pamla68

:clap2::clap2::clap2:Hi all I am pleased to say my date is June 19th! Sing me up, add me to this list, do whatever you need to add me to the June bandsters '07 group!

Thanks everyone. I guess alot of you didn't have a hernia.

<p>Hi all,</p> <p>I had my EGD Wednesday and the doctor found a hiatal hernia. He said he will repair it when he place the band. Is healing longer? Recovery harder? Return to work long? Help!</p>

I am pre-op, however, I have began to work out after seeing the picture from the here from February. The stomach and "powdered ant" look was a bit much for me so I decided I need a new way of life. I will be a June bandster, wanted to get over the stage fright of posting thick madam pictures, and felt this was good of a time as any. Stay tuned!

My pre-authorization testing:

Psychiatric Clearance

Physical clearance from PCP

Preauthorization

I answered the sleeping questions accurately so I didn't have the sleep study

Then:

EKG/Echocardiogram

Chest Xray

EGD

Blood test

Nutrtion Class

Pre-Surgery Consultation with Surgeon

OTT, is tubal permanent?

I will have what they call "labs" which will check for anything on May 24th. Smoke, infections, drugs, etc. My dtr. won't operate if you smoke.

Congratulations!

My doc says that he does a lot of his surgeries on Thursday and people going back to a desk job often go back to work the following monday. Two weeks if you have a labor intensive job, as he says absolutely no lifting more than 20 lbs for 2 weeks. He said if he were to have it done he'd take a week.

I'm hoping to be one of those Thursday-Monday people...

Hey Tracy! Have you returned to work?

Pamla :straight

Grrrr.. I am so angry.

So I will be appealing.

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

TIA,

Rosanna

What's going on Rosanna? Did you appeal?

Unfortunately,my doctors office is moving to a new location this week so I won't be able to schedule my GI and nutritional class (which are both their pre-requisites) until Monday.

Also there is very good information for you on bandstersinsurance which is a yahoo group. Join and there are several sample appeal letters to assist you.

It has been a very long journey to me with misunderstandings @UHC. Not all plans are alike and varies through your employer. I would like to provide some numbers and slight information that has helped me these last eight weeks of waiting.

1. If your doctors office sends your clinicals throught the USPS this can delay your approval or denial. They have yet to get the original clinicals to care coordination for approval and customer service acknowledge receiving them on March 3, 2007.

2. Have the doctors office to fax them to Care Coordination. There phone number is 800-842-3920. My approval took less than 24 hours.

3. Be persistant! If you are frustrated let them know! I was transfered to Rapid Resolution department on April 11.

4. Check and make sure the Data Team department has recieved your clinicals to place the data in the system to have it reviewed by the CCs.There number is 866-297-9393 prompt #2, then prompt#3.

5. Don't give up!

I also learned there is a difference between pre-determination and notification.

Provider services is who mails out the letters to you and your doctor. The number to give your doctor to check the whereabouts of your approval letter is 877-842-3210.

CPT code is 43770

ICD9 is 278.01

Hope this is helpful to someone.

I'm approved!!!!!!!!!!!!

Visit this website and you should get a good start to your appeal.

http://www.obesitylaw.com/faq.php

Has anyone won from an appeal with United Healthcare??? I have United Healthcare Choice Plus and I was denied getting ready to appeal and was just wandering if anyone has had any luck with this???

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

Wow! I didn't know they would call. I hope they have my number....

pamla68; Hang in there, I went thru the things with UHC also, they will come thru for you soon. :biggrin1:

Now you know you have started something right? How long did it take you to get "the letter".:paranoid

Congratulations! I hope to join you soon!

Care coordination called me this morning. They contacted my doctor's office and have now received the paperwork. The waiting begins.....again....

I just talked to Patricia this afternoon at UHC in the care Coordination dept. She said the fax for them was 866 756-9733?????????????????????

Perhaps that is the local and toll free?:cry

801-567-5499 Predetermination fax. UHC received my paperwork on the March 3. I just feel that since they used to recieve them via mail, they should have contacted Care Coordination, given the information and had care coordination to contact my doctor to tell them to fax it instead. I have just wasted 6 weeks.

:clap2: I just found out through care coordination they no longer accept clinical paperwork in the mail. It should be faxed directly from your doctors office to them! Have your Doctors office call care coordination at 877-842-3210 M-F 6a-6p to get your approval or denial. Same day in most cases. Care coordination stated it was too much of a "paper trail" with the mail ins. I should here something in 24 hours. I hope this helps someone else as well.

I'm here. I contacted the care coordinating department which had no record of "reviewing my case". My doctors office mailed it certified. I had to go back to customer service, irrate, and my case is now at the rapid resolution department and I was told by Gerad to allow now 3-5 business days more. I'm tired ya'll.

3/29/07 I called again to find out that something had been entered incorrect and that it would be fixed and escalated to a supervisor. A couple of hours later I received a phone call from UHC to say that it had been approved and the letters were mailed to myself and the dr. And that they will be checking back with me after the surgery to see how things were going.

So I justed wanted to share my experience to give everyone who is still waiting hope that though things seem crazy it is going to be ok. I guess it just takes longer for some of us to get our approval. :clap2:

May I have the phone number you called? Thanks!