vandernoordh

So as of April 18th I was denied due to lack of having a co-morbid health condition. (I have to have a BMI of over 35 with 1 co-morbid condition) I am a prediabetic, I have high cholesterol, and I have a fatty liver, but these are all not considered co-morbid conditions?! I'm a mess after finding out I was denied, but my Dr has set up a peer to peer review for May 3rd. Has anyone heard of gaining a successful approval after the peer to peer review?

I went through UHC and they approved me next day. See if your PCP can amend your recommendation letter. I did not have a co-morbidity listed, however my PCP added that I was borderline high blood pressure, high cholesterol, and pre-diabetic. It was enough for the insurance company to approve my surgery. Best of luck! Sent from my SAMSUNG-SM-N920A using the BariatricPal App My letter said all of those things so I have no idea why it was not considered to be necessary Sent from my iPhone using the BariatricPal App

Peer to Peer review is scheduled for May 3rd!

i just received and email from the insurance coordinator at my surgeons office and there is a peer to peer review scheduled for May 3rd. Prayers, good thoughts are greatly appreciated!

Yes, I do have light stress in continence. I have no idea that was a co-morbidity.

Thank you! I just thought this would be so much easier than it is proving to be. Sent from my iPhone using the BariatricPal App

When I called that was what they told me. I've never heard of needing a comorbidity when BMI is over 40 Sent from my iPhone using the BariatricPal App

Yes I have degenerative arthritis in my back and hips Sent from my iPhone using the BariatricPal App

So after talking to the insurance company, even though my BMI is 42, I still have to have a comorbidity, which I don't. Sent from my iPhone using the BariatricPal App

Thank you for your encouraging words!

Good thing I'm at work or I would be crying. Thanks for the help.

That's what my insurance said I should do. What is a peer to peer review?

I'm so frustrated. My surgery was scheduled for May 4th and I found out today my insurance (UHC) denied the authorization stating that I did not meet the qualifications because I did not have three qualifying health conditions. My insurance only requires me to have a BMI over 40 (mine is 42) to qualify OR a BMI over 35 and under 40 with three qualifying health conditions. I am so frustrated. How do I appeal the denial? Thanks in advance!

When I called them they told me they would notify the surgeons office and I would be fining out from them not UHC. They were rude the day I called them. I've ready received a call from the nurse line regarding my "up coming surgery" so I'm assuming it is approved. Sent from my iPhone using the BariatricPal App

I'm still waiting to find it if UHC is going to accept my previous weight loss appointments with my PCP. Thursday will be my two week mark since submitting it. Hoping to hear something back soon. Sent from my iPhone using the BariatricPal App

Congrats on starting your journey! Sent from my iPhone using the BariatricPal App

The insurance coordinator at your surgeons office would be able to look at them and answer that question. Sent from my iPhone using the BariatricPal App

Crazyheart14 mine were specifically for weigh loss. The insurance coordinator at your surgeons office would be able to tell if the documentation by your PCP is sufficient for the 6 month requirement. Sent from my iPhone using the BariatricPal App

Next Thursday will be my two week mark since submitting...feels more like 2 months lol Sent from my iPhone using the BariatricPal App

Hopefully I'll get a call soon! The waiting game is for the birds lol Sent from my iPhone using the BariatricPal App

Congrats! Sent from my iPhone using the BariatricPal App

I have everything completed, just waiting for the approval to set the date Sent from my iPhone using the BariatricPal App

How awesome! Sent from my iPhone using the BariatricPal App

I have united health care and just have to do the 6 moths Of physician monitored dieting within the last two years, but no waiting period. Sent from my iPhone using the BariatricPal App

I got a call from a nurse from our insurance wanting to talk to me about my upcoming surgery... Humm maybe they be know something I don't. It was just submitted at 10:30 this morning. Anyone else have UHC and relieved a call from them before your approval? Sent from my iPhone using the BariatricPal App