Skip to content
View in the app

A better way to browse. Learn more.

BariatricPal

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.

UHC Choice v. Optum Guidelines

Hi there!

I ran into an interesting issue today. I have the UHC Choice plan through T-Mobile. They use BRS through Optum, which I'm already registered for. I messaged both my Optum Nurse and UHC to get the guidelines for Bariatric Surgery in order to qualify. I should add in here that I work in Prior Authorizations for an insurance company, so I'm really familiar with the whole process and want to make sure things go smoothly because I know how one missing thing, mischecked box etc can mess things up. While attending the seminar for the office I will be having surgery with, the Director mentioned that a lot of companies were moving away from the six month diet requirement and more towards 3 months, especially with the current state of things/restrictions.

Well my Optum nurse messaged me back, and did list a 6 month diet as a requirement. Though what she sent me was just typed out in a message, not an actual document (which is what I was really kind of looking for- a whole clinical guideline).

UHC got back to me and provide a guideline which does not list a 6 month diet as a requirement (except in Maryland by law- but I'm in AZ).

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/bariatric-surgery.pdf

The office I am going through requires 3 months (which I get and I'm totally fine with), but my husband purposely got us the primo insurance this year for all of my health needs. Plus obviously I would rather have it done sooner rather than later. I also have an entire sheet packed full of past diet attempts (including multiple phentermine attempts, xenical, and metformin), and multiple comorbidities that this could alleviate. I'm just worried with everything going on about it getting pushed back really far.

I'm wondering if anyone else has seen these contradict one another? I'm wondering if maybe it has to do with the fact that UHC just changed their guidelines in May?

  • Views 879
  • Created
  • Last Reply

Featured Replies

No posts to show

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

Trending Products

PatchAid Vitamin Patches

Account

Navigation

Search

Search

Configure browser push notifications

Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.