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UHC Choice plus-won't cover?

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:

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Okay, this is NUTS! I just called my husband's employer. They were so nice and helpful. They called UHC for me and waited on hold and they stuck up for me. Then in the end UHC said they never received the paperwork from my Dr's office! Can you beleive that? After waiting over 3 months and having been denied by UHC--they are saying it's because they didn't get the paperwork. They have never mentioned that the other 100 times I've called. I swear I've heard it all. I'm going to resubmit and start over. Wish me luck! This is crazy.

That is crazy. I think they are intentionally messing up claims. It took me about 3 weeks before I got a hold of someone who admitted that they had done something incorrect to my claim and fixed the problem. You know what? I was thinking I looked at your other post and noticed your BMI was not 40 or over. It seems that once you get to 40 it makes it medically necessary. Just a thought but how much would you have to gain to get to 40? About a month prior to my consult I ate anything and everything just to make sure. Sometimes you have to do what you have to do:biggrin1: But I realize that there is always still the chance that you could gain the weight and still be denied.

It IS over 40 now! I've waited so long and have just been gaining on not really on purpose but because I didn't want to diet and disqualify! The person at UHC also said that the surgery center was not in network and that may have caused some confusion so I think I'm going to go to another center that is in network and resubmit. It's weird because I'm appealing the denial (with the attorney) and resubmitting in two different actions at the same time. Time will tell how this will play out. So, Violeteyes, you finally got approved right? That's awesome. I will not give up!

Yes, I finally got approved. I guess when I think about it my wait has not been as long as some. Right now Im just waiting to hear back from scheduling for a date and to do pre op and diet if it is required.

well i found out the surgeons office accidentally told me i was approved. it was in the wrong file! im actually not approved. ;)

Oh that would be AWFUL! I hope you get aproved for real! My husband's emplyer is now involved and that has really seemed to help get to the bottom of this issue with UHC.

I'm waiting to hear but there's a chance I may only be approved for gastric bypass NOT the lap band. Hmmmm.....not sure what I'd do then.

  • 2 weeks later...

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.

Just keep in mind that if you talk to eight different people at UHC - you get eight different answers. I was told my priority was "bumped up", and then the next person I talked to was very rude and told me that weight loss was never considered a priority issue. So, don't jump on the band wagon until you have the letter in hand. Hang in there it will happen!

I am so depressed....they told me on Friday that I was not approved due to my company plan and that I could appeal it....I do not know where to begin can someone please help me I am dying here with UHC....Thank you all for listening...:cry

Hi everyone, I'm new and also have United Healthcare Choice Plus. I called today to see if I'm qualified and was told no. That Whole Foods didn't elect to cover any Morbid obesity services, diets etc.. I asked the rep. about if I need a new knee would they cover that? yes of course...I'm 32 and I'm just under 5 feet and weigh 199... My mother was banded in February and has dropped 30 pounds. I really need this and have tried a zillion diets etc....lost 50 with atkins but, it's back! Any help would be greatly appreciated!

Hi All,

Well I got a call last night from my Psych. Telling me he faxed over my clearence. Then today after hounding my PCP for like 3 weeks. They faxed over my clearence letter to my surgeon! :faint:

Woo Hoo. I am on my way. just waiting for my surgeons office to fax to UHC for approval..

Keep your fingers crossed for me. Hope they will approve the 1st time and within a very short time period.

Thanks & good luck to everyone!

Rosanna

: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.

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