NYC and HIP health insurance ??

[justicenyce 0]

Hi everyone I am scheduled to be banded on July 8th (NYU). Im a virgo so of course i am waiting for the other shoe to drop:tongue: . I havent heard anything from my insurance (HIP) but my BMI is 44 and i have High BP and diabetis. I didnt do a six month diet plan with a doctor bc i was told i didnt have too. Im just wondering if HIP makes you jump through hoops like the others

thanks guys

Justice :thumbup:

Edited June 1, 2008 by justicenyce

[Angel_P 0]

I have HIP as well and was told by my Dr (the Surgeon) that they approve right away, don't decline, and approve really quickly as well. I have my final pre requisite on Monday and then I am going to send my info in for approval. Good luck!

[justicenyce 0]

I have HIP as well and was told by my Dr (the Surgeon) that they approve right away, don't decline, and approve really quickly as well. I have my final pre requisite on Monday and then I am going to send my info in for approval. Good luck!

Thanks Angel that is really good to hear. I havent heard many people on here talk about HIP. :thumbup: I hear so many horror stories so hopefully everything will work out

Justice

[lisainbohemia 0]

I have HIP also and in May I was looking at HIP's website and under medical guidelines it said that bariatric surgery was revised on April 15, 2008, I printed this out because I was so mad.

In the beginning of April I had called HIP to find out what their requirements were and I was told it had to be medically necessary. So I made all the appointments for pre-op.

Then when I found out from HIP that under these new rules I needed a six month supervised diet it changed everything. Good Samaritan hospital said that if I had to do the six month diet starting from april then some of my pre-op tests would have to be repeated because they need to be current within 3 months of surgery.

Now on HIP's website it is showing the old rules for bariatric surgery dated December 13, 2006. So I called HIP again and they just give me the run around and will not directly answer my question about this six month diet.

Have either of you talked to HIP directly? I spoke with a nurse in the managed care department and she was very nasty and said that she could not answer anything without the surgeon filing the paperwork. I told her that I can't see the surgeon until all my clearances are done which includes the clearance from the nutritionist and if I need a six month diet the nutritionist will not clear me until after that.

This entire process is so upsetting.

Lisa

[chocolate_snaps 3]

HIP never give you a straight answer. My surgeon's office made me do the 6month thing because they couldn't ever get a straight answer. Only to find out at month 4 and the middle of my final semester in college (so i couldnt drop everything to get banded) I found out that HIP doesnt require a 6month diet and exercise thingie. But I was approved after all of the many hiccups in like 3 days I think, maybe a week.

[lisainbohemia 0]

HIP never give you a straight answer. My surgeon's office made me do the 6month thing because they couldn't ever get a straight answer. Only to find out at month 4 and the middle of my final semester in college (so i couldnt drop everything to get banded) I found out that HIP doesnt require a 6month diet and exercise thingie. But I was approved after all of the many hiccups in like 3 days I think, maybe a week.

Just a follow up to anyone who has HIP. Your right HIP will never give you a straight answer and I asked for documentation on their requirements and they never sent them to me. You get the runaround when you call.

In June I went to the surgeon even though I had not finished the six months (had till sept to finish) and told the surgeon about what was going on with HIP. He said he would submit the paperwork without the nutritionist and see what happens. Well I was approved in one day!!!!!!!!!!

So if anyone out there has HIP and is worried about the change on april 15, 2008 requiring the six month supervised diet (according to HIPs website), have your surgeon submit anyway!

Good luck to all!

Lisa

[justicenyce 0]

Just a follow up to anyone who has HIP. Your right HIP will never give you a straight answer and I asked for documentation on their requirements and they never sent them to me. You get the runaround when you call.

In June I went to the surgeon even though I had not finished the six months (had till sept to finish) and told the surgeon about what was going on with HIP. He said he would submit the paperwork without the nutritionist and see what happens. Well I was approved in one day!!!!!!!!!!

So if anyone out there has HIP and is worried about the change on april 15, 2008 requiring the six month supervised diet (according to HIPs website), have your surgeon submit anyway!

Good luck to all!

Lisa

Thanks Lisa. My insurance coordinator told me I needed a 6 month diet plan based on HIP new rule. I was bummed bc i was never told that in the beginning. She submitted my paperwork anyway ( w/o the 6 month) and I was just told on Friday I was approved :thumbup: but i want it in writting bc i dont want any surprises down the road. IM not sure i trust HIP :frown:

[Angel_P 0]

Hi, I just called this morning and I was approved with HIP Prime HMO without a 6 month diet. However I was curious, for those with HIP that were already approved, was there any type of co-pay for the surgery?

[justicenyce 0]

Ok...yes i am officially approved by HIP. I changed my date to July 31. Of course i have to stress over something. I looked at HIP's website and as you all said it mentions 6 month diet as requirement.

Are you guys worried that after the operation is done HIP may re-nig and deny payment becouse I didnt provide the 6 month diet? Im the queen of what ifs but im confused. Why would they say something is a requirement when its not ?

[Angel_P 0]

I'm not concerned about it because it is their job to enforce that, not mine. I will stand up for myself and not give into them trying to cover their butts for not properly doing their jobs. One of the women who works at my surgeons office told me that HIP never asks for a 6 month diet. The way I see it, I pay for health insurance to cover expensive things I can't cover myself at one time......and this qualifies. Oh and by the way, I am having my surgery on the 30th.....we are right around the same time!

[justicenyce 0]

I'm not concerned about it because it is their job to enforce that, not mine. I will stand up for myself and not give into them trying to cover their butts for not properly doing their jobs. One of the women who works at my surgeons office told me that HIP never asks for a 6 month diet. The way I see it, I pay for health insurance to cover expensive things I can't cover myself at one time......and this qualifies. Oh and by the way, I am having my surgery on the 30th.....we are right around the same time!

Thanks Angel..your so right. We are approved and thats so amazing. We are really blessed. Waiting for the other shoe to drop all the time is not healthy. (btw I do have to pay a copay but not sure of the amount yet)

Congrats to you and best of luck and thanks again for your advise :biggrin2:

Justice

Edited July 8, 2008 by justicenyce

[justicenyce 0]

And by the way Angel please keep me posted on your journey. Are you having it done in NYC?

[Angel_P 0]

I am having the surgery done in Syosset (Long Island). I talked to my dad today and he doesn't think I will have a co-pay as long as its in-network and my surgeon is. I tried to call my insurance company earlier and the call dropped so I figure I will find all that out in the next couple of weeks anyway. I will keep you posted, and keep me posted too!

[MartieG 0]

Were is dr geiss' first name and where in syosett is he located?