CoolBrze198

Thanks again for the new replies...I will be looking at a coworkers benefits books tomorrow if she remeber to bring it to work.

I have been searching for the letter I got a while back that I think put WLS as an exclusion. But for the life of me cant find it.

If for some miracle that the WLS wasn't excluded and I was denied last year, then my appeal was denied as well. Do you think I should resubmit everything again has it been to long for me to appeal again???

My 5 years should be up early next year. *fingers crossed* that the exclusion was a figment of my imagination.. lol

Will keep you up to date on what I find out.

And thx for all your replies,

:smile2:

Thanks for your replies.. I guess I will stick with what I have.

I was denied for WLS due to not having 5 years of BMI of 40+

I had just over 3 years.

Then it seems like not long ago (within a year) I got like an update to our coverage book that WLS was excluded.

I have UHC Choice with my husbands work.

My work also has UHC, but not sure of the plan. I even thought maybe switching to our insurance. I will get a benefits book from a co worker and see if there is an exclusion. If no exclusion and I should swithc ( just a thought here) How long should I wait before atempting to even try to get approved?

Or should I just face the facts that I will not be able to have surgery unless I save the $$.

I started the process year before last. But UHC denied me. And then denied my appeal. So I gave up... :smile2:

I am thinking very seriously about findind new insurance. So, I am asking for any help on who to chose and what plan. (I am health insurance illiterate)

I would like to find someone to cover this and the premiums not be thru the roof.

Any suggestions you can give will be greatly appreciated !!!

TIA,

Rosanna

What's going on Rosanna? Did you appeal?

Hi Pamla,

Well I did it.

I think it said in my denial letter that when you appeal you should have an answer within 15 days. So here I am waiting again.

Wish me luck.

I wanted to wish you luck again. I hope you have already or soon will be filing your appeal. Will your doctors office help you with it?

Hi Ragdoll,

I faxed in my appeal letter last wednesday. I am keeping my fingers crossed. I have a gut feeling that I will be denied again. But hey, you never know. I copied a letter off of a yahoo group. Of course I changed it to fit me. So of course I am hoping whoever gets it is empathetic with me.

Please keep your fingers crossed.

How have you been?

Hi Pamla

I haven't started the appeal process just yet. I just got my denial letter in the mail a few days ago. I have been doing some research on what to say in my letter and what else I should be doing.

How have you been?

KIT

What's going on Rosanna? Did you appeal?

I have some notes that I can send you, what was the reason for they gave for the denial?

Could you send them to me as well? Please.

Grrrr.. I am so angry.

I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off.

So I will be appealing.

Anyone have a situation like mine & appealed and won??

TIA,

Rosanna

Grrrr.. I am so angry.

I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off.

So I will be appealing.

Anyone have a situation like mine & appealed and won??

TIA,

Rosanna

Grrrr.. I am so angry. :fish:

I was told that I didn't have a BMI of 40 or more for 5 years. Which I knew I didn't. But I have had 40 BMI for the last 3 years and as they can see if they looked thru my past 5 years of medical records that I can lose but I can't keep the dern weight off.

So I will be appealing.

Anyone have a situation like mine & appealed and won?? :help:

TIA,

Rosanna

Well I called UHC again today and was told it was still in review. And the lady I talked to couldn't believe it is still in review since it was submitted on the 19th. So she put a rush on it. So I will try them again on friday. Good grief! Come on and approve me already.

Will post if I hear anything else!

I just got approved today! Paperwork was sent in on Friday!

Yeah Ragdoll.... I am so happy for you.

:clap2: :clap2: :clap2: :clap2:

Hopefully I will be right behind you... When is your surgery date?

Keep us posted on your progress.

:phanvan Well, I called UHC this am and gave them my reference #. They told me my paperwork was with the nurse for review....

I asked when they got the paperwork. And she said on the 19th. Dern how much longer is it going to take. Read my reports already!!!

My tentative surgery date is May 22nd. "That date is contingent on hearing back from UHC with an approval prior to May 7th." That is what my surgeons office told me...

So, I am patiently waiting... Well make that IMpatiently waiting... :phanvan

Will post more when I have some news... Hopefully good news in the next couple of days...

Good luck everyone else!

Hi Everyone,

I was curious...

May paperwork has been submitted to my Ins Co. for approval.

And I want to take some before, during & after pictures as well as my measurements.

What my question is.. Is there a certain outfit I should take these pictures in? Like jeans & a t-shirt that fit now, shorts & tank? Or should the clothes be different?

I want to wear something that shows my actual size. You know clothes can hide our weight. (Somewhat).. LOL

TIA,

Joaquin,

What Dr. are you questioning?

Where area you from? What area are you looking to have surgery in?

I am sure there is someone on these boards that can refer you to a reputable Dr. in your area. LapBandTalk members are the best!

Good luck in your journey!

Hi MSMom & Annie,

I too have UHC Choise Plus.. I haen't had BMI of 40+ for the 5 years. I have been anywhere from 34 - 41. I had HBP a few years ago. And a boarderline diabetic.. But nothing other than that.

My Dr's office just submitted my paperwork to Ins. I am so very anxious to hear the outcome. I will post on here as soon as I know.

I called them friday afternoon and was told it was still in review.

*Keeping my fingers & toes crossed*

Good luck to the both of you as well.

Hi Ragdoll,

I am in the same boat with you. My Dr's office said they submitted to my Ins on the 21st/23rd One of those days... I will keep my fingers crossed for the both of us that we will get approval soon and on the 1st try..

Good luck & Take care,

Well,

I called UHC on friday about noon. And the girl I talked to said they have received my paperwork on the 19th.. (I guess I will never know the date everything was sent since I've heard 2 different dates now...) Any how, she told me it is still in review and gave me a reference # for when I call back....

How long should I wait to call back. I want to know now... Ugh!! :cry

I told her if I didn't hear anything by wed. I would call back. But I don't want to wait that long. Do you think they are working on approvals on the weekend? :help:

TIA,

WOOoooo HOOooooo......

:clap2: :clap2: :clap2: :clap2: :clap2:

Congrats..

So when is your band day?

Well, I got an email from my surgeon's office this am. They said they submitted to UHC on sat (21st)

So I guess I will give them a couple of days and I will be calling them to see how things are coming along. Will post and let you know.

Good luck

Woo Hoo... I am so glad. He should've went home before Gina! I think she was awesome. And I am glad Lakesha is still there. I just love her.

Have you got your Number 1 picked out yet? I am down to 2..

Hi All,

Well I got a call last night from my Psych. Telling me he faxed over my clearence. Then today after hounding my PCP for like 3 weeks. They faxed over my clearence letter to my surgeon! :faint:

Woo Hoo. I am on my way. just waiting for my surgeons office to fax to UHC for approval..

Keep your fingers crossed for me. Hope they will approve the 1st time and within a very short time period.

Thanks & good luck to everyone!

Rosanna

I am looking for a letter that my PCP can send to my LapBand surgeon.

My Dr. requires a letter from my PCP saying that I am cleared by him to have the surgery.

TIA,

Rosanna

Hi Everyone,

I was just wondering if anyone has a letter that I could share with my PCP to say that I am ok for surgery.

It seems like what ever I tell them. He just doesn't understand.

So I was looking to see if I could find a post where someone shared their letter. But have had no luck.

TIA,

Rosanna

http://www.myspace.com/workingonanewme

I just signed up for another myspace page. I am like some of you. I have another page but don't want my friends on my list to know I am working on Lap Band.. Be sure to add me. I will update my page when I get some pictures.

Thanks,

Rosanna

:help: I will be right there waiting with you. I have a PCP that doesn't believe in WLS. I a trying to get an appt with him and see if I can get his letter to say that I am healthy & approved for surgery... But that looks like that won't be till June.. Grrr.. So I am looking for a new PCP before I can submit everything. Then keeping my fingers crossed..I would hate to start over and find a new PCP.. I think all is ready to go other than PCP approval & submitting to surgery... how aggrevating is that. I have my Psych eval scheduled. Time for the count down. Looks like I will be waiting on PCP clearence... Grrr.

Anyone have any ideas on some local PCP's in Lakeland or Plant City---Florida:help: :faint:

I will be thinking of you all Keep us up to date with your journeys.

:clap2: :clap2: :clap2: