Just got off the phone with UHC....the guy on the end of the phone sounded like he had no clue. He said that it was not covered. I gave him the CPT code, he said it was not covered. So many of you have UHC...I was really suprised. He said to call my HR manager...but it is my DH job, and I don't want to talk to anyone up there if I can avoid it. Any suggestions? Should I just keep calling, or is NO a NO?:lost1.5lbs:

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,

Thanks for starting this thread! My DH's co. just got UHC Choice Plus & I was all excited that lap band would be covered but I'm realizing it depends on what his co. chose on plans. Ugh! I'll just have to dare myself on asking his HR about this. He has a small co. (under 100 ppl). I was so excited that we got off BCBS in hopes so I could have this surgery.

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.

So I will be appealing.

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

TIA,

Rosanna

What's going on Rosanna? Did you appeal?

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 also have United Health Care and they said it is not a covered charge. I am lucky because my husband has Blue Cross & Blue Sheild of Illinois and it does cover. However, the psy. evaluation, blood work, dietician, EKG and so on should be covered by United. Please do not give up. I have read they give loans with low interest rates. Good luck!

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

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?

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?

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.

Rosanna,

Sounds like you are at least giving it a shot! Does your insurance have any kind of peer to peer review they will do or anything? I think its usually a conference call with your surgeon?

I am doing well, 5 days post op and completely out of energy. I havent had any real food in about a week and am ready to start eating some mushy stuff. I cannot complain though, everything is exactly how it should be. I just know if you keep at your insurance company you can get an approval. They are a beast to deal with but with determination and no exclusion on your policy I cant see how it cant be done! Hang in there!

Just to let you know keep trying. I have been told for the last 6 weeks by UHC that they don't pay. I spoke with a rep. Tuesday who now says they pay 80%. Now both my primary and secondary insurance both say they will pay. I am in the waiting stage now. I hope to hear in the next couple weeks. I am very nervous they will change their minds again. Good luck to you and don't give up.

JP

By all means keep calling. I was told for 6 weeks by UHC that is was not a covered charge. Now they say it is a covered charge and they will pay 80%. Call and ask for a supervisor. Good luck.

JP

Reading all of these posts makes me nervous. My paperwork was sent to UHC on 6/5/07 or at least that's when it was supposed to be sent. I have attended an information session and a support group. I have had my initial consult with the surgeon and have clearance from all of my doctors. Now I am playing the waiting game. Wish me luck!

Hello All,

I am new here and I have a few questions. I recently submitted my paperwork for approval on today. I have BMI 43 & Hypoythyroid. I only have dr's records and previous weightloos atempts from the the last 2 yrs (No insurance for over 2 yrs). I called my ins co (UHC Choice) They said that my co has elected to cover the Lapband Surgeries with the following conditions. BMI 35-40 w/ commodities or BMI of 40 and over. I asked the rep about the nutrion eval, drs referrels, medical rec 5+ yrs etc. And she said that that is not a requirement per my insurance coverage that was elected from my company. She also indicated that I didnt need an a prior approval. Has anyone heard this before? If so do I have a chance of approval based on my current status if the other information is required.

All advice is appreciated

slynbrown: I also have UHC Choice Plus. Sounds like I have close to the same policy as yours. Didnt have to have anything besides my bmi of 40+ I was so lucky that they didnt require anything else because I hardly ever went to the Dr before. So there would have been no why I could have come up with the 5 year history. The insurance office for the Dr I used made sure of all of the requirements before sending in my info. vbmenu_register("postmenu_489414", true); vbmenu_register("postmenu_489414", true);