TITLE 19 WISCONSIN REQUIREMENTS FOR APPROVAL?

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Hello,

I am in the process of started my visits and i am wanting to know what is deemed medically necesssary per title 19? I called the customer care and I was informed only my provider can request that information? If anyone can help me I would appreciate it??

[Luvin_Life125 558]

Welcome to the forums! Where in Wisconsin are you from and who is your surgeon? I live near Hayward and am having surgery in Wausau. Sorry I can't help with your question, but I wanted to say hi!

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Welcome to the forums! Where in Wisconsin are you from and who is your surgeon? I live near Hayward and am having surgery in Wausau. Sorry I can't help with your question, but I wanted to say hi!

I AM IN MILWAUKEE MY SURGEON IS DR. CHUA- AURORA SINAI HOSPITAL.. How far along are youin the process?

[Luvin_Life125 558]

I have completed all of my insurance requirements and was just approved 10-15 days ago (not exactly sure how long ago ). I am scheduled for surgery 11/11 but I am desperately hoping to get surgery moved up and done before the end of the month. My husband's employer is going through some stuff and we don't know if he will have a job after October which means insurance ends if the job ends. I will find out Monday if it can be moved up.

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I wish you the best of luck!! & I pray your husband keeps his job that is not a good thing either especially so close to the holidays coming .. Are you having the rny?

[Luvin_Life125 558]

Good luck to you too! Unfortunately, I am not a candidate for RNY due to gastric polyps found during my pre-op EGD. Looks like I am stuck with the sleeve instead. Which procedure do you prefer?

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Good luck to you too! Unfortunately, I am not a candidate for RNY due to gastric polyps found during my pre-op EGD. Looks like I am stuck with the sleeve instead. Which procedure do you prefer?

I am hoping to have the rny I go to my first apt with the surgeon in about 1 week I have been to the nutrisionist and I go to the shrink this coming week I am just hoping I get approved I have High blood preasure,hiperlipidemia, pre diabetes, 6 herniated discs, degenerative disc disease, acid reflux, osteoarthritis,and I am going in the morning for my sleep apnea consult because my Doc suspects I have that also..... Good lord I hope I qualify ... I called my insurance they said only the provider (MY Doctor) can inquire on what co-morbidities are covered so I also go to my Primary in the Am. i AM going to have them call if they dont already know and inquire on what i would need to qualify and hopefully I will get good news so I can stop stressing already . If you dont mind me asking what would disqualify someone from being able to get the rny and have to go with the sleeve? When will you find out for sure if you can get your surgery date moved up? by the way my name is Vicky nice to meet you..

[Luvin_Life125 558]

Nice to meet you too! My name is Candace. Good luck and I hope you can get an answer as to what requirements need to be met to qualify for surgery. How frustrating to not be able to get simple information. As far as what qualifies someone to not be a bypass patient , I am not exactly sure on everything. I can't because they don't want to leave part of my stomach inside when it can't be monitored to make sure the polyps haven't grown , changed, etc. It is called an at risk gastric remnant. I should find out today if they can somehow squeeze my surgery in before the end of October so I will keep my fingers crossed! Good luck at your primary care appointment and with your sleep study! Keep in touch!

[STARTING NEW 21]

Hello,

I am in the process of started my visits and i am wanting to know what is deemed medically necessary per title 19? I called the customer care and I was informed only my provider can request that information? If anyone can help me I would appreciate it??

OK, I GOT THE ANSWERS TO MY QUESTIONS... SO I WILL POST WHAT I FOUND OUT IN CASE SOMEONE ELSE IS FROM WISCONSIN AND HAS BADGER-CARE TITLE 19 ... WITH TITLE 19 YOU HAVE TO HAVE 2 OF ANY OF THE FOLLOWING CO- MORBIDITY 1) UNCONTROLLED HIGH BLOOD PRESSURE, UNCONTROLLED DIABETES, sleep APNEA , OR SOME TYPE OF LIFE THREATENING CARDIOVASCULAR ISSUE BEING CAUSED BY THE WEIGHT.. THERE ARE ALSO OTHER Criteria YOU HAVE TO MEET.. LIKE 6 MONTHS WITH DIETITIAN , LETTER OF MEDICAL NECESSITY etc...