I got a call today from the surgical scheduler at my surgeon's office. She said UHC has given us 48 hours to "show proof of documented weight loss attempts in the last 5 years". I called my PCP (who is fantastic) and he sent over a letter. Per the scheduler, it wasn't good enough, they needed the notes. He sent over the notes. I'm guessing it won't be enough to satisfy UHC.

You see I lived in NY for 3 years, but knew I was coming back, so kept my PCP here. He only has my weight documented for 2003 and early 2007. UHC didn't care that I faxed them my Weight Watchers cards from 2005 and 2006, they will only take PCP info.

It doesn't matter that he's been my PCP since 1990 and can show a weight history over 17 years (that's always been too high!)

So while it isn't totally a "NO", I'm not expecting good news tomorrow or Thursday.

If I do get denied, I've decided to put on my big girl panties and APPEAL. I'll pay an attorney to file the appeal for me. I went to Obesity Law and Advocacy Center and they seem like just the people to do it. I've worked too hard for UHC to say NO. :frusty:

If I have to, I'll self-pay. I won't be able to afford it for a while, but I'll do it.

I would really appreciate any and all POSITIVE thoughts sent my way because I really was looking forward to being a Halloween Bandster.

Thanks for listening. :ranger:

I have UHC choice plus and my approval was such a breeze. So, don't quit, appeal, appeal and appeal!

Best wishes!

My surgeon's office faxed Walter & Kelly at obesitylaw.com all of the information they had including my application. I sent 15 pages to them myself today. Now I have to wait to see if they will be able to take my case (for free) ... or if I will have to pay them to file my appeal. I'm hoping I fall under the guidelines for Allergan (parent company) to pay for them to fight this appeal for me. If not, I'm fully prepared to pay them myself.

Waiting is so hard....:faint:

Margie

I just got an email from Walter...they're taking my case and I don't have to pay! :whoo::whoo::whoo:

This is the best news I've gotten in weeks!!!

Congratulations! I hope it all works out for you! I have to believe that every appeal that is won will slowly chip away at the powers that be and make them realize that this surgery is valid and essential to many people! Thanks for doing your part!

Margie, Hon, I'm right here with ya.

I don't have UHC, but CDPHP in NY is kinda the same. I'm in your boat - been denied, appealed, and appeal was denied. I'm on second level appeal and just emailed Obesity Advocacy this morning. I do hope they can help me, too.

I'll be here cheering you on and hoping for a similar outcome. Keep fighting the good fight!

NYtrink (Kat),

I hope Walter and Kelly can help you! I'll keep my fingers crossed for you. Please let me know how you make out :confused:

Just got the call today...UHC denied. I knew they probably would, but it's still a blow. Looks like I have to fight them now, but I'm up for it.

Fight em and Good Luck!

I'm sending good vibes your way!

Any news???? Walter and Kelly took my dh's case and got it approved in 10 days!!! They're amazing! I'm dying to hear how this turns out for you!

I have UHC and didn't even want to go through the BS..so I went to Mexico. I just assumed they would deny. I don't have much co-morbid problems with my BMI of 40 but we all know that carrying around that extra weight, it's just a matter of time before other problems start. They are just trying to save their money so they can give bonus' to their bigwigs. I did try to get them to pay for the fills and just got the reject notice..well, they didn't ever respond..they just posted it on the website. If they're not going to pay for something, they why do they even bother requesting the Dr.'s notes.

I work with insurance companies all the time and they are not real high on my list, lemme tell ya!

Keep up the fight. Keep us posted. I agree, every win helps those that come after us!