Disappointed doesn't even begin to describe what I currently feel...

[sassyfrass23 525]

Yes ma'am! The UHC rep even tried to walk me through step by step but our screens were totally different, which was no surprise. After the call ended I continued to look but had no luck.

[jj7481 363]

Stop calling the insurance company.Let the dr office handle the submission process.Too many calls to insurance sends a red flag...Let the coordinator who does this for a living handle it.

Stop calling the insurance company.Let the dr office handle the submission process.Too many calls to insurance sends a red flag...Let the coordinator who does this for a living handle it.

This!

Let me reiterate...THIS! lol Your surgeons office deals with this so much that it's an art form. Coordinate through your surgeons office. You may have to wait a little longer, BUT....they'll be able to explain exactly what the next step is.

[sassyfrass23 525]

Tonya called back and I shared the information with her! She was just as confused/appalled as I was. So, she said she was going to look over my policy again and then call UHC to discuss it further with them. I'm dying for her to call back and tell me that it was all a big misunderstanding. Preferably before they close today Fingers crossed!!

[Nurse_Lenora 903]

I'm glad your surgeons office is dealing with everything for you. That's what you pay them for! ( or insurance pays them whatever! Lol)

[Danita 10]

Sounds like they are saying have it in 6mons b4 surgery...stay on top of this. Something isn't right. Good luck

[sassyfrass23 525]

That's how I perceived it, @@Danita !

When I mentioned that to Tonya, she said that they never submitted before a patient had completed ALL requirements and basically proven to Dr. Nguyen that they were serious about the lifestyle changes that this surgery entails.

So...Tonya called this afternoon, but thanks to my crappy service at home, my phone didn't ring and she left me a fairly vague VM. All she said was that she spent quite a bit of time investigating this this morning and consulted with her administrator. She asked me to call her back on Monday so she could tell me what SHE (yes....she emphasized "I" when she said that last sentence...not that it may mean anything) found out.

When I spoke with UHC last night, they did say that my doctor could submit a request to escalate my status to urgent to possibly override the additional 6 month wait. But, I don't have any present "life-threatening" or critical issues that I could see him arguing to get that approved. However, if I really am required to wait 6 more months, I feel like although it was an honest mistake, it was still their mistake. And they should try whatever they can to help get this expedited. I tried to bring attention to this in the very beginning and because Tonya had never heard of it before, she thought the reps who relayed the information to me were wrong and basically said not to worry about it. So here we are 6 months later and she's finally investigating.

Grrr!!

I've always enjoyed my weekends...who doesn't? But I guess I will be eagerly awaiting this weekend to pass so I can call her first thing Monday.

[Danita 10]

I'm sorry this has happened. I hope ur wknd goes by fast as well. Surely you don't have to wait another 6mon. I'm going into my 2nd month...insurance required 4mon

[Djmohr 6,965]

@@sassyfrass23

I totally understand why you would be so upset, I think I would have seriously cried.

I really hope that you get answers on Monday and that everything works itself out.

Hugs! Oh, and hands off the donut box! LOL!

[sassyfrass23 525]

Hands have been tied up to prevent any cheating, @@Djmohr !! And trust me...it's taking everything I have not to cry. I'll hold the tears back until Monday. They'll either be happy or sad tears...

Here's a question for everyone:

I had my policy printout that my surgeon's office pulled when they verified my insurance on day 1. I just reread it and never found the statement about 6 additional months of waiting or the prior auth requiring 6 months.

So- how can they have my policy worded one way for me or any of us (patients) to see, but have special stipulations on their side that we're unaware of? I would think UHC would list everything out in the open and have it all written in black and white...even if it was "small text." This just sounds sneaky to me. And my obsessive/control freak side is in full swing. I have got to chill.

Edited January 30, 2016 by sassyfrass23

[CrazyCatLadyinLA 17]

Is it possible UHC updated its Bariatric policy on January 1st?

[sassyfrass23 525]

Is it possible UHC updated its Bariatric policy on January 1st?

I don't think so. All of this came about when I began the process in 2015 :\

[jantra12 28]

I was denied. My insurance excluded this surgery. I am having to pay cash price. But it's totally worth it to me.

[sassyfrass23 525]

I hate to hear yours was denied @@jantra12 ! But so glad you can still go through with it.

Unfortunately- self pay for the bypass is not an option for me. $70,000 - $80,000 is just not a realistic expense for me

[Missy407 63]

Oh gosh, I feel your pain. My surgery was canceled/put on hold three days before my pre-op diet was scheduled to start because of an administration mistake. I went bananas. Literally reaching for xanax upset. You will eventually get your surgery and it will probably be when you originally thought it was but the uncertainty is awful. I did eventually get the surgery but that pre-op snafu still leaves a bad taste in my mouth. Once you do get approval and move forward try really hard to put this emotional roller coaster behind you and start fresh. Good luck, Im rooting for you!

[jantra12 28]

@@sassyfrass23 I hope everything works out for you!! ????????