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pre-op requirements DR or INS? hate the scams

knhtown

By knhtown, in Rants & Raves

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knhtown    121

knhtown
Posted

United healthcare approved me today (UHC-Choice) PRIO to this My surgeons office said I must do 6 months of diet/sleep apnea study/nutritional visit/phyc eval/ekg/and get cleared for surgery. I asked is that my insurance requirements or yours? Billing coordinator (very rude through the whole process) no,no that's ins requirements see here. She pulls up what I know as "general guidelines" I told her that wasn't required of my lapband- please submit for me. She refused without medical clearance and a endoscopy/colonoscopy- I complied. Now please submit- shes stays true to her nasty self"what am I submitting? your band has no issue and you have done the requirements. Me please just submit as is.. Billing coordinator- well I will but this is a waste of time....... This am ,Approval letter is on myuhc. Cant wait to call miss congeniality on Monday!!! (ever think you could be wrong? maybe you were just trying to scam me to get all this done? I posted here so some will hear my story and find hope that you may get approved!!

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aNYCdb    310

aNYCdb
Posted

Not to sound like I'm defending poor customer service, but having insurance approve without any of the presurgical hoops they make you jump though is a bit abnormal, but ever plan is different and congrats for being approved without all of the presurgical things they generally make you jump through. As someone with UHC I wish they didn't make me jump though all of those hoops, but like the commercial says I must have picked the wrong plan.

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KCgirl061    1,533

KCgirl061
Posted

I’m confused. Do you have an actual surgery date or are you just cleared by insurance? What happens if the surgeon says “No, insurance approval or not, I’m not doing your case until you do MY requirements?”


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knhtown    121

knhtown
Posted

Yeah sometimes I think the DR requires it- this billing coordinator just went off of general info posted for UHC I dared to ask are those yours or the insurance requirements- now I know its NOT the ins requirements as I had suspected

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knhtown    121

knhtown
Posted

The surgeon already told me it doesn't make sense to do a 6 month proven diet he agreed that the lapband experiment was enough. Insurance approved my surgery (removal of band and sleeve)

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RNY2018    1

RNY2018
Posted

I have UHC/BCBS and Im required to do the 6 month plan as well. Im ok with that, as it gives me time to see all the areas they require. Im in month 3 and everyone has been supportive and informative. Hoping to be cleared for an Aug surgery date!

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Go To Topic Listing Rants & Raves

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    • LeighaTR

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      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.

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