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Old 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
Default 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
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Alt Weight Loss Surgery Insurance
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.

   
Old 05-31-2007, 11:26 AM   #2 (permalink)
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Join Date: Apr 2007
Location: Upstate New York
Posts: 757

Weight Statistics

6/16/2007 meda-fast
Start Date:
July 19,2007
Surgery Date:
5' 6"
Height:
325 lb
Start Weight:
187 lb
Current Weight:
150 lb
Goal Weight:
138 lb
Weight Loss:
37 lb
Lb Left to Lose:
42.4615384615 %
% Lost:
no time line i just want it to be lost
Goal Date:

Body Mass Index
52.4506427916
BMI Start:
30.1792929293
BMI Current:
24.2079889807
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Send a message via Yahoo to armywife2aerial
Default

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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Old 05-31-2007, 04:23 PM   #3 (permalink)
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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
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Keep trying and please try again with a different rep.
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Old 05-31-2007, 07:48 PM   #4 (permalink)
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Join Date: Mar 2007
Location: Floyd County Virginia
Posts: 9,445
Blog Entries: 6

Weight Statistics

September 19th 2007
Start Date:
September 19th 2007 June 18,2012
Surgery Date:
5' 10"
Height:
363 lb
Start Weight:
226 lb
Current Weight:
170 lb
Goal Weight:
137 lb
Weight Loss:
56 lb
Lb Left to Lose:
37.741046832 %
% Lost:
When I get there again
Goal Date:

Body Mass Index
52.0793877551
BMI Start:
32.4240816327
BMI Current:
24.3897959184
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

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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Tough people do...



This Ribbon is for our Lady Lisa and all the women that fight this ugly disease.
RIP Jerry my friend



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Old 05-31-2007, 08:29 PM   #5 (permalink)
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Join Date: Apr 2007
Location: NY
Posts: 10,174

Weight Statistics

4/19/2007
Surgery Date:
5' 9"
Height:
260 lb
Start Weight:
152 lb
Current Weight:
165 lb
Goal Weight:
108 lb
Weight Loss:
-13 lb
Lb Left to Lose:
41.5384615385 %
% Lost:

Body Mass Index
38.3910943079
BMI Start:
22.4440243646
BMI Current:
24.36357908
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Send a message via AIM to Kenyar Send a message via Yahoo to Kenyar
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Fight it. Call again. Dont give up.
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KenyaR.

Lap RNY 4/19/07
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Old 05-31-2007, 09:51 PM   #6 (permalink)
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Join Date: Nov 2005
Location: Tokyo, Japan
Posts: 24,793
Blog Entries: 9

5' 5"
Height:
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((((((HUGS))))) If you want it, don't give up!!
__________________
"In every job that must be done, there is an element of fun."
So long as you are putting your best foot forward, then,
PATIENCE and PERSEVERANCE
for any/every endeavor you embark on, are imperative for success.

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Old 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
Default

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
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Old 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
Default 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!
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Old 06-08-2007, 12:22 PM   #9 (permalink)
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Location: Tokyo, Japan
Posts: 24,793
Blog Entries: 9

5' 5"
Height:
Default

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."
So long as you are putting your best foot forward, then,
PATIENCE and PERSEVERANCE
for any/every endeavor you embark on, are imperative for success.

Just a li'l bit 'bout myself
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Old 06-08-2007, 06:53 PM   #10 (permalink)
Seasoned Veteran
 
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Join Date: Mar 2007
Location: Floyd County Virginia
Posts: 9,445
Blog Entries: 6

Weight Statistics

September 19th 2007
Start Date:
September 19th 2007 June 18,2012
Surgery Date:
5' 10"
Height:
363 lb
Start Weight:
226 lb
Current Weight:
170 lb
Goal Weight:
137 lb
Weight Loss:
56 lb
Lb Left to Lose:
37.741046832 %
% Lost:
When I get there again
Goal Date:

Body Mass Index
52.0793877551
BMI Start:
32.4240816327
BMI Current:
24.3897959184
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

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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Tough times never last
Tough people do...



This Ribbon is for our Lady Lisa and all the women that fight this ugly disease.
RIP Jerry my friend



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