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jem8384

LAP-BAND Patients
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Everything posted by jem8384

  1. Hi I was wondering if anyone out there has submitted their 5 year weight history to UHC or any other Ins company and it was not a consistent 5 years? That's the problem im having now I have 5 years of weight history but not consistently ya know. For example I don't have weights for 05&06. Why? No insurance couldn't afford to go to doctor but however I do have 2000-04 weights (courtesy of past OB/GYN) and 07 weights till present with PCP and current OB/GYN. Any advise would be good. Thanks so much!
  2. Bubbles77 im glad I can give you some insight. I was approved they didnt give me any problems with the scattered medical history or the BMI of 40 for 5 years it was great I really didnt have a problem with UHC. Now, what my doctors office did tell me is that UHC rarely gives them issues which is a good thing they said they love working with them. I my surgerversy is coming up and im down 90 pounds Good luck too you!
  3. Right here! im will be banded on August 24th on the pre op liquid diet. :wink2:
  4. jem8384

    Approved!!!

    Congrats all your hard work has paid off!! sooo happy for you? :wink2::smile:
  5. Hey yzplnxg I would call UHC and talk to a Care Coordinator thier customer service knows nothing its sad. I know this because the first time called to check the status the customer service rep sent me straight to care coordination and she gave me a number for the pending autorization. Every time I called after that and spoke to customer care they told me it was still pending. So I called last Friday and they told me that it was still pending called on Monday and Tuesday same thing. called on Wednesday and what do you know I got a customer service rep with some brains and and she was nice to send me over to a care coordinator and spoke to a very nice lady and she told me it was approved and it had been approved since last Friday and they had also sent the letter that day. They know nothing about pre autrizations I would call again and ask to speak to some in Care coordination and they will also be able to tell you if you paperwork was not sent with the correct info. I hope this helps.
  6. I will be keeping my fingers crossed for you!! im sure things will work. Dealing with United health are has been a breeze. Let me know how it goes.
  7. jem8384

    missed the phone call..

    congrads!!! I know how you feel I was approved on Friday and didnt now until yesterday. I was biting my nails all weekend. I wish you the best of luck!
  8. Hey I got the word that I was approved for surgery on Aug 26th. wish me luck!!!
  9. jem8384

    Oh happy day!!!

    Oh HAPPY DAY!!! I got my approval today on the phone. I have been approved through UHC. Surgery is scheduled for the 26th of August. I hope the worst is over I waited 2 weeks to hear those magical words. Wish me luck!!! If you have any advice let me know. Thanks
  10. jem8384

    United Healthcare

    Cajummama you have given me hope!!!! im in the same predicament.
  11. jem8384

    support

    Hi guys!! I need some words of support this evening. I had my info sent to the united health care this week and im biting my nails with worry. What im worried about is the 5 years of being morbidly obese and thats is one of the major requirements my BMI has been in mid to high 30's but in the last year just hit 42. Im not really worried about anything else just that I know they have denied people in the past. If im denied i will fight it belive me but I dont want a fight but I will cross that bridge when I get to it. So someone please tell me their experience bad or good. I want to hear it. thanks
  12. HI I read your blog post you start last year and im the same situation i have not always had a BMI of 40 for 5 years. Did you get approved for surgery?

  13. jem8384

    United HealthCare Five year history~?

    HI Acadiamom, Im in the same boat have not been at 40 BMI for 5 years im with UHC and I went to Obesity Action Coalition online and looked up some advocacy groups in my area and there was you know the senate and reps of the state and you can write them for help. is this what you did? Thanks
  14. HI yzplnxg Well I was able to gather up a 5 year history LOL I had to dig and remember doctors I had gone to in the past. I have my 3rd Appt with surgeon this week and they will send all the info to UHC then. Now when I did the seminar and we had the Q&A with the nurse that handles the ins info I asked her what about spotty weight history. I told her I did not have 5 consecutive years of weight history but I had 5 years she said that was fine the ins company is understanding of that I was sooo HAPPY when she said that. Also my BMI has not always been at 42 its been at 37,36, 32, etc. and she also told me they will submit the paper work at the BMI im at now which is 42. I also have looked at the paper work that doctor has written up he has diagnosed me with Morbid obesity and thats what the insurance want to see. I have done the yo yo diets got the weight off just was not able to keep it off. Also every UHC plan is different I see on here that some peoples UHC plan you can be under 40 BMI with comorbilties and my plan you have to be at 40 BMI nothing else. Also when I call I speak to care coordinator the customer service reps no nothing about WLS they have given me such bad info about it and doctors office also speak to care coordinators to get their info. I hope this has helped. GOOD LUCK!!
  15. jem8384

    wow, i got aproved in 2 days

    Congrads!! I hope I get approved as fast as you I am also with UHC.
  16. jem8384

    how did you pay your portion?

    im going to take a loan out on my 401K. I look at as im paying myself interest plus putting it back with every paycheck.
  17. jem8384

    How obese did I need to be 5 years ago?

    I hope not! I believe they will submit your weight from the first time coming in. I will keep my fingers crosses or you! let us know.
  18. jem8384

    How obese did I need to be 5 years ago?

    Congrads sooo happy for you!!! the Patient coordinator told me at my doctors office that the ins company will take your BMI at what you are now. Im at 41 BMI but the last 5 years are to show that you have been over weight. I guess they dont want to see people gain a crap load of weight in a year to get this surgery. I mean I can definetly prove i have been over weight the last 5 years just not at a BMI of 41 for the last 5 years. Keep in mind that my INS is United health care choice plus.
  19. Hay yall! ( a little Paula Dean there LOL) I was wonder if any of PCP charged you for writing a letter of medical necessity. Well mine just did. I have never heard such a thing. Let me know? Thanks
  20. thank you much! It doesn't seem fair it really doesn't but I tell you one thing it took me a Nano second to yes i will pay it lol. They get paid very well I mean I get my explanation of benefits mailed to me and I look at it and im like wow ya know like wow and my doctor probably saw me for like maybe an hour. I was almost like this is rude for them to ask me to pay for it.
  21. Exactly I just went ahead and paid it! im just determined a little scared of denial and appeal but im determined. :thumbup:
  22. LOL I was shocked when they called me and asked me if I wanted to pay it. I do believe in patient doctor loyalty the longer your there with that doctor the more he will do for you. There is nothing wrong with big cheerleader LOL I can move! my weight doesn't get in my way! LOL :thumbup:
  23. Thanks for letting me know because my doc just charged me 40.00. May I ask what did it consist of? I mean for 40.00 it better be good you know what im saying?
  24. jem8384

    How obese did I need to be 5 years ago?

    Girl im in the same boat! i would say you are ok but you know with the insurance company.
  25. its UHC choice plus

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