casenior

So my company's policy only has 2 requirements for obesity surgery: 1. Minimum of 40bmi for 5 years & 2. Be a minimum of 21 years old I had lapband surgery in 2008 and lost 60 lbs before it eroded in 2011. I had to have it removed and by 2013 was back up to my pre-op weight of 255. At the time I was with another employer and weight loss surgery was an exclusion so no revision surgery for me. Last week UHC denied my request for the sleeve because I don't have 5 years of a 40 bmi.. Despite my doctors notes that I had another procedure in place in the beginning which was why I don't have 5 years. My surgeon's care coordinator told me yesterday that they have scheduled the peer-to-peer for next Tuesday. She said 9/10 times the "medical director" that reviews the requests is a primary care physician and they don't fully review everything submitted, they just look to see if you satisfy the eligibility requirements. So she is confident my surgeon can get them to overturn the decision. If this type of situation happened for you with United Healthcare (initial denial), what happened for you? Thank you! Sent from my iPhone using the BariatricPal App

@@Dr-Patient that was awfully bold of you.. How do you know he wasn't/isn't already doing that? Don't assume. Sent from my iPhone using the BariatricPal App

Dang son! Lol got more shoes than me! Waiting on my insurance approval still but I know my addiction will be dresses.. Since I never want to wear them and I'll definitely have the legs for them! Sent from my iPhone using the BariatricPal App

Houston, TX.. Insurance denied my surgery request yesterday and waiting on my surgeon to do the peer to peer with UHC to overturn their decision. Sent from my iPhone using the BariatricPal App

Prayers your way!! ❤️ Sent from my iPhone using the BariatricPal App

What's an inverted gastric sleeve? Sent from my iPhone using the BariatricPal App