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05-31-2007, 10:05 AM
| #1 (permalink) |
| Big Loser Join Date: Mar 2007 Location: Raleigh, NC
Posts: 127
Weight Statistics 3/23/07 Start Date:
not yet waiting for date Surgery Date:
Height: 353 lb Start Weight:
270 lb Current Weight:
200 lb Goal Weight:
83 lb Weight Loss:
70 lb Lb Left to Lose:
23.5127478754 % % Lost:
12/31/09 Goal Date:
Body Mass Index 62 BMI Start:
62 BMI Current:
35 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |  United Health Care I am really mad! I called UHC before I stared my long process with Duke Weight loss and asked them if they covered my surgery, and the person that I talked too told me that I need to submitt the claim and if I passed all the criteria they would pay. Well, now that it is time to put up or shut up they are saying that my policy does not cover WLS. My policy. All the other UHC policies covery it but mine does not! What kind of bull is this!  I have not gotten a letter yet, but that is what they told me when I called to check on the status of my claim. My only saving grace is that I can change insurance companies with out too much trouble. The only question I have about that is if they would make me wait a year before I can have the surgery.? Any know?  UHC
__________________ ANNA  |
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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05-31-2007, 11:26 AM
| #2 (permalink) |
| WLS Master Guru  Join Date: Apr 2007 Location: Upstate New York
Posts: 687
Weight Statistics 6/16/2007 meda-fast Start Date:
July 19,2007 Surgery Date:
5' 6" Height: 325 lb Start Weight:
201 lb Current Weight:
150 lb Goal Weight:
124 lb Weight Loss:
51 lb Lb Left to Lose:
38.1538461538 % % Lost:
no time line i just want it to be lost Goal Date:
Body Mass Index 52.4506427916 BMI Start:
32.4387052342 BMI Current:
24.2079889807 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass   | call agen  I have united health care the empire plan. I have found it all depends on who you talk to. somedays there helpfull somedays i think i could do there job better. Honest the first time i called them the women i spoke with did not even no what bariatric surgery was. they call it wait loss surgery. I would call agen. I think who ever you talk to was a smuck.
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05-31-2007, 04:23 PM
| #3 (permalink) |
| WLS Mentor  Join Date: Aug 2006 Location: Milford Kansas
Posts: 1,205
Weight Statistics 09/01/2006 Start Date:
5' 4" Height: 254 lb Start Weight:
144 lb Current Weight:
140 lb Goal Weight:
110 lb Weight Loss:
4 lb Lb Left to Lose:
43.3070866142 % % Lost:
02/01/2008 Goal Date:
Body Mass Index 43.5942382812 BMI Start:
24.71484375 BMI Current:
24.0283203125 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass  | Keep trying and please try again with a different rep. |
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05-31-2007, 07:48 PM
| #4 (permalink) |
| Seasoned Veteran  Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 3,527
Blog Entries: 1 Weight Statistics September 19th 2007 Start Date:
September 19th 2007 Surgery Date:
5' 10" Height: 363 lb Start Weight:
211 lb Current Weight:
165 lb Goal Weight:
152 lb Weight Loss:
46 lb Lb Left to Lose:
41.8732782369 % % Lost:
12/31/09 Goal Date:
Body Mass Index 52.0793877551 BMI Start:
30.2720408163 BMI Current:
23.6724489796 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Call again. Have them look up the call that you made if they tell you no. Yes they keep record. If the person you get on the phone dont sound helpful to begin with hang up. And call back. Thanks to HIPPA if you change insurance companys and as long as 90 days dont go buy without having health insurance they have to cover you. I dont know if they will put you on the preexisting clause with this or not. You will need to find that out before changing. And also make sure they cover it before switching. This is about all I can help you with right now. Make the call and call it Weight Loss Surgery. If they say yes.....ask what criteria you have to meet. Good luck honey. Remember your fighting for yourself here. |
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05-31-2007, 08:29 PM
| #5 (permalink) |
| Seasoned Veteran  Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,308
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Fight it. Call again. Dont give up.
__________________ Anything worth having is worth working for Kenya R.  Lap RNY 4/19/07     |
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05-31-2007, 09:51 PM
| #6 (permalink) |
| Super Moderator  | ((((((HUGS))))) If you want it, don't give up!!
__________________ "In every job that must be done, there is an element of fun."   Just a li'l bit 'bout myself |
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06-01-2007, 07:39 AM
| #7 (permalink) |
| Big Loser Join Date: Mar 2007 Location: Raleigh, NC
Posts: 127
Weight Statistics 3/23/07 Start Date:
not yet waiting for date Surgery Date:
Height: 353 lb Start Weight:
270 lb Current Weight:
200 lb Goal Weight:
83 lb Weight Loss:
70 lb Lb Left to Lose:
23.5127478754 % % Lost:
12/31/09 Goal Date:
Body Mass Index 62 BMI Start:
62 BMI Current:
35 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Thanks guys! I am going to keep up with insurace at this point. Have not gottten the my letter yet so I am still up in the air. Will keep you updated. thanks for the support
__________________ ANNA |
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06-08-2007, 12:06 PM
| #8 (permalink) |
| Big Loser Join Date: Mar 2007 Location: Raleigh, NC
Posts: 127
Weight Statistics 3/23/07 Start Date:
not yet waiting for date Surgery Date:
Height: 353 lb Start Weight:
270 lb Current Weight:
200 lb Goal Weight:
83 lb Weight Loss:
70 lb Lb Left to Lose:
23.5127478754 % % Lost:
12/31/09 Goal Date:
Body Mass Index 62 BMI Start:
62 BMI Current:
35 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Update So here is my update! The insurance could not find record of my doctor submitting anything and they could not tell me anything more, so I decided to call the doctors office instead of trying to get answers through the online website service which is how I normally do it. Well, come to find out, that the file has not been submitted to insurance!!!!! It has not even go to medical review! Now how the process works at Duke, you have to have all your tests, a first visit with a nurse pract, nutrit., phsyc., and they all the reprots are sent to dictation and all that can take up to two months, then if nothing is wrong your file is sent to the docs for approval which can take another month, then to insurance, 2 to 4 weeks, then a surgery date is scheduled 3 to 6 weeks out. The whole process can take between three to 8 months if nothing is wrong. Now I have had some issues come up and I have had to visit a hemotoligest to get my red blood cells up. This has taken another 6 weeks extra. So when I was told that my file was sent to insurance, I thought I was 3 to 6 weeks from surgery when accually I am more like 2 to 3 months still out!  When I asked the lady in the office why I was told that my file was sent to insurance she said she did not know, and that I should have relized that I could not be approved until they got my cell count up.! I am not a happy camper, but I will wait and smile and wait and smile and do what they tell me to do! Sorry about the novel!
__________________ ANNA |
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06-08-2007, 12:22 PM
| #9 (permalink) |
| Super Moderator | Awwww, (((((((HUGS))))))))) Hang in there, I'm sure you'll get what you need. Sending good vibes to you.
__________________ "In every job that must be done, there is an element of fun." Just a li'l bit 'bout myself |
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06-08-2007, 06:53 PM
| #10 (permalink) |
| Seasoned Veteran Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 3,527
Blog Entries: 1 Weight Statistics September 19th 2007 Start Date:
September 19th 2007 Surgery Date:
5' 10" Height: 363 lb Start Weight:
211 lb Current Weight:
165 lb Goal Weight:
152 lb Weight Loss:
46 lb Lb Left to Lose:
41.8732782369 % % Lost:
12/31/09 Goal Date:
Body Mass Index 52.0793877551 BMI Start:
30.2720408163 BMI Current:
23.6724489796 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Anna if that was a novel I have a habit of writing books like War and Peace then. LOL. I find it very distastful when they said. you should have realized you could not be approved until your cell count was up. Its there job to tell you these things. Some body missed the boat on that one. Honestly they probally didnt want to tell you that but needed it. Unfortunally it does take a long time for this sugery to be ready to go from the surgeons stand point and then to the insurance companys. Be aware that UHC is at a 45 day approval right now instead of the normal 30 day. So be made aware of that when the time comes to send it in. Anna you will get there. It gets so tiresome I know. Patience is a bad word to some but in the last few years I have come to embrace it. You will to. I hope this note finds you well. |
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