United Healthcare Frustration

[jkennon 2]

I filled out my insurance forms for a Bariatric Program here in Oklahoma and after 3 months got a call that I was approved and started the process. Attended a Seminar in May and finally got to my first visit with my surgeon. I was extremely happy because he has a 5 star rating!! Just got all my other appointments set up for nut and cardiologist and the many many other appointments that are required with this program only to get a call that I have to go through BRS for my insurance to pay. I call them to register mind you I have been dotting my Is and crossing my Ts getting ready with diet and exercise, quitting smoking etc. BRS informs me I have to be enrolled in their program officially as of yesterday and they require my surgery to be done at a Center of Excellence. There are none in Oklahoma!!! I now have to start all over and travel states away for all my appointments. I feel like everything was just ripped out from under me and defeated! So disheartening! There are absolutely no out of pocket benefits so there is no way I can afford to continue to move forward at this time. I know I should be happy my insurance covers it at all but right now I can't see past the veil of tears. So frustrating!

[Happygirl73 0]

I was searching for information on my own insurance and found your post. I'm sorry for the late reply but wanted to provide some info. Have you checked Integris Baptist Medical Center's program? They are a Bariatric Center of Excellence; my insurance requires it, too. Best wishes to you for approval and a successful procedure.

[frust8 962]

There is a poster on here,I forget his name but he works for an insurance provider. He said something similar to asking that they consider your case on an individual basis, although you are out of network you are a special circumstance and the restriction should be waived for you. Perhaps he'll see this post and weigh in with the correct terms. If you speak their language you just might get farther. [emoji307] You, stay strong. I'm fighting a battle also, if that's any consolation.

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[336Mike 549]

Ask them what their requirement is in terms of distance within miles, that the Center of Excellence has to be from where you live. Typically if there isn't a contracted provider within 50 miles an exception can be granted. And don't just take the word of the rep on the phone, you may need to ask to speak to a supervisor or manager if the rep doesn't seem to be helping you.

Turn your frustration into action and push them on this. You can be successful here!

VSG 10/11/17
HW = 360
SW = 292
GW #1 = 220 3/7/18
Final GW #2 = 210 (6'5") [emoji256]

[frust8 962]

Hi Mike I'm just evesdripping on here this AM, the nearest Center of Excellence to me is 50+ miles, the one I'm now strongly considering is 54.1 miles, if necessary I'll bring that up to both Medicare and Medicaid. Power to all my Bariatric Pals!

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[michelekarch 6]

I filled out my insurance forms for a Bariatric Program here in Oklahoma and after 3 months got a call that I was approved and started the process. Attended a Seminar in May and finally got to my first visit with my surgeon. I was extremely happy because he has a 5 star rating!! Just got all my other appointments set up for nut and cardiologist and the many many other appointments that are required with this program only to get a call that I have to go through BRS for my insurance to pay. I call them to register mind you I have been dotting my Is and crossing my Ts getting ready with diet and exercise, quitting smoking etc. BRS informs me I have to be enrolled in their program officially as of yesterday and they require my surgery to be done at a Center of Excellence. There are none in Oklahoma!!! I now have to start all over and travel states away for all my appointments. I feel like everything was just ripped out from under me and defeated! So disheartening! There are absolutely no out of pocket benefits so there is no way I can afford to continue to move forward at this time. I know I should be happy my insurance covers it at all but right now I can't see past the veil of tears. So frustrating!

I have UHC also. My says that if I have to travel to a center of excellence..they cover gas and hotel. Check into that. Good luck to you!

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[Fab 0]

I think Weightwise in Edmond is a center of excellence also.

[frust8 962]

So did you get in touc
h with Weghtwise or did. another location other than Edmond work out better for you?[emoji34]

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