. Another question (sorry) lol, your pcp need to know your surgeon name? I ask because my pcp is part of Baystate Hospital and they have a Bariatric Surgeons, but I dont like it....do you have any problem with your pcp or insurance ffor choose a non local surgeon???? Thanksssssss

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Go To Topic Listing Insurance & Financing

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